Five Assessment Findings That Should Concern You

Did you ever watch the old Star Trek TV show? No of course you didn’t, but this is just you and me talking here right? OK, remember when something would threaten the ship. The captain’s first response was to say, ”Go to red alert.” or “Set condition red.” and the lighting would change and a little alarm would sound. That funky shaped light on the front console would start pulsing red. Everyone knew to treat the situation with importance.

I don’t know about you, but I have a list in my head of assessment findings that cause me to shift mental gears into condition red. I don’t need to say anything overly dramatic, but everyone on who works with me can tell when I’ve switched gears to condition red.

For one thing, I start moving just a bit faster than my usual casual pace. I delegate tasks in a laundry list fashion. “I’m going to need an O2 mask. Lets get the pram to the door and bring a stair chair up here. Jesse strip me a line in the rig and check the status of Swedish ER.” The patient may not know the difference, but people who work with me can tell that I’ve set condition red.

Here are a few of the assessment findings that send off alarm bells is my head.

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Lesson From The Street: Skin Doesn’t Lie

I hope you’re sitting down for this. I trust that a good number of my readers do indeed sit while surfing the internet so I’m just going to tell you this strait up. Sometimes … patients lie. They do.  Occasionally they intentionally tell us bold, outright lies. And it gets worse. With even greater frequency they are just plain inaccurate. They may not be intentionally deceiving us, they may be confused, misinformed, exaggerating, in denial, overwhelmed or embarrassed. Regardless of the reason, we are frequently faced with subjective information that isn’t all together accurate.

What’s an EMT to do?

I don’t want to suggest that you should skip or disregard your subjective assessment. The things that your patient tells you are vital and important clinical findings. Even inaccurate information can give you vital clues regarding the patient’s mental status and physical condition. But I’d also suggest that you put a premium on physical findings that give you instant and accurate information about the patient’s physical condition. The longer I work in emergency service the more I find myself falling back on basic patient assessment truths like this one:

Pay attention to your patient’s skin.

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