Medical History Form Patient Name Date Of Birth Medical History Do You Have Or Have: Fill & Download for Free

Suggested starting point: As an AEMT, how do I ask a transgender person for their biological gender without being offensive?Also suggested: New article identifies issues for transgender treatment in emergency departmentsWhen you’re pulling health history from a trans patient assumptions can make your life difficult and many healthcare intake processes aren’t designed to catch trans people in a normal intake.Last time I did an intake (two weeks ago), the nurse doing the intake never noticed that I’m trans and the only clue the surgeon had was that my medications included a really high dose of spironolactone (okay, it’s not high for trans people but if you’re used to spiro in other contexts, it’s really high.)If you don’t know that the person you’re talking to is trans, and if they don’t volunteer that information (given the rates at which trans people are assaulted and harassed by medical providers there are reasons that many of us won’t tell medical providers that we’re trans) you may not have any indication that they are trans.If you know that they’re trans, making sure that you are using their name and preferred pronouns (if you don’t know, ask) and then let them know that you need to get some medical history information from them, some of which may pertain to the gender they were assigned at birth and their transition history.The important thing for health providers to understand is that trans people have a really hard time trusting medical care providers and you need to understand why this is sensitive… it’s not just about respecting our identity, it goes further than that.Nearly 1 in 5 transgender people have been denied medical care for being transgenderOver 25% of trans people have been harassed by care providers2% of trans people have been victims of violence in doctor’s offices, 1% were victims of violence in emergency roomsMore than 25% of trans people have delayed seeking treatment for fear of harassment in medical settings, 1 in 3 have delayed preventive care for the same reason.[1]If you want actual and effective methods of gathering information, it needs to happen at an organizational and process level. Patients need to be given an opportunity to self report transgender status and they need to be made aware that it is safe for them to do so. Medical intake forms need to be designed in a way that allows you to gather health information from transgender patients which may pertain to the gender they were assigned at birth rather than the gender they identify as.Going back to my recent intake: The patient medical history process was digital and one of the things I appreciated is that I was able to mark N/A on every piece of medical history that pertained to having a uterus (when was your last period, are you undergoing menopause, etc.) That’s good. What’s not good is that there was nowhere that the process captured information about things like date of last prostate exam. For trans men who may have marked “Male” on the form, it is unlikely they would have been presented an opportunity to provide potentially relevant information that pertains to having a uterus (all of those things I marked N/A to.)I wish I could give you something simple and easy. Some phrase you could use or questions you can ask. The truth, sadly, is messier than that and real effective change is going to have to come from institutions. If providers join the push for tools that allow them to effectively identify and treat trans patients, that kind of pressure from within the system can be a significant part of achieving that change.As always, I’m available in the comments for further questions and to expand on any of the above.Footnotes[1] http://www.thetaskforce.org/static_html/downloads/reports/reports/ntds_full.pdf

Most definitely - I had a young woman admitted with a broken leg onto the orthopaedic trauma unit I worked on during my degree- I was told to keep a close eye on her apparently she was diabetic, and god knows what else she came up with. We asked how she broke her leg she said she fell! Seemed a bit odd to dismiss a compound fracture as a just fell off a kerb kinda thing but we couldn’t prove otherwise.anyway whilst assisting other patients I turned around and noticed this woman stuffing chocolate in her mouth , I didn’t think anything of it but later on thought it was a weird thing to do considering she was an insulin dependent diabetic! I asked her why she had chocolate and not requested we did a blood sugar first and she stated it was because her sugars were so low she needed it immediately! Again, odd!A couple of hours later we found her unresponsive did a Bm and found her to with seriously low sugar levels - that didn’t match either considering we gave her insulin to her as her sugar levels were really high half hour earlier!This continued for a day or so until the ward manager called the staff to the front desk and stated something was very wrong with our patient - her name hospital number and date of birth were registered with a hospital in reading about 45 miles away and it had flagged on the database as she seemed to be the same patient in 2 hospital trusts! Discreetly we had security attend the ward and hang around to monitor this lady’s movements as above all else her medical history stated NO form of diabetic diagnosis or broken leg!after close monitoring we discovered she had been stealing the insulin from the drug trolley when our back were turned and self administering to keep herself in our hospital! The police were called to remove and arrest her for theft, falsifying medical information, identity theft and there was a few more things, when we removed her bag from the locker it was rammed with all the missing drugs and insulin stolen from our ward and the ward she was on previously that was being investigated and we knew nothing about! Even as removed from us wearing handcuffs she was still screaming she needed her meds lol! She deffo needed psych meds no doubt! We never found out who she really was but we did discover she had munchausens syndrome!I must admit I was fascinated by her condition and went on to do my dissertation on munchausens as well as having direct conversations regarding the condition and research with the guy who first put this set of symptoms together and named them as munchausens- hell, I’m still fascinated by the motivation for this illness!

At the onset of symptoms, this is what you need to do.Firstly, you need to be calm. This in turn will help the patient to be calm. We need to make sure we don’t contribute to a rise in blood pressure.Assist them to sit down. Somewhere near their front door would be ideal. Lots of well-meaning relatives will assist the patient upstairs to bed so they can lie down. This just means the paramedics are going to have to carry them down a flight of stairs (which wastes precious time). If you are already upstairs, just sit them down. Don’t try taking them downstairs yourself. There is a high risk of sudden unconsciousness - you do not want to be halfway down a flight of stairs when this happens.Call for an ambulance. Tell them you suspect the patient is having a heart attack. Tell them who the patient is and precisely where you are.Next return to your patient. Check they are still alert - you need to be constantly ready to deal with any potential deterioration (there is a chance you might have to perform CPR if they go into cardiac arrest).Ask them if they have any drug allergies. If they are not allergic to aspirin then you need to give them some if there is any in the house. Aspirin comes in tablet form, usually in a dosage of 75mg or 300mg each. If they are 75mg, give the patient 4 of them. If they are 300mg, give the patient 1 of them. Ask the patient to chew rather than swallow the medication (it absorbs into the blood quicker this way).Next, ask them if they have any GTN (glyceryl trinitrate). Patients who have angina will often be prescribed this medication. Ask them to take the drug as they normally would (usually it will be in a little bottle of liquid which is sprayed into the mouth).Continue to monitor and soothe the patient. Keep them calm. Assure them that help is on the way.If they are still completely alert and really uncomfortable, it is fine to give them any pain relief they might have prescribed to them. Use the standard prescribed dose.If you are still waiting for the ambulance, get a pen and paper and make some notes for the paramedics. This is really helpful and can save us some time. Note down the following:Patient’s full name.Date of birth.Address (if your location is not their home).Exact time symptoms started.Patient’s medical history. Particular attention to any heart problems.Patient’s current medications (they might have a prescription list - if so just keep it handy for the paramedics).Any allergies the patient has.Next of kin contact details.Patient’s GP/doctor’s surgey.Is patient a smoker? If so, how many cigarettes per day.Any history of heart problems in the family.If you are still waiting then just try to keep them calm and closely monitor them for any signs of deterioration. Summon help from family or neighbours if they are nearby (you might need assistance if the patient goes unconscious). You might want to have a bowl handy (patients often vomit when having a heart attack). If they do look like they might be deteriorating, assist them to the floor. Update ambulance control if they appear to be losing consciousness. Lie them flat on their back.Be prepared to start CPR (chest compressions). This you must do immediately if they appear to have stopped breathing. Be prepared to clear any vomit from their mouth. You can do this by tilting the head to one side, or roll the patient onto their side (this allows the vomit to drain naturally from the mouth using gravity - we do NOT want that vomit blocking their airway) if you have a few people to assist you. Ask someone to update ambulance control that patient has arrested.If you are performing CPR, and there are other people with you, make sure you swap who is delivering chest compressions regularly as it is strenuous work and you will quickly get tired, but make sure these swaps are fast and minimise the time when no compressions are being delivered.Continue until the ambulance crew arrives, then follow their instructions.Phew! That’s a long list of instructions right?Don’t worry about following it TO THE LETTER. It is just a basic guide designed to maximise the patient’s chances of a good recovery. Some of the elements above might not be possible depending on where you are - don’t worry about that - the main thing to remember is good communication. Summon help fast, keep patient calm and keep a close eye on them for deterioration. Usually, ambulance control will talk you through the rest.