IowaEMT Posted March 27, 2007 Posted March 27, 2007 A normal person is CAOx4 (person, place, time, situation). What would you put for a patient who only responded to verbal stimuli and was very confused/disoriented. You ask him/her questions and they respond with unintelligible mumbles. Are they orientedx0? Thanks in advance.
emt-b_wa Posted March 27, 2007 Posted March 27, 2007 state just that. IE patient responds to verbal commands inappropriately or with garbled speach
JPINFV Posted March 27, 2007 Posted March 27, 2007 Remember that there are limitations to verbal questions. I had a patient over the weekend being returned to a SNF following a procedure that had a history of a CVA with right side hemiparesis and unintelligable speech. Her speech wasn't even slurred, she tried to talk and only noise came out. She could understand everything we said, though, and we could communicate effectively through gesters. Unfortunately there wasn't an A&P in the packet, but I think she had damage to her Broca's area.
DwayneEMTP Posted March 27, 2007 Posted March 27, 2007 Like emt-b_wa is saying, if it doesn't fit, don't use it. I'm only a student, so take what I say with a grain of salt, but the only time I use AaO is on a patient that is completely alert and oriented. Otherwise the abbreviations is too vague to be of a lot of use. For example in class we discussed for half an hour or so whether it's a/ox3 or a/ox4. I was taught x4 (person, place, time, event) but our instructors (and I believe my medic book, though I can't find it right now (Essents of Paramedic care 2nd)) uses a/ox3. So we've been instructed to use a/ox3 with a qualifier (pt a/ox3, - loc, clear memory of event). People smart then I am probably use a/ox2, etc, but I'm finding that if they fall short of 3 (4) there is more mentation info needed on the PCR than will be covered by this abbreviation. Those are just my thoughts...I'm betting our betters will be able to give you some better info... Good question! Dwayne
Just Plain Ruff Posted March 27, 2007 Posted March 27, 2007 Try looking at this. It took a little bit to load but it's pretty good. http://books.google.com/books?id=PKqXqB0W7...6k_6CM#PPA55,M1
becksdad Posted March 27, 2007 Posted March 27, 2007 Pressed for time right now as I need to get ready for work, but look in any EMS text for the Glasgow Coma Scale, which addresses the very questions you ask concerning responsiveness/neurological status. Most useful for trauma, as medical scenarios must consider other factors such as prior CVA, as described above.
Eydawn Posted March 27, 2007 Posted March 27, 2007 I just describe what's going on with my patient using verbal descriptors, especially if the situation is not one that lends itself to the AAOX __ situation. I find that it makes a lot more sense to me and I can give a much better picture if I actually write things out completely in trip reports with the exception of BP, P, RR. I actually use whole words describing it verbally to the doc- why wouldn't I just write it out completely so the quality control review and the possible future lawyers can also understand it? Back on topic a bit I use X4 but used to confuse this with the AVPU scale. Which is why I now just completely describe their awareness level vs using the abbreviation. Wendy CO EMT-B MI EMT-B
ERDoc Posted March 27, 2007 Posted March 27, 2007 There is no hard and fast rule. Even the A&OX3 or 4, depending on what you use, has no officialness (pardon the made up word). It is just jargon that we use to save time when trying to get a point across. It's easier than saying the pt is alert and oriented to person, place and time (and possibly event if you like). As someone before me said, document what you find and you can't go wrong.
Ridryder 911 Posted March 27, 2007 Posted March 27, 2007 Good points Doc! KISS.. Keep it short and simple. Where everyone will understand it. R/r 911
Chief1C Posted March 27, 2007 Posted March 27, 2007 A normal person is CAOx4 (person, place, time, situation). What would you put for a patient who only responded to verbal stimuli and was very confused/disoriented. You ask him/her questions and they respond with unintelligible mumbles. Are they orientedx0? Thanks in advance. I'd document their level of consciousness and that the patient has an altered mental status with unintelligible speech and their response to verbal command. Whether or not it was an appropriate response, etc.
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