Hello, med students. My name is Zach Olson, and thank you for downloading this week's episode of the EM

Clerkship podcast. We've been working our way through a series of episodes on specific tips to

crush your slow. How would I train you? What specific tips would I give if I knew that you were

going to come and rotate with me at my hospital in my department? We have covered the first 10 tips these last

couple weeks. So if you haven't checked those out yet, go ahead and start there. But now we're getting

into like the really good stuff. So tips 11 through 15 this week. And the overall theme today is going to be your history.

How to take a great history from the patient that is both efficient, but still allows you to give like a great thorough, impressive presentation to the attending. What are the most

high-guiled things you can ask about when taking a history that your attending actually needs?

And that when you put it in your presentation, they're going to be really impressed by and

you're going to actually help them out. The patient history is the foundation that a great

presentation is built on. what do you need without getting

bogged down in detail and delaying care too much because you're just like asking about everything

does that make sense that's what we're focusing on this week starting with tip number 11 so this is

actually a billing tip and it carries over into your presentation.

And so to bill a level five chart, you need four descriptors. Level five chart is the highest

level build chart. And so in almost, I will say in all, all patients that come to the emergency

department, you should be getting four descriptors describing each complaint that the patient has every time. And so the way it

typically works is attendings and residents, they're going to take those four descriptors. They're

going to put them in the chart. It makes the level five chart. It's called four descriptors.

That's what we're, that's what you need to ask on history. That's what I would be wanting anyways. And I would love any student who clearly laid it out for me because have you seen attendings where they're kind of documenting as you talk? I mean, if you did this, this is like what they need. So what are the descriptors? What are, what's a descriptor? You've heard of like O PQRST or Codiers.

There's lots of mnemonics that you learned for your med school oskies that you need when taking a history.

So you can use whatever one of those you like.

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