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Signs and Symptoms

Posted Apr 24th, 2012 by Pat Brown
You know the commercial where the man in a hard hat walks up to the construction sitewhere he works and he sees his doctor dressed in his lab coat with no protective gear on. Thedoctor thinks he is operating this guys jack hammer but in truth the jack hammer is out of controland dragging the doctor down a path of destruction. The camera switches from the doctor andzooms in on the man’s face. The man’s facial expression is clear as he uses the universal headsign of no and thinks “can doc possibly believe that he knows what he is doing, he’s a doctor nota construction worker.” Although the patient side of me was laughing outloud, the nurse sideof me was asking questions. Are we as patients diagnosing and treating ourselves so much thatwe forget who the experts are? Or have we just not been trained to triage [figure out] where theboundaries are between the trained and untrained eye?

I am prone to believe it is the latter, so the best way to self or family triage is to know thesigns and symptoms. The signs are the list of ailments that could occur from a disease, disorder,a medication, or treatment. The symptoms are the actual ailments that keep nagging you untilthey get your attention. Your job provides you with the tools you will need to work. Your signsand symptoms will give your doctor the tools necessary to do his/her work. The most importantthing you need to know about triaging signs and symptoms are the level of care needed. Thelevel of care required can be determined by these categories: imminent [call 911], immediate[too many symptoms are present], and illness [nothing works I need a doctor]. Knowing thethree I’s will help you manage the gauge between self-care and medical intervention.

Imminent level of care is usually the easiest symptom to triage. Any bleeding that occursafter an accident, unconsciousness, gunshot wound, a broken or dismemberment body part, andstop breathing requires imminent care. No brainers, right? The difficulty in triage increaseswhen people try to determine immediate care from illness care. The reason this is tricky is thatillness care can change to immediate care quickly and with no warning. This is why the signsand symptoms are crucial, not just the what, but the how much, how long, what color, whatworked, and what did not work. With that said, lets do a doctor patient dialogue with signs andsymptoms. Doctor: What seems to be the problem today?

Patient: Doc, I can’t seem to shake this cough?
Doctor: Are you a smoker?
Doctor: Are there any other symptoms with the cough?
Patient: Yes. My head is stopped up and I can’t sleep.
Doctor: How long have you been coughing?
Patient: Off and on for a while but it just got worse.
Doctor: A while? What’s a while? A week, a month, or more than that?
Patient: I don’t know but now the coughing interferes with my work.
Doctor: What seems to be the problem today?
Patient: Doc, I can’t seem to shake this cough?
Doctor: Are you a smoker?
Doctor: Are there any other symptoms with the cough?
Patient: Yes. My head is stopped up and I can’t sleep.
Doctor: How long have you been coughing?
Patient: Off and on for a while but it just got worse.
Doctor: A while? What’s a while? A week, a month, or more than that?
Patient: I don’t know but now the coughing interferes with my work.

If this sounds like the dialogue you have with your doctor, you need to find out a basicunderstanding of how the body part in question is suppose to work. You need to tell him whatyou tried to do about it and when. Write it down because when you are sick you can getconfused or not remember. Doctors are the experts but they need your help in order to determinethe best diagnosis based on your signs and symptoms.


References
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Osmancevic, L., & Pedijatrija, D., (2011). The clinical characteristics of celiac disease in
children at the time of detection. Pediatrics Today, 7(2), p133-139.
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About the author

Ms. Pat Brown MSN, APN, RN
Doctoral Candidate - RN for Luten Nursing Services and ADJ FCLTY at UOP

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