Check out January’s EMS World magazine for the first of a series of patient assessment articles by myself and my cohort, Mr. Gene Gandy.
Assessing the Patient With Altered Mental Status.
With Altered Mental Status, would that be you or the patient? That bit always confuses me.
I’m going to call you out on question #6. In this day of identity theft, I don’t think it’s ethically sound to ask someone with an altered mental state to publicly disclose their Social Security number!
How about asking them their zip code instead?
Here’s the problem I see with zip code is what about people with multiple zip codes? For all intents, my home address is near school, but for tax reasons my “permanent” address is at my parent’s house about 2 hours away from where I currently live. So, do I answer with the zip code for where I live, or the zip code for my “permanent” address, which includes what is listed on my drivers license?
It shouldn’t really matter, as long as you know what you are telling them. Tell them what is on your DL, since we will often be looking at that to compare answers. This isn’t for a background check, just for mental status.
I think it’s perfectly ethical. It’s part of the demographic information we get on just about every patient. However, I understand when people are reluctant to give it. In fact, that’s a pretty good demonstration of present mental capacity, in itself: “Patient refuses to provide SSN, citing identity theft concerns.”
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You called Gene Gandy a cohort. You’re in trouble.
On the Social Security number, I don’t even like to give it to my employer. I do not like to volunteer that to anyone else. Pennsylvania used to include that on all continuing education documentation. Due to the concerns about identity theft, they haven’t for 5 – 10 years.
On the other hand, we usually obtain the patient’s SSN and provide that to the hospital registration people, so asking it as part of a mental capacity exam, when it will be asked later on for billing purposes, should not be a problem.