Clinical skills for Medical graduates : A quick revision

What questions you will ask to patient with pain in the chest or Abdomen? 

Remember the mnemonic:

SOCRATES

S: Site,

O : onset,

C character,

R: radiation ,

A associations,

T time course,   

E exacerbating & relieving factors 

S severity

S : Site of pain : Can You tell me exactly where the pain is?

Intensity of pain 

2.Onset: When. did this problem start?

How dd it start?

I mean suddenly or gradually?

Q3 What were you doing when it started ?

First three questions can be asked in a variety of other  complaints also.

From here on it is only about pain and follows

PQRSTUV.A

3.Character of pain

: How would you describe. your pain?

I  mean is it burning, cramping, stabbing or.

gripping?

4.Radiation:Does it move anywhere?

5.Severity:

On a scale of  1 to 10 ,if 10 is the worst pain you‟ever  had, 

 how would you  grade  this pain?

If 6 or more, then say,“Oh Mr. / Ms………..

It must be hurting you a lot.

Show sincere  empathy .It is very important in clinical practice

Say I  am here to help you and we will do our  best to make  you feel more.

comfortable”

6. Time Duration When did you notice it for the first time?

7.Underlying Factors Do you have any idea what might be causing it? 

Aggravating factors:

Is there  anything  that makes  it worse?

Alleviating factors: Anything  that makes it better?

8.Variability:  Is it. continuous  or does it come and go? 

Is it. progressively worsening?

(If intermittent ask). How. many  times have you. had this problem?

(If intermittent ask). How long. does each episode last?

9.Associated symptoms:

These questions are case-specific,and will let you rule out various causes of the pain