Ripping the Myth: Patients’ Symptomatic Descriptions of Acute Thoracic Aortic Dissection

Abstract

The objective of this retrospective project was to assess the frequency with which patients presenting to an emergency department had used the descriptive terms "ripping" and "tearing" to describe their symptoms from later-confirmed acute thoracic aortic dissection. METHODS METHODS The authors conducted a retrospective chart review from 58 patients who had presented to two suburban and urban emergency departments with suspected acute thoracic dissection between 1997 and 2015. They reviewed charts for patients' pain descriptors in ambulance personnel records and initial notes and dictations from ED triage nurses, staff nurses, and physicians. These pieces of documentation would have been made before the diagnosis of acute thoracic aortic dissection could been confirmed. RESULTS RESULTS The authors identified a sample subset of 29 (50% of total charts pulled) patients later confirmed to have had an acute thoracic aorta dissection. They found that no sample patients used either the descriptors "ripping" or "tearing" when communicating their presenting symptoms. In this paper, the authors will provide several alternative terms patients have been shown to offer for this life-threatening condition. CONCLUSIONS CONCLUSIONS Although the terms "ripping" and "tearing" have historically been associated with acute thoracic aortic dissections, these project results indicate that clinicians may consider other descriptive symptomatic terms from patients when evaluating patients' symptoms for this potential life-threatening condition.

The Use and Structure of Emergency Nurses’ Triage Narrative Data: Scoping Review

“…There were 27 studies that reported on the specific keywords that were present within the narratives [ 38 - 41 , 43 , 79 , 81 , 83 , 86 , 89 - 93 , 95 , 99 , 101 , 102 , 104 , 107 - 111 , 117 , 118 , 125 , 126 , 131 ]. The number of keywords ranged from 1 [ 101 ] to >160 [ 39 ], with a median number of 11 (IQR 3-24.5) keywords reported ( Table 4 ).…”

“…However, 11% (3/27) of studies did not report the exact number of keywords used [ 38 - 40 ]. The authors reported the use of express keywords with correct spellings [ 86 , 93 , 101 , 107 , 109 - 111 ] as well as intentional variations such as misspellings, abbreviations, or truncations [ 39 , 40 , 81 , 92 , 108 ]. One of the studies searched for terms using keywords in 2 languages (English and French) [ 95 ].…”