Excretion means urination and defecation. It is sufficient to find out the frequency and the condition as well as color and smell of the urine and stool. If the patient has abdominal pain, be sure to collect urine in a paper cup or other container and examine it before throwing it away. Small urinary stones that are excreted are sometimes overlooked. Pain associated with excretion is also an important symptom.
States of consciousness are classified in various ways, but you should know at least the following four categories.
1]Lucid: Normal state of consciousness
2]Semicomatose: Falls asleep immediately unless stimulated (same as somnolence)
3]Comatose: Does not react to any stimulus
4]Delirium: The patient has impaired consciousness and cannot converse, but nervous activity is strong. Patient is excited and hallucinates.
Even if symptoms are described in detail in communications from a ship, since the doctor is not able to examine the patient, the diagnosis can only be a conjecture. Inevitably, the doctor must often say "XX is suspected", and indicate treatment for the time being. On the other hand, you may be more interested in knowing how to treat the patient than in obtaining an exact diagnosis. For this purpose, it is necessary that questions be written clearly.
Body position and skin condition can be observed whether or not the patient is conscious. Skin condition includes skin color (yellow, pale, etc.), sweat, moistness, and elasticity.
Body position means the position of the patient when lying down (on his back, on his right side, etc.). If the patient is suffering from chest or stomach pain, he may not be lying down, but sitting up and gasping for breath. The patient will most likely be in whatever position is most comfortable.
3 Past history (see the patient's MEDICAL RECORDS)
Be sure to write down any chronic disease the patient have had before boarding ship, or any illness for which he is taking medication. Important past history includes high blood pressure, diabetes, heart disease, and epilepsy. Some people are prone to recurring conditions such as ureterolithiasis. Noting "had appendectomy" is acceptable, but simply noting "has appendicitis" is not sufficient information.
If a patient has allergies, find out the cause of allergy in as much detail as possible. Try to determine what foods or medication caused the allergic reaction.
