When approaching a patient, try to do so in a non-threatening manner. Their heart rate may already be elevated and their stress level is likely higher than normal. Bringing calm to a patient as they deal with a crisis is perhaps one of the best "medicines" we can bring to the field. 

Moving to the side of a patient tells them literally and figuratively that you are on their side. Facing off with a patient shoulder to shoulder can be threatening. Standing over them when they are in a seated position can have the same effect. Make sure that your posture and position are not adding stress to an already difficult situation. 

The tone you use should be non-threatening, friendly and professional. You are communicating some very important things to your patient on the approach. They are wondering who you are and if they can trust you. Are you brand new and looking forward to testing your skills, or have you been around the block a few times and there to help them? The tone in your voice and the words you chose can make a big difference. 

Always ask permission and wait for acknowledgement from your patient before touching them. Keep in mind that they may be entirely focused on their crisis and may not hear or understand you right away. Be patient and watch and listen for clues that you've made a connection and that they understand what is happening to them. Their acceptance of what you and your team needs to do is important. "My partner would like to take your blood pressure, is that okay?" or "I'm checking to see how your pupils react to my light" goes a long way towards making your patient feel comfortable with what's going on. 

Introduce partners and junior medics and ask permission on their behalf. Too many people talking or asking question can be confusing. Limit the confusion by allowing one member of your team to make the connection and maintain it. If you've started the patient interview, then either finish it or smoothly hand it off to whomever is helping you. Make sure the patient knows what's going on. This gives them some sense of control. "My partner would like to ask you a few more questions, is that okay?"

Getting on your patient's level helps. Don't tower over them. If you have to, take a knee. Not only are you making yourself less of a perceived threat, but you may put yourself in good position to catch a patient that falls out on you during your interview. 

Your approach to your patient can set the tone for the entire patient encounter. Pay attention to your approach and practice with friends and family. Ask them for feedback about how your approach makes them feel. In a short time, you'll be well practiced and approaching patients like a pro. 

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Replies to This Discussion

Excellent advice. Only one comment; introduce yourself, and let them know what your qualification is, so they know with whom they are dealing. That's especially important if you aren't in uniform. I run outings for the Sierra club, and I hike a lot and go out in small boats, so I'm not in a uniform, though I have a WFR patch, and they may wonder whether I know what I'm doing. If I'm leading a group, the group knows who I am, but if I find an injured person who isn't connected, they need to have a handle on me.


An excellent comment, Robert, and right on target. Introductions are important. 




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