Writing an HPI. Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for.

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Presentation transcript:

Writing an HPI

Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”.

Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”. 3. Characterization

Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”. 3. Characterization OPPQRST Pertinent positives

Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”. 4. Pertinent negatives

Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”. 4. Pertinent negatives 3. Characterization OPPQRST Pertinent positives

Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago… 3. Characterization He denies any… 4. Pertinent negs

Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… 3. Characterization He denies any… 4. Pertinent negs

Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… 3. Characterization He denies any… 4. Pertinent negs 1. Opening sentence

Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… He denies any…

Mr. Smith is a 48 year old man s/p appendectomy who presents with chest pain. The pain began 3 weeks ago… He denies any…

Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… He denies any…

Mr. Smith is a 48 year old man with HIV who presents with chest pain. The pain began 3 weeks ago… He denies any…

Mr. Smith is a 48 year old man with HIV with recent CD4 count of 22 who presents with chest pain. The pain began 3 weeks ago… He denies any…

Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… He denies any…

Mr. Smith is a 48 year old man with known CAD who presents with chest pain. The pain began 3 weeks ago… He denies any…

Mr. Smith is a 48 year old man with known CAD who presents with chest pain. The pain began 3 weeks ago… He denies any… 2. Context

Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 4 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. 3 weeks ago… 2. Context

Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 4 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. Baseline 3 weeks ago… 2. Context

Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 4 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. Baseline 3 weeks ago… Is pain the same as before? 2. Context

Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”.

Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 3 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. 3 weeks ago… He denied any… 2. Context / baseline 3. Characterization 4. Pertinent negatives 1. Opening

Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 3 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. 3 weeks ago… He denied any… In the ED… 5. Other tests (not diagnoses) if will change management 2. Context / baseline 3. Characterization 4. Pertinent negatives 1. Opening

Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 3 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. 3 weeks ago… He denied any… In the ED… 5. Other tests (not diagnoses) if will change management 2. Context / baseline 3. Characterization 4. Pertinent negatives 1. Opening