How Do I Sign Michigan Banking Medical History

Signature past medical history form

hey everyone welcome back to clinical physio with me Carla da da so in this video we're going to go through the key things to ask as a part of your past medical history drug history and social history questions during your subjective examination let's start with past medical history and our key acronym is hashtag thread Sox once again that's hashtag the Red Sox let's go through what each of those things stand for so first the hash tag is the hash and that's because the medical sign for a fracture is a hash T stands for thyroid conditions H stands for heart conditions R stands for rheumatoid conditions II stands for epilepsy a stands for asthma and other breathing pathologies d stands for diabetes S stands for previous use of steroids O stands for osteoporosis C stands for a personal or a family history of cancer and the S on the end stands for history of surgery let's go through those one more time so hashtag thread Sox hash stands for fractures T stands for thyroid conditions H for heart conditions are for rheumatoid conditions II for epilepsy a for asthma and other breathing pathologies D for diabetes s for previous use of steroids o for osteoporosis C for a personal or family history of cancer and S stands for previous surgeries and what we'd like you to do is repeat and go through and rewind through that acronym until you've got it right because these are the things that you need to ask your patient about every time you go through their subjective assessment in terms of past medical history and you will need to get a response for each of those and the course note it down so now we're going to talk about drug history and in this section you'll need to make a note of each drug that your patient is taking and you will also want to ask if they have been taking any steroids and/or anticoagulant medication why well the prolonged use of steroids is linked to osteoporosis which may contraindicate physiotherapy techniques such as joint manipulation and/or could help you with your clinical diagnosis for example you could consider an osteoporotic thoracic wedge fracture for your patient with thoracic pain who has been taking steroids for many years in terms of anticoagulants the use of anticoagulants is a contraindication for aggressive manual techniques including massage and manipulation and is also a contraindication for acupuncture now from a patient progress perspective knowing the dose and the type of analgesia they are taking is paramount for example the patient who says that their pain has been the same for the last two months may not have told you that they are now taking a higher dose of tramadol and this may indicate that their pain could actually be considered as worse likewise your patient may be improving if their pain is the same but their analgesia is reducing in dosage if you can become familiar with regular drugs that come up again and again so that you understand why the patient may be taking them and if you haven't heard of a particular drug before do ask your patient why they're taking it as it may well tell you about an additional medical condition that you didn't know they had it's also helpful to know which drugs are anti-inflammatory codeine or neuropathic based in nature so you can figure out if your patient's current analgesic regime is appropriate for their condition so for example are they taking a neuropathic medication such as gabapentin for their shooting burning nerve pain if not you could ask them to speak to their GP who could review their analgesia so now we're going to talk about social history and we're going to make a note of some of the key factors that might be affecting your patients social life this may include accommodation for example knowing whether or not a person with an ankle fracture has stairs at home may be important to your treatment plan who does your patient live with who are the key people affecting your patient may it be children a partner older relatives that they care for or do they live alone and this may be important for example if you have a young mom who has three children and is picking up their children all the time is that contributing to their back pain also things like occupation what does your patient do day in day out does their work affect their symptoms how about hobbies are these related to their symptoms or perhaps may their hobbies give you an opportunity to create a goal with your patient and broadly asking your patient if they are coping is a good way of finding out about their home circumstances and their personal perspective on emotional coping and stress levels if psychological factors are coming into play during the subjective assessment such as a failure to cope or excessive anxiety explore this in terms of the impact on the current physiotherapy problem as this may well change your treatment approach ie educating or explaining to your patient that their spine is not crumbling may well reduce their stress and their anxiety levels and get them moving quicker and better which might be better than simply asking them to repeatedly bend forward as an exercise beware of working outside of your scope of practice if you feel that your patient does need access to psychiatry counseling or CBT services then referring them to the right professional via your patients GP would be better than trying to deal with the problem yourself after all MDT working is more efficient more effective and better for your patient in the long run and that completes our video thank you so much for watching as always and we'll see you again soon right here on clinical physio