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The Importance of Asking and Receiving an Accurate Past Medical History when Evaluating Patients over the Phone (PMH)
Introduction by Ravi Raheja, MD
Video by Marci Lawing
Having an accurate Past Medical History (PMH) is critical when assessing the appropriate care to give to patients. There are no visual cues to guide the caregiver when assessing over the phone. Therefore, the importance of properly asking for a patient’s Past Medical History is even more crucial and requires careful listening skills. In this video case scenario, Triage Nurse Educator, Marci Lawing showcases how always asking patients for their Past Medical History improves assessment and prevents potential patient complications and delays.
Video Blog Transcription:
The Importance of Asking and Receiving an Accurate Past Medical History (PMH)
Welcome to the Learning Center, a place where nurses can learn and discuss the newest and best practices to triage their patients. I am Marci Lawing the Triage Nurse Educator. To better illustrate how important an accurate Past Medical History (PMH) can be to the outcome of a call, let me tell you about Alexis. Alexis’s mother is calling tonight; She is concerned that Alexis developed a fever that afternoon. Mom reports her temperature at this time is, 101 degrees rectally, and there are no other symptoms. Alexis is eating and drinking well, is wetting diapers, and her breathing is normal. She is a little cranky, but it’s almost her bedtime, so that’s normal behavior for her. If the nurse did not ask about Past Medical History (PMH), one could assume “Home Care” advice would be appropriate. Alexis does have a medical history, though. She was born with renal reflux and a short urethra. The doctor had explained to Alexis’s mom, that if Alexis developed a fever without any reason, such as no exposure to illness, or the absence of any symptoms, she would need to be seen in the Emergency Department (ED) immediately. If the nurse had not asked about Alexis’s Past Medical History (PMH) and the mother “assumed” that the nurse could see Alexis’s record, this bit of information could have easily been missed resulting in a potential delay of care and serious complications for Alexis.
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