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Most people seem to be failing due to inadequate data collection. If this is of any help, I would like to share a mnemonic to ensure u ask everything during a phone encounter for diarrhoea:
ON CALL IDIOT ['On Call'since this is a phone encounter] - please dont think about "idiot" being offnesive - it is just a mnemonic people !
O - Onset ?
N - Number of Times a Day?
C - Consistency ? / Color? / Content ? [Blood, Fat, Mucous ?] + Crying ? Cramps Suggestive ?
A - Associated Symptoms [Fever, Runny Nose, Cough, Ear Discharge ?, Vomitting ?]
L - Listless baby ? Lethargic, not Sleeping ?
L - Liquids not passing ? [i.e. not urinating ?]
I - Immunization up to date ?
D - Diet Change ? Dehydration signs ? Day Care Center ?
I - Infections in family ? Immunicompromised mom ? [HIV ?]
O - ORS counseling
T - Travel history recently ?
Write this down on ur sheet before u pick up the phone...and u are ready to rock and roll !! practice the order of questioning at home on a phone while u practice with ur study partner !
and ofcourse make sure u ask the name of the baby first and then refer to him/ her by name :-) I guess you can tweak the mnemonic a bit for a case of fever too !
can u please tell me is the case taking and the questions for history taking same for telephone case as the normal case or anything different ,
and how about physical examination and councelling part with a telephone case?
history taking is very much the same - except that you are asking the mother about her baby - instead of the patient directly.
At times when you asking questions like "does Adam have sunken eyes ? " - she will say "Wait doctor, let me go and look" - and will come back after 30 seconds to reply.
About physical examination - you say "Mrs. Ray, there are many things that could have caused these loose motions - a physical examination and some tests are necessary to determine the exact reason - Could we have Adam at our hospital as soon as possible ?"
physical examination over the phone would be limited to asking mom to check for :
- ear discharge
- runny nose
- sunken eyes
- skin rash
- crying and position suggestive of colic
thanks dude it was really very very helpful .
its really gr8
when is ur e xam ind doc
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