WHOWoman (pregnant (trimester) / breast (how often)) SELF or someone else REQUEST for product POM register Elderly Child Appearance (ill looking, lethargic child) REQUEST for symptom help POM register Have you used the medicine before? I am sure I can help.To help me give the best advice, though,I’d like a bit YES: any further info needed? more information from you, so I need to ask a few questions. Is that OK? NO: REQUEST for symptom help How has he come to request this SYMPTOMS: Could you tell me product? what sort of trouble you have had........? Duration !....For how long How and when it began, Timing of symptoms How it has progressed What have you tried so far ? Any other symptoms or anything different from usual Decision: REFERRAL Danger, Duration, Incomplete info TREATMENT: effective and safe (medical history and medicine use) (age restriction) OUTCOME: improvement within usually 1 week, otherwise DOCTOR NEW prescription medicine CD register, dispensing history Hello. Thank you. I will quickly process the prescription. Is this prescription for you? Is this a new prescription for you ? What has your doctor told you ? whereas those that happen during exertion such as exercise or heavy work may not be. or has been. . For accidents and injuries:_ The person is.There is severe bleeding from any part of the body.g. You tell me you’ve had this problem since . or I’m not quite clear what you meant by . e. did it work? . unconscious. .The person is experiencing severe stomach ache that cannot be treated by OTC remedies. For example the use of a topical corticosteroid inappropriately on infected or infested skin may substantially change the appearance. was the doctor or dentist seen on previous occasions. without improvement) Suspected adverse drug reactions (to prescription or OTC medicine) Danger symptoms. . History taking is particularly important when assessing skin disease. Also ask then some more direct questions to exclude danger symptoms Other questions could include what treatments have you tried so far this time? What sort of treatment were you hoping for today? What other medications are you taking at present? Do you have any allergies? REFERRAL:Long duration of symptoms Recurring or worsening problems Severe pain Failed medication (one or more appropriate medicines used already. do the current ulcers resemble the previous ones. was any treatment prescribed or OTC medicine purchased and. I’d just like to make sure I’ve got it right. In recurrent mouth ulcers.The attacks of heartburn that occur after going to bed or on stooping or bending down are indeed likely to be due to reflux. .Could you just tell me what sort of trouble you get with your piles? I’m not sure I quite understand when you say .There is a suspected broken bone or dislocation.The person is experiencing severe chest pain or is having trouble breathing. allergy to ingredients such as local anaesthetics may produce a problem in addition to the original complaint. . for example. . if so. . . . Past medical history includes general health status. A review of systems uses open-ended and closed-ended questions to probe for other symptoms or conditions. and hospitalizations.g. involving acute symptoms. The chief complaint history What can I help you with today? Tell me more about your. siblings.... family. looking for patterns of disease and common causes of death. and social histories. adverse reactions to medications. ears. It tends to start at the top of the body (head.. Focused open ended questions: LOQQSAM LOCATION: where is it ? where does it move to? ONSET: when did it? How long do you have it? QUALITY: what does it feel like? Describe the feeling in your own word. not found during the HPI. marital status. eyes. infectious diseases and immunizations. genitourinary tract. and offspring. also known as a chief complaint history.. gastrointestinal.. etc.A complete medical history consist of five components: history of present illness (HPI). cardiovascular. focuses on the present symptoms and by itself is the history used in most ambulatory situations. nose and throat) and move down. personal. financial status. past medical history. Family history asks about significant health events in the lives of parents. family history. respiratory. past. or a review of the health record... personal/social history. and current living arrangements. and a review of systems... The HPI. QUANTITY: how frequently is it? How bad is it? (pain scale) How much interference daily routine? SETTING: how did it happen? When do you notice it? In which circumstances? What happened just before it started? . It contains both active and inactive problems in a problem list. personal habits such as alcohol or smoking. Personal history includes occupation. e. FACTORS: work? OTHER QUEST: taking? What other symptoms do you have? What else happended? How else do you different around the time it happened? What makes it better? What worse? What have you tried for this? How did it What do you think cause this problem? What medications are you currently SIT DOWN SIR S I T D O W N S I R Site or location of a sign/symptom Intensity or severity Type or nature Duration Onset With (other symptoms) Annoyed or aggravated by Spread or radiation Incidence or frequency Relieved by Closed ended questions Summarization .ASS. SYMPTOMS: feel bad or MODIF. conditions) that the patient is an appropriate self-care candidate.. namely: • Quickly • Establish • Suggest • Talk and accurately assess the patient....So. allergies. administration. NO severe or persistent/recurring symptom. about medication action. adverse effects about what to expect. NO self-treating to avoid medical care appropriate self-care strategies medication or general care measures with the patient. ASK about current complaint SCHOLAR ASK about MAC (medication.that started 3 days ago. You have had . Closure Is there anything we need to discuss today? Each letter in the QuEST acronym is intended to represent a sequential step in the consultation process. about follow-up The SCHOLAR • Symptoms: • Characteristics: • History: What are the main and associated/related symptoms? What are the symptoms like? What has been done so far? Has this ever happened and what was .. that your are feel out of sorts after taking your tablet. medication and other types of allergies. how do you feel about that ? What effect is this having on you family ? ICE IDEAS Why do you think has this happened ? Have you any ideas about it yourself ? . when you take the blood pressure tablet“ EXPLAIN „Explain to me why you are worried about taking this new tablet“ DESCRIBE „You say. and tradeproducts. describe this feeling to me“ I am really sorry. TED TELL „Tell me more about the feeling you get. natural products.successful? • Onset: When did this particular problem start? • Location: Where is the problem? • Aggravating factors: What makes it worse? • Remitting factors: What makes it better? The MAC • Medications: name and generic • Allergies: • Conditions: prescription and nonprescription medications. other medical conditions. I’d like a bit YES: any further info needed? more information from you.CONCERNS you ? EXPECTATION WHO What has been going through your mind ? Is there anything that is part. Is that OK? NO: REQUEST for symptom help How has he come to request this QuEST SCHOLAR MAC product? NEW prescription medicine CD register.To help me give the best advice. Is this prescription for you? Is this a new prescription for you ? What has your doctor told you ? . though. Thank you. lethargic child) REQUEST for symptom help POM register Have you used the medicine before? I am sure I can help. so I need to ask a few questions. Worrying What do you think might be the best approach ? Woman (pregnant (trimester) / breast (how often)) SELF or someone else REQUEST for product POM register Elderly Child Appearance (ill looking. I will quickly process the prescription. dispensing history Hello. esp child Check for interactions Check for allergies. spray etc). herbals • Allergies: medicines/ other types • Conditions: “WHAT DID YOUR DOCTOR TELL YOU (INSERT MEDICATION NAME HERE) WAS BEING USED TO TREAT?” “HOW DID YOUR DOCTOR TELL YOU TO TAKE (INSERT MEDICATION NAME HERE)?” “WHAT TYPE OF RESPONSE DID YOUR DOCTOR TELL YOU TO EXPECT FROM (INSERT MEDICATION NAME HERE)?” Check dose if appropriate. FOLLOW UP (1 week) The SCHOLAR • Symptoms: main + assoc. adverse effects./related • Characteristics: how are they • History: Action taken? Ever happened and what was successful? • Onset: When did it start? • Location: Where is the problem? • Aggravating factors: worse? • Remitting factors: better? The MAC • Medications: also OTC. ADMINISTR: (eye drops.Quickly SCHOLAR MAC Establish if SELF care candidate Suggest SELF care strategies Talk about medicine. duplications .