Friday, March 20, 2020

It was the shoes

The purpose of a triage interview is to gain pertinent information about the patient as quickly and efficiently as possible.   It is best to let the person triaging direct the questions.  It saves a lot time.  It helps when it is actually not painful.

In truth, it is acutely painful at times.

While I was watching the Wizard of Oz recently, it occurred to me that explaining how the triage interview works can be compared to the tale of how Dorothy comes to be present in Oz.  I leave out the Tin Man and the Cowardly lion due to time constraints.

Me: "Why are you here?"

Patient: "Well, there I was, living with Auntie EM and Uncle Henry, and Miss Gulch was mean to Toto**... so I ran away, and.."

Me: "Why are you here TODAY?"

Patient: "Well, because Miss Gulch was taking Toto away, and  I decided to run away from home.  I met this man, a fortune teller, who told me there was a  tornado..."

Me: "What are the SYMPTOMS that caused you to come to the ER today?"

Patient: "After I went up in the the tornado I landed on a wicked witch, then the munchkins told me to follow the Yellow Brick Road...

Me: "Excuse me..."

 Patient:  (keeps talking)... with Toto and the scarecrow, and we were headed to Emerald City because..."

Me: "I'm going to stop you there.  If you could use one word to describe to me the complaint that brings you here today?"

Patient: "Well not really, it's complicated, its about way more than one thing..."

Me: "STOP.  One symptom, impulse or concern.  Just one"

"Oh.  Headache.  But...."

Me:  () Actually, I don't say anything.  The thought bubbles have stolen my speech.

**In my scenario, Toto is an emotional support iguana because Dorothy says he is.  In my opinion he is poorly trained.