History Taking - Australian Paramedical College
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Hi everyone. In this session we're going to talk about history taking. Now, let me be honest with you. History taking is one of the single most important things that you will ever do as a paramedic. You will be meeting patients and people generally that you've never met before. Therefore, when you meet them you need to find out what's going on, why have you been called? What is the problem that they're presenting with? What can you do for it as a paramedic? Of course, to be able to provide care that is safe and of high quality you need to make sure that the care that you deliver does not cause any harm to your patient.
This will give you guys an opportunity to recognize the importance of history taking in paramedic practice, wherever that practice may be. Use the processes of observation, questioning, and document review to be able to help you in your assessment and management of that patient as well as talking about how paramedics can improve their history taking. Let's be honest, history taking is not something that occurs naturally and passively. It's an active process that you need to consistently work on all the time.
Okay, so here's a figure. This first box here, history taking forms approximately 80% of paramedic practice. Try and think of an of a situation that paramedics attend to. Imagine that you're sitting on a station and your radio bleeps or you're sat in the ambulance and you get the mobile, the call on the mobile data terminal and you're given a private address, 87 John Street. Underneath that address is a little bit of information about the situation. 56 year old male feeling generally unwell.
Now, unfortunately for the paramedic that's sometimes what does happen. You're given your given very little information. Now to the experienced paramedic it's actually not a problem because you go into the address, you ask the right questions, you focus in on what the patient's telling you, you communicate effectively, and you include in listening skills, and then you're able to undertake a focused in depth history. That then generally leads to some kind of intervention.
That could be something as simple as taking the patient to another healthcare provider, whether it's a doctor's surgery or the emergency department, or it might even lead to the paramedic giving some kind of medical intervention like a drug. History taking is really, really important. Now, the reason it says 80% of paramedic practice is because the paramedics have really only got a small amount of skills and things that they can actually do. Now, the rest of the time they're actually asking questions to be able to make that decision, so asking questions in the right order, at the right time, about the right thing is really, really, really important. History taking skills improve over time, but requires an ongoing commitment for self improvement. Now the reason it says that is just because you've learned how to use OPQRS&T to assess a patient's pain doesn't mean that that's all you need to do.
Now history taking it goes way beyond the using the OPQRS&T mnemonic, and eventually over time you'll learn all these skills and all this knowledge to be able to assess your patient, but bringing them all together is really the important part here, and you're able to do that both in a clinical setting when you go on placement or when you're qualified & working as a paramedic, but also when you're doing your prep classes you're given opportunities to bring it all together.
Now, let's say you're qualified & you stopped learning. Now, your history taking is going to take a hit here because if you stop learning the clinical signs and symptoms, the clinical manifestations of diseases and conditions, you're not going to be able to ask the right questions so you can see how the history taking really does link in to your clinical skills and your clinical knowledge.
You gain learned knowledge from a range of places, including the education provider, including the college, university. You gain it from your own personal readings. When you walk into that address, within the first 10 seconds and experienced paramedic can work out if they are time critical, if the patient is time critical or non-time critical...
For more information about courses and becoming a Medic / Paramedic or any other professional in the pre-hospital emergency health care sector visit The Australian Paramedical College :
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RTO 32513
