Objective vs. Subjective Data in EMS: How to tell the difference
At first, the difference between objective and subjective data seems to be pretty simple….but dig into the data that EMS collects and you can easily find yourself second guessing just what you thought was straightforward about it.
The truth is, however, that it IS simple; we tend to overcomplicate things when we focus too heavily on them. So let’s talk about it…
Meriam Webster defines objective as an adjective “involving or deriving from sense perception or experience with actual objects, conditions, or phenomena.” This tells us that something objective can be understood by utilizing our five senses; it is either a measurement or an observation that we take note of.
A perfect example of objective data in EMS is response times. The time it takes for a unit to respond, from dispatch to on-scene of a call, can be measured with geographical analytics.
Other examples of objective data in EMS are:
- Destination time
- Chart completion time
- Time on/off chest (CPR) time
- CPR depth/rate
- EDM time to dispatch
Something that is subjective is often defined as arising out of or identified by means of one’s perception of one’s own states and processes. This is where things tend to get tricky and lead us into some rough waters. Subjective data can be gathered from multiple sources but most typically comes from the patient relaying information to the provider, and the provider relaying that information back without the use of their five senses.
For example: if a patient tells the provider they have had chest pains on and off for the past two weeks, that is subjective, it cannot be proven other than being told that is the case by the patient.
One of the most common pieces of subjective information we receive in EMS is the report of pain. Pain is subjective! The patient is relaying what their pain is to the provider and, unfortunately, there is no exact way to measure the validity of the pain scale!
To keep subjective data in EMS simple, we must ask ourselves a few questions:
- Did the patient relay this information or can it be measured?
- Did the provider observe this information?
- Is this information observable by the five senses?
- Can this information be verified?
Objective vs. Subjective Examples
Let’s pick through a scenario to separate the findings into subjective and objective categories:
As an EMS administrator, you begin reviewing a record in which the narrative states the crew responded to a 52-year-old male patient who is diaphoretic, pale, and who stated: “My chest hurts!” Per your provider’s documentation, the patient’s initial respirations are 28 times a minute, and their heart rate is 120 beats per minute. The provider relays that the patient grabs his chest and states “it really hurts, please help, I’m in so much pain.” The provider documents the patient’s pain at a 10 out of 10 on the Wong-Baker pain scale score. The provider then notes that the patient was hooked up to EtCO2 monitoring by the first responding Fire Department upon their arrival and a 12 lead was performed prior to moving the patient which showed a rhythm of Sinus Tach and 3mm elevation in the lateral leads with reciprocal changes. They relay that the patient’s initial blood pressure is 210/140. The provider treats the patient by starting an IV and giving Nitroglycerine and Aspirin. You note that the crew was on scene for 45 minutes before transport and that they spent 32 minutes at their destination.
Let’s break this down:
- Objective data:
- 52-year-old male
- Respirations 28
- Heart rate of 120
- Diaphoretic and pale
- EKG shows Sinus Tach with 3mm lateral ST elevation and reciprocal changes
- Blood pressure is 210/140
- 45-minute on-scene time
- 32 minute destination time
- Subjective Data
- The patient has chest pain
- Chest pain is 10/10 on the Wong-Baker pain scale
Why is the patient’s chest pain subjective? Because the patient is relaying this to the provider and there is no measurable way to observe this finding with the five senses. On the other hand, the diaphoresis and paleness of the patient is objective because these are observable findings that are visible to the provider.
Do you now have a better understanding of objective vs. subjective data within EMS? Many data sets that EMS administrators encounter and deal with can quickly become tricky to decipher; however, if you stick to the root of the information and keep it simple, you will be successful! You’ve got this!
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