Injury while kayaking - p.2
Patient Presentation (day 8): The group has been unable to travel due to high wind and waves. The patient states that he has been treating his finger per your recommendations of increasing frequency of hand washing and topical application of antibiotic ointment on the affected tissue. However, he approaches you two days later, complaining of feeling unwell.
Initial Assessment: You observe that airway, breathing and circulation are adequate and that no loss of consciousness or no back or neck trauma has occurred.
Focused Assessment:
Vitals
Skin is sweaty and warm. HR 90 RR 15.
Physical Exam
The physical exam reveals that the patient’s left index finger is still swollen and red. Additionally, you notice some
red streaking on the inside of his arm.
SAMPLE
The patient reports that he started feeling unwell the previous night. He complains of feeling weak and of some joint
pain in his hand and elbow. He states that he slept poorly and woke up covered in perspiration. He thinks that he
may have a fever. He also complains that his left armpit feels tender.
What’s next?
Provider questions:
Initial Assessment: You observe that airway, breathing and circulation are adequate and that no loss of consciousness or no back or neck trauma has occurred.
Focused Assessment:
Vitals
Skin is sweaty and warm. HR 90 RR 15.
Physical Exam
The physical exam reveals that the patient’s left index finger is still swollen and red. Additionally, you notice some
red streaking on the inside of his arm.
SAMPLE
The patient reports that he started feeling unwell the previous night. He complains of feeling weak and of some joint
pain in his hand and elbow. He states that he slept poorly and woke up covered in perspiration. He thinks that he
may have a fever. He also complains that his left armpit feels tender.
What’s next?
Provider questions:
- How has your assessment of this patient changed?
- Given the patient’s condition and the weather forecast, what is your plan?
