The environment of the emergency department increases the amount of stress a patient experiences. Stress can cause a patient to have trouble remembering their medical history, their medications and their doctor’s name. Stress can also cause patients to give a confusing history of their reason for visiting the emergency department as they struggle to remember all of their symptoms. Confusing histories and memory lapses caused by stress impact the care patients receive.
To resolve memory lapses caused by stress, you can keep a card or a piece of paper with you that includes important information. This information may become very useful should you be in a condition that does not allow you to speak to the doctor. Important information includes
- Past medical history
- Past surgical history
- Drug Allergies
- Physician name(s)
Past medical history (abbreviated PMHx)—your past medical history includes all chronic medical conditions you have. Examples include asthma, heart attack, congestive heart failure, diabetes, Crohn’s disease, cancer (specify the type). Your past medical history does not include acute conditions that are minor such as a recent sore throat or a cold. If you do not have any health conditions, write “none”. Medical conditions are often abbreviated and you can search the internet for accepted abbreviations.
Past surgical history (abbreviated PSHx)—Your past surgical history includes all surgeries you have had. Examples include appendectomy, heart cath, cesarean section, triple bypass. In general, your past surgical history will not include procedures such as a root canal or tonsillectomy. If you've never had surgery, write “none”. Surgical procedures are often abbreviated and you can search the internet for accepted abbreviations.
Medications (abbreviated Meds)—your medications includes all medications you take for chronic conditions such as the ones you listed under your past medical history. If room allows, write down the dosage and the frequency you take them. In addition to medication for chronic conditions, you may be taking antibiotics or steroids for an acute condition. Antibiotics and steroids are medications your doctor needs to know about. Be specific about the names of the antibiotics and steroids. List antibiotics and steroids on your card or paper in pencil or other method so you can remove them when you are through. If you do not take medication, write “none”.
Drug allergies—your drug allergies includes all medications you have taken that caused an allergic reaction. If room allows, it is helpful to write the type of reaction. Types of reactions include anaphylactic shock, rash, facial swelling, or itching. If you do not have any drug allergies, write “No known drug allergies” (abbreviated NKDA).
Physician name(s)—write the name of your doctor(s) and their specialty. You can abbreviate "primary care physician" with "PCP". If you have room, include their first name and the city their office is located. Your doctor may want to call your regular doctor or specialist to discuss treatment options or start a plan for following up for further care. Specialties are often abbreviated and you can search the internet for accepted abbreviations.
Your doctor will ask you about any medications or medical history you have. You can hand the card or paper to your doctor and rest easy knowing you haven’t forgotten any important history or medication. Certain conditions and medications can alter what additional medications you can receive.
During your visit, the doctor will ask you questions including why you came to the emergency department. You can prepare by reading over the most common questions asked by doctors in the emergency department and ready your answers. Your doctor will want to know
- What pain or problem prompted you to come to the emergency department
- When did the pain or problem begin
- What other symptoms have you noticed
- What makes the pain or problem worse and what makes it better
- Have you had this problem in the past
What pain or problem prompted you to come to the emergency department—Your doctor wants to know which symptom you are experiencing is the worst. There are often accompanying symptoms that can also be quite severe. You can help your doctor by ranking your top three symptoms in order of most severe to least severe.
When did the pain or problem begin—Your doctor needs to know when your problem began. Be as specific as possible. Avoid phrases such as “a few minutes”, “I’m not sure”, or “some time ago”. Patients have also explained that their problem started “after my surgery”. The problem starting after a surgery is important information however the doctor does not know when the surgery was done.
What other symptoms have you noticed—Your doctor wants to know what other symptoms you are experiencing. Additional symptoms can help your doctor determine what tests are needed. A patient who is experiencing chest pain and nausea will need different testing than a patient experiencing chest pain and back pain.
What makes the pain or problem worse and what makes it better—Your doctor can determine what may or may not be the cause of your symptoms by knowing what improves or worsens your symptoms. For example, if you are experiencing chest pain and movement makes the pain worse, your doctor can adjust testing to provide a more thorough evaluation of other possibly life threatening conditions.
Have you had this problem in the past—Your doctor wants to know if you have experienced your symptoms in the past, if anything was done for it, whether or not you were evaluated by a doctor and what (if anything) made it better.
More often than not, you won’t be seen by the doctor as soon as you step into the emergency department. You can use the time available to improve your communication with your doctor by considering or even writing down your answers to the above list. Accurate answers to the above questions improve the care you receive and help your doctor to find the cause of your symptoms.