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Use of language interpreter — best practices (LEARN).
LEARN: Listen, Explain, Acknowledge, Recommend, Negotiate; use
certified interpreter (not family); speak to client (not interpreter);
short sentences; verify understanding/teach-back.
Gender-inclusive practice
Use "partner" instead of "husband/wife"; ask preferred name and
pronouns
Expected appearance
Clean, appropriate dress, alert, no acute distress
,Expected skin findings
Intact, warm, even tones
Unexpected skin tones (PCJE)
Pallor, Cyanosis, Jaundice, Erythema
Diaphoretic skin suggests
Fever, shock, or pain
Unexpected skin temp/moisture
Cool, hot, sweaty (diaphoretic), or clammy
Facial features expected
Symmetrical movement
Facial features unexpected
Droop, mask-like face, twitching, lesions, swelling
, Emotional state expected
Relaxed, cooperative
Emotional state unexpected
Grimacing, restlessness, tearful, withdrawn
Eye contact expected
Appropriate for situation (consider culture)
Eye contact unexpected
Avoidance (anxiety/confusion/defensiveness); penetrating stare;
squinting
LOC ladder
Alert → Lethargic → Obtunded → Stupor → Coma
Alert
Awake; oriented ×4 (person, place, time, situation)