vendredi 2 octobre 2015

Symptom in medicine: the eight rule

  • Where is your pain or numbness? This obviously wouldn't work for more generalized symptoms like fatigue or shortness of breath.
  • How long have you had the symptom? If it's something intermittent -- like a spell of chest pain -- how often does it happen and how long does it last? Is it gradually getting worse? Getting better? Staying the same?
  • What were you doing when you first noticed the symptom? Were you just sitting there? Arguing with someone? This is particularly important if the patient is having dizziness, Ely noted.
  • Are any other symptoms associated with this one -- for example, light-headedness or shortness of breath?
  • What is the "quality" of the symptom -- what does it feel like? "Patients sometimes say to me, 'What do you mean? It's just a pain, doc.' Well, is it like an elephant stepping on your chest, a fire in your chest, someone stabbing you with an ice pick, or what? I want to stay open-ended as long as possible, so [I usually say] 'Just tell me ... what it feels like,'" said Ely.
  • What is the "quantity" of the symptom -- for example, how bad is it on a scale of 1 to 10?
  • What aggravates the symptom?
  • What alleviates the symptom?

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