number of elements

ggparker14

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I would like other's opinions on number of elements in following HPI:

Presented to the ED triage area ambulatory with the complaint of migraine headache. Has had headache since yesterday. Said this is like his typical migraine.

Thanks for any help.
 

btadlock1

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I would like other's opinions on number of elements in following HPI:

Presented to the ED triage area ambulatory with the complaint of migraine headache. Has had headache since yesterday. Said this is like his typical migraine.

Thanks for any help.
Not much...
Definitely Quality (Migraine) & Duration (Since Yesterday)
Maybe location (headache), and if you're feeling really creative, Severity ('typical')
I'd really caution against using Severity, though - saying that something is 'typical', doesn't really tell you anything - what's 'typical' for this person, may be extreme, or mild, for anyone else. Overall, I'd score this HPI as brief.
 

ollielooya

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Yep, another classic case of an HPI that is "straddling the fence" with the questionable 4th element. I was wondering about this too, Brandi. My first thought was that "typical" statement might be considered, but it's too bad (with a migraine) that severity was not clearly documented. Wondering how others might regard this?
 

MnTwins29

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Brief

I agree with a brief HPI of three elements - location, quality and duration. Brandi already stated my reason for not using "typical" - what is typical for one patient is not necessarily "typical" for another. And just what IS a "typical" migraine? OUCH! :eek:
 
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