This was the first virtual session that Alex and Mike from Marjon Sport and Health Clinic led. The main topic discussed during the session was the subjective assessment. For our own development we also got given two tasks that needed to completed by the subsequent session so it could be conversed. This included a case study which presented the subjective information and a research task about medication.
| Reflective Summary
In order for the subjective assessment to be both efficient and effective, we can use a specific format so that nothing gets missed. There are 6 headings which areas can be grouped into: general health and contraindications, history of present condition (HPC). past medical history (PMH), medications, social and family history and aggravating/easing factors. This will allow us to get a thorough picture of the patient’s present condition, understanding what the client wants out of the appointment and if they have any concerns. As we had only recently learnt about Vertebral Basilar Insufficiency (VBI) in lectures, it was good to recap this red flag as I was previously confused by it. I now feel a lot more confident on the signs and symptoms of VBI, the most significant symptom being the onset of sudden neck pain that is unfamiliar to the patient. Signs and symptoms can be remembered by “the five Ds” which are dizziness, Diplopia (double vision), Dysarthria (difficulty with speech), Dysphagia (difficulty swallowing), Drop attacks (loss of consciousness) and “the three Ns” nausea, numbness in the face and Nystagmus (repetitive uncontrolled eye movement). When asking your client about aggravating/easing factors it is also important to gauge if they have had any previous treatment if so what. We want to know this to see if there was a particular treatment that they found was effective so we can incorporate this into the appointment. As well as treatment, we want to know if they have tried ant form of exercise-based rehab to see if they engaged with it and if not why. This can help you to understand what needs to be changed from previous experiences. Areas for further improvement My first area for further improvement would be to become more familiar with the format of the clinical notes, so once we are able to treat clients again in the Marjon Sport and Health Clinic, I will be able to complete this confidently, collecting all the important information that is needed. I also need to consider the clinical value of special tests so that I am selecting the tests which have a high clinical value, in order to make the most accurate judgement. For example, I am now aware that the extension rotation test for VBI is weak so may consider their symptoms more than the outcome of the test. My final area for improvement would be to revise what is included in each part of OLDCARTS, so when I am completing HPC it is done efficiently and with all the necessary information. Things to Remember:
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