Next, perform the OPQRST mnemonic to learn more about the patient’s pain:
THE OPQRST of Pain
O – Onset
Key Question: What were you doing when the pain / discomfort started?
P – Provocation / Palliation
Key Questions: What makes the pain / discomfort better or worse? What have you tried to reduce the symptoms? Did it work?
Support Questions: Has this ever happened before? If so, when?
Q – Quality
Key Question: What does your pain feel like?
Support Question: Can you describe it for me?
R – Region / Radiation
Key Question: Can you point with one finger to the main area of pain / discomfort?
Support Questions: Do you feel pain anywhere else? If so, can you show me or tell me where it is?
S- Severity
Key Question: How bad is the pain or chief complaint on a scale of 1 to 10, with 1 being no pain and 10 being extreme pain?
Support Questions: What is the worst pain you have ever experiences? How does this compare?
T – Time Frames
Key Question: When did you first notice the symptoms?
Support Questions: Have the symptoms been continuous? If not, has the feeling come and gone?
After the focused history, perform a focused examination of the heart, peripheral circulation and abdomen. Also, perform an ongoing assessment of all children with cardiovascular problems during transport, observing for changes while on the cardiorespiratory monitor. Remember that the patient’s status may change during transport, therefore observe and document any physiologic trends. We discussed the Pediatric Assessment Triangle (PAT) last week. Remember to use it (Appearance, Work of breathing, Circulation) to monitor effective perfusion and respiratory rate, heart rate, blood pressure, and pulse oximetry. Be prepared to increase the level of respiratory and cardiovascular support if the child worsens or fails to respond to treatment.
Next week, we will discuss cardiac dysrhythmias. |