Chief complaint: Difference between revisions
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Other terms sometimes used include '''Reason for Encounter''' ('''RFE'''), '''Presenting Problem''', '''Problem on admission''' and '''Reason for Presenting'''.{{fact|date=November 2011}} |
Other terms sometimes used include '''Reason for Encounter''' ('''RFE'''), '''Presenting Problem''', '''Problem on admission''' and '''Reason for Presenting'''.{{fact|date=November 2011}} |
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Analyzing for the chief complaint involves assessment using the acronym [[Socrates (pain assessment)|SOCRATES]] |
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==Prevalence== |
==Prevalence== |
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Revision as of 06:07, 13 June 2012
The Chief Complaint formally known as CC in the medical field, or termed Presenting Complaint (PC) in the UK, is a concise statement describing the symptom, problem, condition, diagnosis, physician recommended return, or other factor that is the reason for a medical encounter.[1] The patient's initial comments to a physician, nurse, or other health care professional help form the differential diagnosis.
In some instances, the nature of a patient's chief complaint may determine whether or not services are covered by medical or vision insurance.[2]
Medical students are advised to use open-ended questions in order to obtain the presenting complaint.[3]
Other terms sometimes used include Reason for Encounter (RFE), Presenting Problem, Problem on admission and Reason for Presenting.[citation needed]
Analyzing for the chief complaint involves assessment using the acronym SOCRATES
Prevalence
The collection of chief complaint data may be useful in addressing public health issues.[4] Certain complaints are more common in certain settings and among certain populations. Fatigue has been reported as one of the ten most common reasons for seeing a physician.[5] In acute care settings, such as emergency rooms, reports of chest pain are among the most common chief complaints.[6] The most common complaint in ERs has been reported to be abdominal pain.[7] Among nursing home residents seeking treatment at ERs, respiratory symptoms, altered mental status, gastrointestinal symptoms, and falls are the most commonly reported.[8]
| Type of history | CC | HPI | ROS | Past, family, and/or social |
|---|---|---|---|---|
| Problem focused | Required | Brief | N/A | N/A |
| Expanded problem focused | Required | Brief | Problem pertinent | N/A |
| Detailed | Required | Extended | Extended | Pertinent |
| Comprehensive | Required | Extended | Complete | Complete |
See also
References
- ^ http://www.usc.edu/health/uscp/compliance/tm6.html#6
- ^ Optometric Management
- ^ sBMJ | Taking a history: Introduction and the presenting complaint
- ^ http://www.cdc.gov/PHIN/architecture/implementation_guides/Healthcare%20Related/PHIN_Healthcare_Encounter_Chief_Complaint_v231.pdf
- ^ Nelson, E; Kirk, J; McHugo, G; Douglass, R; Ohler, J; Wasson, J; Zubkoff, M. (1987). "Chief complaint fatigue: a longitudinal study from the patient's perspective". Fam Pract Res J. 6 (4): 175–88. PMID 3455125.
{{cite journal}}: Cite has empty unknown parameter:|author-name-separator=(help); Unknown parameter|author-separator=ignored (help); Unknown parameter|month=ignored (help) - ^ Emergency Medicine
- ^ Graff, LG 4th; Robinson, D. (2001). "Abdominal pain and emergency department evaluation". Emerg Med Clin North Am. 19 (1): 123–36. doi:10.1016/S0733-8627(05)70171-1. PMID 11214394.
{{cite journal}}: Cite has empty unknown parameter:|author-name-separator=(help); Unknown parameter|author-separator=ignored (help); Unknown parameter|month=ignored (help)CS1 maint: numeric names: authors list (link) - ^ Ackermann, RJ; Kemle, KA; Vogel, RL; Griffin, RC Jr (1998). "Emergency department use by nursing home residents". Ann Emerg Med. 31 (6): 749–57. doi:10.1016/S0196-0644(98)70235-5. PMID 9624316.
{{cite journal}}: Cite has empty unknown parameter:|author-name-separator=(help); Unknown parameter|author-separator=ignored (help); Unknown parameter|month=ignored (help) - ^ "Evaluation and Management Services Guide" (PDF). www.cms.gov. December 2010. Archived from the original (PDF) on 2012-04-11. Retrieved 2011-02-27.
External links
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