This time I chose a couple of topics that while do not relate to each other they do relate to your everyday duties.

1 - Cap Refill - How often do you really check for it? This is one of the most basic yet overlooked assessment techniques I see used all the time.

This simple test can tell you about a patients cardiovascular status. If a refill time is greater than 2 seconds, this may indicate poor circulation and inadequate cardiovascular function. While other factors such as patients' age, gender and environmental factors should be taken into consideration with the Capillary Refill test. It is a good start for a baseline cardiovascular function and can lead you to other more evident or possible overlooked signs and/or symptoms.

So, take that two seconds and check your patients "cap refill". You will probably document it, so you might as well do it.

Speaking about documentation, leads us to the next topic - "Capitals"

2 - It is important to document appropriately when filling out your ambulance call report, we all know it is a legal document and a permanent record of your patient care. So, by CAPITALIZING when
needed, it makes it easier for other healthcare providers to understand your assessment and treatment. It also assists YOU should the report be called into question at a later date.

As a suggestion, capitalize things like mnemonics like AVPU, DNR etc and named symptoms or diseases such as Kussmaul's respiration or Wenckebach. Don't forget EKG findings QT, P-R or QRS. Using
proper capitalization not only helps your documentation it also makes it easier to scan the report for "key" items.

I think you are getting the idea. While for the most part using lowercase will not hurt your patient, it may cause confusion down the line.

Lastly - Do you know what a "capitulum" is? ...  and no they did not use it in medieval times. :)

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Capitulum - is the lateral aspect of the humerous. It articulates with the head of the radius.
 
Use that next time in your call report and dazzle your quality assurance officer.

Remember, performing the basics and documenting appropriately will always help you perform better patient care and prevent you from missing important clinical signs, not seen on an EKG or while
administering medications.

 
Jim Hoffman is a contributor to EMS Solutions.
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