MSE more than A&O x4....
The Mental Status Exam, or MSE from now on, is one of the most critical exams a paramedic or first responder must master. Why? We have developed the 3 C's of setting the tone, right? (I hope you read those posts, if not take a quick look). CONVICTION is a critical component to setting the tone as is CONFIDENCE. But, how do you act confidently when dealing with the difficult patient while being convicted about the fact that you have a duty to act? This can be difficult, no doubt about it. However, taking time to understand the principles of a good mental status exam makes it much easier to operate confidently. So where should you start when looking at developing your methodical approach to the mental status exam? Well, you need to be very versed in your medical directors guidelines and intent. You MUST understand what the medical director has asked of you and what they have taken the time to articulate as their INTENT. The first place to start is the guidelines or protocols dealing with Decision Making capacity, consent, and refusals. These things have been provided as a guide in helping you determine what their intent is. Secondly, it is the best place to start when developing your own methodical approach to the mental status exam. The MSE is extremely important for EMS providers, and yes there is much more to it than A&O x4. So, stay tuned as we develop the principles of the MSE. In the meantime get in your guidelines and take a look so you can be more PREPARED to make the difficult decisions later. And as always, own the day and go out the door with intent.
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