Clinical Scenarios and Testing Protocols

Clinical Scenarios and Testing Protocols

There are a number of clinical scenarios where it is predictable that a clinician will need and order a specific point of care test.  Therefore, when rooming the patient with the following clinical scenario, the staff that is rooming the patient should perform the appropriate test and record the results in the Labs/Procedures section of the full encounter note.

1.      Sore throat, age 4 – 20:  obtain quick strep.  A quick strep is not necessary if the patient has a sore throat and a red rash (scarlet fever), or a close contact with a recently documented strep infection. 

2.      Abdominal pain, nausea, or vomiting in a female aged 15-45:  consider obtaining urine pregnancy test.

3.      UTI or other urinary symptoms (burning, frequent urination, blood in the urine):  obtain a urine dip.

4.      Confusion, loss of consciousness, or altered mental status:  obtain pulse ox and fingerstick glucose.

5.      Vaginal discharge: 

a)     Patient undressed from the waist down

b)     Prepare room for wet prep swab and GC/Chlamydia

6.     Female with acute lower abdominal pain (and no history of hysterectomy)

a)     Age 12-50:  consider urine pregnancy screen

b)     Patient undressed from the waist down

c)      Prepare room for wet prep swab and GC/Chlamydia

7.      Acute chest pain:  obtain 12-lead EKG and pulse ox.

8.      Palpitations, new or acute complaint:  obtain 12-lead EKG

9.      Tachycardia (over 110 bpm) or pulse irregularity during vitals, and no obvious cause listed on the medical history:  consider obtaining 12-lead EKG and a rhythm strip

10.  Dizziness or syncope:  standing and lying down pulse and BP (orthostatics)

11.  Worried they may have diabetes:  obtain fingerstick glucose

12.  Complaints of excessive thirst:  obtain fingerstick glucose