Check up 11 Workin pairs. Mateh each photograph with what the person issaying. ‘My hospital number? t's 3438235 and my GP's name's rane. ‘Good morning, sean. My name's Dr Bray, ‘Sorry. don't know my GP's phone number Contieave that blank? 2. How important are accurate patient records? Givereasons. 3. Inyourcountry.are patient records kept on coraputer coron paper? Which ofthese two systems do you think isbetter? Why? Listening 1 Personal details 1 @ Look atthe chart containing personal details of Mr Karlson. Then listen and correct any details 1-8 that ‘may be wrong. Tick (/)items that are correct. Surname: Johnson: Karlson _1 First name(s) Dave Law Sex M Address 3 Park View Mansions, — 2 Castlefield Manchester M6 7DE Admission details DuncanWardat + p.m conv 9 November 2008 nee te Hospital No 19736045 ay DOB 27 1053 — | ‘Telephone number 0166 405 7001 Marital Status single: aut 4 Occupation Postman Sane GP Dr Khaw eee Clo paivinvright arn 2G Listen again and check your answers. 3 Work in pars. Decide what questions the doctor asks for each piece of information on the form, » Language spot Asking short and gentle questions + Ask gentle questions to put the patient at ease, Use Can you tell me what / who + noun + verb? What's your surname /family name? Can you tell me what your surname /family name is? + Remove words to make questions shorter. What's your fist name? Your frst name? Haye you any other names? (And) Any ather names? >> Go to Grammar reference p |?reroesuromeutmnn anisms aiming nen se rinrerenreorinmneene Presenting complaints 5 ae, PRCT RMS of An this unit ‘© asking about personal details. © asking questions about the presenting complaint ‘© describing and asking about pain writing upacase report 1 Make gentle questions or short questions forthe Listening 2 questions youmade in Listening 1,3 ircdadtiwcoalaiee 2 Whentakingthehistory ofthepresentingeomplaint 4 wort inpatrs. What doyouthink each patient in pictures a-h might be complaining of? (HPC), you often ask about pain. Use these words to complete the questions. makesitworse/better? _diditstart? on? youupatnight? spreadanywhereelse? _—_the painis ike? had the pain? getthe pain? the pain forme? hhadtthe pain before? constant? a Wheredoyou Does the pain Does it wake can you tell me what > c a © Canyou describe £ Howlonghave you g Isthereanything which. hh When. i Isthereanything which brings it j Isthepain, k Haveyou 3. Workin pairs. Match these words toa question in2, 1 —L_ duration 2 onset severity ___ trigger radiation —— and___ character exacerbation alleviation —— site —— previous episode constancy 2 G Listen, Match each picture in with a conversation, 1 oe i 4 Gas (ae wor anee 10 3G Listen again, What three questions are used by the 4 workin ples Each choosea painandaskeachother " docty toaskaboutthe presenting complaint FC)? NaN eae 2 Can you tell me wh 3 What ean —__ 4 What other questions can you use to ask about the PC?6 Unit oa 5 @ Lstentofivepeoplestating wheretheyarehaving 3 Cover thestress patterns in. Take turns saying problem. Which partof the body are they referringto? a word toyour partner, who will then identify 6 Witha partner, think of non-technical terms for body apreerer st partsa-k 4 Try notto look at and 2, Work in pairs. Take turnsteading the sentences below by adding the correct words that, match the stress pattern. a Mrs Evans can’t walk properly. She's gota pain inher». b He'svery tender here on the right side of the @enearhis kidneys. ¢_Ahmed's #® feels as ifit's on fire when he swallows, 4. Hedamaged his + when hefellon the pavement. € James has got a crushing pain around the ‘but nothing in his arms or legs Tthink there isa fracture in the ® The pain radiates from around the 5 Workin small groups. Take turns describing patient you have treated with a problem related tothe parts ofthe body a-kand then answer questions from the group members, in the right hand tothe back What... Vocabulary Pronunciation Describing pain Medical terms: word stress 1. Work in pairs. Which descriptions 1-10 do you associate 1 Workin pairs. Write words from a-k above that match with the conditions a~j? In some cases, there may be more each of these stress patterns. than one answer, 1 piercing /boring a. sciatica 2 extremely severe /intense b uretericcolie 3. aching © acute pancreatitis 4 scalding / burning appendicitis 5 like a tight band €- degenerative arthits oy around my head f cluster headache 2 G) Listen and check your answers, 6 dull/persistent/vague —g_ cystitis 7 excruciating /thunderclap h_ tension headache 8 shooting 1 sub-azachnoid 9. spasmodic haemorrhage 10 crushing / gripping J} angina pectoris2. Workin pairs. Decide how you would differentiate between the pain inb-ein .Givereasons foryour answer 3 Foreach description, write M (mild), S (severe),or ‘V (very severe). Then say which condition a~jin¥ each patient below is possibly describing, 1 Igetthis vague headache sometimes during the week. 2 —— The headache is excruciating, {can't bearto lookat the ight, 3. ____ The pain in my stomach is so badit makes me double up. 1 get this sharp pain when you press my side hereon the right and then let go. All my joints hurt. lam wracked with pain. 4 You can ask a patient to describe pain ona scale of 10 10, What other ways can youaska patient toassess the severity of pain? 4 5 It’s my job 1. Before you read the text about Dr Henderson, a cardiologist, discuss witha partner what you think being a cardiologist involves. 2. Alloftthe statements below are true. Find information inthe text to support each statement. 1. DrHenderson’s tear s very skilled 2 The work of her team depends on the support of other people. 3 Details about the closest relative are taken from patients. 4 Patients have two numbers (other than their phone number) on their hospital records 5. The data collected need to be accurate 6 Checks are carried out to make sure patients are who they say they are. resenting complaints 7 Use SOCRATES in the history of the presenting complaint to help you remember the main questions you need to ask about pain site; onset eharacter radiation; assocation; timing; exacerbating and alleviating factors; severity differentiate (¥) distinguish tel the aiference between Dr Gillian Henderson ‘My names Dr Henderson. 'm a cardiologist at 2 London hospital. The highly trained team of which | am part deals with the diagnosis, investigation, and ‘treatment of patients with all forms of heart disease, including cardiac transplantation and some sorts of vascular disease. ‘None of our work would be possible without the support of other people in the hospital team —the ‘riage nurses, the receptionists, and soon. Their works. vital to the smooth running ofthe department. When patients arrive for the first time, personal information istaken:name, address, telephone numbers, next ‘of kin for contact in case of emergency and other Information suchas their GP's name and address their NHS number, and their unique hospital number ‘We deal with alarge catchment area andalso deal with referrals rom outside the area, tourists visitors toAKE private patients and soon, so the potential for confusion is great unless the ata that are taken are accurate and the systems secure At various stages of patients'contact withthe hospital, information is checked to make suet iscorrect and that the patients can confirm their identity For ‘example,on arrival atadinic patients might be asked theirGp’s name or part of their telephone number for ‘example the last three numbers. Then during the consultation s a nurse oradoctor might also ask their date of birth. All this Isforthe benefit ofthe patient toensure the hospital team does not make mistakes and people do not use patients’ details fraudulently Wecan thentuinto a dealing with the patients’ treatment : insafey. RF ( lee Go et. \ 48 Unit? [AKLE(n) Accident and Emergency ‘apport (n) relationship © Oe inspiratory @@©e crepitations Listening 3 Apresenting complaint 1 Workin pairs or groups. Decide what the abbreviations belowstand for Pulse 100/wan BP: 100/70 man /Hg JV? Not elevated CVS NAD ore POM epee eAal) Mapa) Fk CRRHONE audible abdomen — normal CNS - NAD 2 @ Listento part of a conversation between Dr Martin, doctor in A&E, and Mr Wood. As you listen, make your ‘own notes about Mr Wood's presenting complaint. Speaking 1 Discuss the signs above. 2 Discuss the correct diagnosis for the shoulder pain. 3 Decide what the diagnosis was on arrival at the hospital. 4 Outline your immediate treatment, » Language spot Tenses in the presenting complaint » Understanding the time patients are referring to when they speak is crucial to making a correct diagnosis. You should be very comfortable understanding the difference between the Present Simple, Present Continuous, Present Perfect, and Present Perfect Continuous. 9 Goto Grammar reference p 122 1 Decide whether each sentence a-irelates tothe time shown in diagrams 1, 2,3,0r4 below. PC =Presenting complaint | 1 Present simple PC fees = u = et 2 = 2 f PRESENT CONTINUOUS L L Time Now 4 Present Perfect ContinuousPresenting complaints. 9 mE a _1__ I'vegotaheadache, Speaking b __ Ivebeenhavingthisshootingpaininmy 4 Workin pairs, Decide what possible conditions the leg. notes below relate to. © —— theepgettingtheseflashinglightsaround j= ED pain js ‘i dwteoeiietioat pain just above belly button; goes A = Maurie icing a atacand. rough to back; makes me double up, © —— Thepaingoesright through you. worse aftera fatty meal; drink Se gn sell a hh ____ rmnottskinganythingforthem, ee eee eee i ____ Theattacks have increased. pain there all the time; 2. Workin pairs. Complete the sentences below with caine on after dinner ‘the correct form of the verb. if more than one tenses last night possible, explain the difference 1 My mother___ (have) these painssince last Tuesday she still has them. = 2 {you normally go)forarunatthe same time every day? 3 Thepain. (ease) a little since yesterday. o . dicta sharp patrvin the right side: 4t (lie) in bed for four weeks now. haven't makeyme double ups been out ofitonce, doctor. never had it befores 5 lean see the rash. (get worse). It’s much feeling sick; side very redder tender to-touch; 61 (not take) any medication at the moment, only thing reliever 7 (pain spread) to your shaulderoris it just itiybendingknees here? tochest 2. Workin paits, Decide what questions the doctor asked in each case, Take turns asking and answering questions 3. student A, goto page 114 Student B, take history from Student A Write notes as you listen and decide what the patient's complaint is 4 student B,goto page 16.Student A,take a history from Student B. Write notes as you listen and decide what the patient's complaint is.10 Unit? Culture project ‘Being aware of your own body language and the body language of your patients will help youintaking a history. 1 Finda picture a-cto match each description of body 1 __ Thedoctorisnot sure about what 2 Ingroups, discuss what the body language in would heissaying. ‘mean in your own culture. 2 @.B.© The patient isnot comfortable or at ease. 3. Usethe internet to find: 3 —__. Thepatientisangry, 1 other fields besides medicine where understanding 4 ‘The doctor is bored and unsympathetic. non-verbal communication is important, é ihe ci ivetcwrine ikeeandtoviling 2. whata patient-centred approach in history taking means therapist cartane esabtng, 3. what the Calgary Cambridge method ts 6 —_ The patient doesn't understand what the doctor is saying. 7. Thedoctorand patient aren't ‘communicating,clerk ( patient) (v) take a history froma, patient and wete it up Writing Acase report 1 Complete the extract from the case report written by Dr Martin after the consultation with Mr Wood on page 8. Insert the verbs inthe correct form into the appropriate blank space. present have be smoke be work radiate ‘A 49-year-old man presented 1 in Aa E with chest pain. He had had the pain for 3 hours prior to arrival. The pain 2 in the centre of his chest and 3 to his left shoulder. He ____4a history of chest pain on exercise, which has been present for the previous six months He _____ approximately 20 cigarettes a day and © teetotal. He has been prescribed aspirin, B-blockers for the previous two years, and a GIN spray to use as required, which is two to three times per week. His father died of a myocardial infarction aged 65. He 2 as a gallery attendant. Complete the clerking from these notes, Ofe sweaty bat ne abarmalucves Un CRS. BP 30/82 pe vo/mun regular. He gue analgesia streptokinase N been Heckers-coneunne, Pawn serele and. afcer com days begin. wrabhiee Presenting complaints 11 ee Checklist ‘Assess your progressinthisunit, Tick (7) the statements which are tue. | can ask a patient about personal details. | can ask about the presenting complaint. |can ask a patient about pain, I can understand time relationships in the PC and HPC, Key words Nouns body language culture non-verbal communication ‘Adjectives for pain aching boring burning crushing dull excruciating ripping intense persistent piercing scalding severe shooting spasmodic ‘thunderclap vague Useful reference Oxford Handbook of clinical Medicine ‘Th edition, Longmore eta |SBN 978-0-19-856837-7