Pain And Emergency Room Visit

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.

Kathy, a 20-year-old woman, awakens one morning to a tingling, numb sensation covering both of her feet. This has happened to her a number of times throughout the year. In the past, when experiencing this sensation, within a couple of days to a week the numbness would subside, and so she is not too concerned. About a week later, she

Mrs. Smith signs in the emergency room with chest pain. Several nurses rush to get her vitals, blood samples to send to the lab, and obtain an EKG. While performing an assessment on Mrs. Smith, the nurse inquires about the amount of time she has been feeling this way. Mrs. Smith replies " My sister passed away 2 weeks ago and I have been having this chest pain ever since". After the physician reviews over all of Mrs. Smith 's lab and radiology test results, he informs her that she is not having chest pain from a heart attack, it is simply the result of untreated anxiety.

Patient was in the ER room when first seen. PT was with her family members and family states that she speaks little English and that she has had abdominal pain for the past day along with bloody stools. Family states that she is on calcium supplements and no other medications. Last oral intake is 24 hours ago. Family states no known past medical history. Pt is in the hospital bed in the fetal position and towards the right side. Patient's airway is clear and breathing is normal. Skin is warm and dry. Patent is AAOx4. Assessment of head, neck, and chest show no signs of deformities. Abdominal area not assessed due to severe pain. Back is without deformity. The upper extremity shows no sign of deformities or trauma. The lower extremity shows

On Exam:  BP today was 140/86. Head and neck exam was all clear. She had no oral or nasal ulcers. She had no lymphadenopathy or bruits. Heart sounds were normal and the chest seemed clear, as did the abdominal exam. Musculoskeletal exam disclosed widespread Heberden's and Bouchard's nodes. She had no swelling or stress pain at the MCPs. She was not tender at the CMC joints. She had no swelling in the wrist, elbows or shoulders. She had no soft tissue tender points. She has bilateral knee crepitus but only slight instability and no effusions. She had actually good range of movement of both hips. She was tender in the lumber spine and has a scar at the lower lumbar spine from her previous operations. Her feet are somewhat flat with tenderness across the

The medical assistant should listen to the patient and try to make him as comfortable as possible, then ask questions such as; Why are you feeling this way? Are you in pain? Is there anything we can do to change how your feeling. The medical assistant should also inform the Dr. of all of this information.

DOI: 1/23/2014. This is a 36- year old male relief driver who sustained injury while he was putting away the automatic tarper when he was struck on the right shoulder and got driven into the ground and twisted his right foot. Per OMNI, he was diagnosed with right shoulder strain, and back/neck/right foot fracture. As per office notes dated 6/3/16, the patient is complaining of numbness in all extremities specifically the bilateral feet, arms and bilateral elbows. He has had a flare-up of pain that past couple of weeks around lateral column of the right foot made worse with walking and standing. He has been taking Neurontin 300 mg thrice a day which is helping control his symptoms. He apparently had a bilateral upper extremity upper extremity

“It’s from a kitchen knife cut. The small scar on her finger got infected and spread throughout her whole hand,” the doctor concluded and led the woman inside the clinic.

Per medical report dated 11/24/15 by Dr. Cano, the patient is complaining of severe numbness in the right hand, tightness around the right worse than left hand. She also associates this with dropping items. She is unable to button her shirts or raise her arms up to her elbows. This is continuous all day long. Also, associated is severe low back pain with numbness, radiation, and muscle spasm in the thoracic area, and numbness and radiation down the right sciatic nerve with severe low back pain. She continued to work, sixteen-hour shifts, seven days a week. At this time, she is unable to function. She states that she has had 24 sessions of physical therapy that has definitely helped her.

John is a forty-five year old male who presented in the emergency room experiencing abdominal pain in the right lower quadrant of the ventral cavity. The pain is felt in the umbilical region, right iliac region, and right lumbar region. He is also experiencing pale skin and fatigue. John has a previous history of gastritis(inflammation of the stomach), gastroesophageal reflux disease(stomach acids coming into esophagus), and bradycardia (abnormally slow heart rate). After the laboratory drew blood, the doctor began examining John. Upon his examination, he discovered that John's epidermis was abnormally dry and flaky; this is also known as ichthyosis, proximal to the tibia and fibula. Once the blood work came back, the doctor found the source

She reports tenderness to the posterior aspect of the cervical spine, trapezius region and scapular region with deep palpation.

On 11/21/16 I met Mr. and Mrs. Messing at the office of Dr. Adams. Ms. Messing said she has not made any other follow up appointment. She wanted to wait until she saw Dr. Adams and spoke with him. There was a long wait for Dr. Adam. Ms. Messing arrived in a wheelchair, her neck was still in the Miami j collar but her chin was towards her chest, head was sinking down in the collar. This was not how the collar fit her when I saw her at the rehab unit. She continually pulls on the collar due to a skin break down under her chin. The wound to her chin is almost completely healed. Ms. Messing rates her pain at a 4 to a 10. She reports having a jolting tingling burning pain to the top of her head. She is alert and oriented. Family brought the MRI disc from test ran while in rehab unit at St. Joseph Mercy. Family also brought the entire cervical collar that have been tried to

The patient is an 80-year-old right-handed white female, who presents with her male partner for evaluation of left lower extremity symptoms. She did present for an EMG nerve conduction study in May. At that time, she gave a history of intermittent numbness into the anterior lateral thigh. The numbness rarely extended below the knee at that time, and it rarely occurred on the right. There was no clear radicular component. Her exam was normal. Her EMG of the left lower extremity was limited because she is on Pradaxa, but it was normal and CBs were consistent with a mild motor neuropathy. The diagnosis was possible meralgia paresthetica. The patient now states that the numbness is intermittent. It is on the anterior thigh, but now it goes down into the calf anteriorly and

The patient was last seen in the office in February. Please see that note for complete details. She has several issues she would like to discuss today. She tells me that she has really been under a lot of stress of late. She had been caring for her sister, who has uterine cancer. In addition, her husband 's brother recently died, and there have been issues regarding a property they co-owned. She sold her house in New York and is now renting a house here in Portsmouth. She feels all that she has been doing is moving and cleaning. She feels that she is a little bit settled, however and is hoping that she can get back to her normal regimen. She has not been walking as much as typical, and she would like to lose a couple of pounds and plans to get back into that, as well as her physical therapy exercises that she has been doing for her neuropathy.

Per medical report dated 10/26/15 by Dr. Parsioon, the patient was initially seen on 9/14/15 for evaluation and treatment of cervical pain. At that time, he had neck pain without radiculopathy and bilateral hand tingling. IW stated that physical therapy made his neck pain increase and he wanted to make sure that it is okay to continue this. His chief complaint is pain in his neck radiating to the right shoulder and arm. He states the only time he gets the tingling sensation in the hand is