Lessons in History…

Posted on May 8, 2008. Filed under: Journal from behind the desk... |

Taking a history from a patient is a challenge, sometimes the patient will give one word answers and sometimes it’s difficult to get the patient to stop talking. None-the-less a good and comprehensive history is essentially….

Is that Gina from Code blog?

Here is an example of why….

Little girl tells mummy she put a bead up her nose. Mummy looks and can’t find it, they rush to the hospital. Wait for a few hours and then the Doctor hears the story of a little girl who put the bead up her nose. He too can’t see anything…

Now perhaps I’m a bit of a tough nut, had this been my patient (or child), I would have gone down the “well as long as your chest is fine, I don’t think we need to worry too much, you’ll snort it back, swallow it and poo it out”

But I’m talking about the super keen shiny new registrar, who decided an Xray was necessary.  Exposed the young girl to some radiation and guess what….Nothing showed up.

Now the lesson here is simple…..if a child tells you they’ve put something up their nose, take a history detailed enough to find out if she then took it out again.  With tears in here eyes the little sweetie said…

“Everybody asked if I’d put it up and I did, but nobody asked if I’d got it down again!”…

(Rich sarcastic tone….)Oh, how her mummy laughed….having spent a quality 5 hrs hanging around the hospital….

The second lesson this week is in cheek biting. Essential behaviour to stop you laughing in your patients face when they come up with a corker.

My example this week was a lady who had felt achy and unwell and told me her “nymphs were up”.

Hylas has tonsillitis and his nymph loads where up again….

Hmmm, assume she meant Lymph’s….AKA Lymph Nodes.

I was of course a true professional, and doubt she even noticed the little grin that kept trying to sneak across my face….ho hum.


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[…] I said only last week history taking is a vital part of clinical assessment, but when it comes to problems “down […]

[…] Shouldn’t Happen in Health Care emphasises the importance of taking a history. Little girl tells mummy she put a bead up her nose. Mummy looks and can’t find it, they rush to […]

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