Monday 26 March, 2007

Hints and tips on the medical consultation

Posted in Advice, Emergency Dept., General Practice, Michael Tam at 21:37 by Michael Tam

Original article by: Michael Tam :: Printer friendly

Whether you are seeing a patient in an outpatient clinic, the emergency department or in general practice, the ability to engage in a medical consultation is vital to clinical practice.

The medical consultation is your basic tool and good communication is king.

Throughout all modern Australian medical schools, the idea and skills of being a good communicator is drummed into students so I won’t necessarily repeat skills that are obvious or self-evident. Rather, the following are some tricks and suggestions that may make you a better communicator.

A good way to think about the goals of a medical consultation is that it has three functions (1):

  1. Build the doctor-patient relationship
  2. Collection of data
  3. To agree on a management plan

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Wednesday 7 March, 2007

Collect blood in the serum tube first

Posted in Emergency Dept., General Practice, Michael Tam, Procedures, Wards at 22:00 by Michael Tam

Original article by: Michael Tam :: Printer friendly

Vacutainer system

This short article is relevant for those people or institutions that use vacuumed tubes for venepunction and does not apply to using a needle and syringe.

One of the disadvantages of using a vacuumed tube system for directly withdrawing blood is that there is always a possibility that the needle dislodges or that the vein collapses before all the necessary tubes are filled.

For a long time, this would involve an apology from myself to my patient and a second venepuncture to collect the necessary blood. This is actually a reason that to this day, I still prefer using a plain needle and syringe (despite the increased needlestick risk) for patients with either difficult access or who require blood in many tubes.

However, this is a trick that I learnt from experience:

Always collect blood in the serum tube first.

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