Complaining about Chiefs
ESPNHIFIOPQRSTSLUDGEM
Historical Fact Finding
Tools of the Trade
Reasonable Clinician
Ridiculous Ridiculousness
100

What is a "Chief Complaint"?

The reason a patient or family/bystanders called 911. 

100

What does the "P" in OPQRST stand for?

Provocation/Palliation

100

What does "SAMPLE" stand for?

S-Signs and Symptoms

A-Allergies to Medications

M-Medications Prescribed/Taken

P-Pertinant Medical History

L-Last Oral Intake

E-Events Leading Up To....

100

What letter of SAMPLE would a patients use of tobacco fall under?

P

100

What is a differential diagnosis?

Possible causes of the patients symptoms and presentation. 

100

What red fruit is often mistaken for a vegetable and is the star of marinara sauce?

Tomato

200

Why do we document "patients own words"?

Provides patient perspective and provides clarity. 

200

What is a pertinent negative?

Something you expect to find based on chief complaint, patient presentation, or assessment findings, but is absent. 

200

What class of medications should amplify your index of suspicion for bleeding in trauma patients?

Anticoagulants/Blood Thinners

200

What is the CAGE questionnaire used to screen for?

Alcohol dependence 

200

Why is pattern recognition important for providers?

Allows quick identification of critical conditions based on experience. 

200
What crunchy "vegetable" comes in green, yellow, oragne, or red and is actually a fruit?

Bell Peppers

300

What is a mechanism of injury?

The strength, type, and direction of forces applied to a patient, causing injury. 

300

What is "Onset"?

What the patient was doing when the complaint presented, and a specific time when the symptoms began. 

300

What are 2 drug classes that may indicate a patient has a history of cardiac problems?

Beta Blockers/ACE Inhibitors/Diuretics/anti-hypertensives/Blood Thinners/Antiarrhythmics/Statins/Nitrates

300

If a patient is experiencing chest pain, what portion of the OPQRST acronym would have the patient describe their pain?

Q

300

What is an anchoring bias?

Focusing too early on a single diagnosis and ignoring other possibilities, even when signs and symptoms exist outside of the original differential diagnosis. 

300

This green fruit is essential for tacos but is definitely not a vegetable. 

An avocado

400

Why do we ask for a chief complaint?

Prioritize questions/structure assessment/aspect focus. 

400

What is "Palliation"?

Anything that makes a patients symptoms subside/makes a patient feel better.

400

Why do we ask patients if they have any allergies to medications?

To avoid harmful risks and complications and to ensure a good continuity of care. 

400

What is the best assessment finding for quickly evaluating if a patient is in a state of hypoperfusion without having to even touch the patient?

Skin signs

400

What concurrent signs with abdominal pain should throw up a red flag for a provider treating a patient?

Sudden onset, rigidity, signs of bleeding or shock, unexplained bruising. 

400

Another vegetable like fruit that is typically either sliced and added to sandwiches or placed in a brine to make a pickle is what?

Cucumber

500

What is an example of a "vague" chief complaint?

Just say something vague, like theres at least 200 answers I can think of. 

500

What are "Associated Signs and Symptoms"?

Symptoms, separate from the chief complaint, that frequently accompany or are expected to present with certain complaints. (Nausea with chest pain/chest wall pain with a cough). 

500

What are 2 locations you may find a patients prescribed medicaitons or a medication list?

Purse, refrigerator, bathroom, wallet, past hospital paperwork. 

500

What is a good question to ask a patient who is complaining of swollen legs, with one of thier legs presenting a warm to touch and painful?

Have you traveled recently?

500
Why do we include a field impression in a pass on to the ED?

Validates your clinincal reasoning and helps continuity of care. 

500

This purple plant is vegetable like and often found in stir-fry, but is actually a berry. 

Eggplant