Notes
Slide Show
Outline
1
Techniques of the Comprehensive Physical Examination
  • Medic 1
  • Paramedic Education Program
2
Objectives
  • Review the general approach and systematic method used in performing a comprehensive PE
    • Pathophys will discuss abnormal findings specific to disease
    • Patient Assessment will discuss focusing the PE as needed
    • Use small group discussions to define the issues
3
Discussion Groups
  • Group 1
    • Andre, Rob, Frank
  • Group 2
    • Jennifer, Joe, Chad
  • Group 3
    • Sam, Cliff, Mary
  • Group 4
    • Jessy, Janis, Brandi
  • Group 5
    • Brian, Kristin, Gordon
4
Discussion Group Guidelines
  • Work as a Team
  • Everyone contributes to the success & failure of the Team
  • Respect each team member’s ideas
  • Rotate the role of team leader, note-taker, and spokesperson
  • Open your minds; Think Broadly
  • Learn from each other
5
What is the purpose of a Comprehensive Physical Exam?
  • Why is it performed?
    • What should you expect to gain from it?
    • What should you not expect to gain from it?
  • Group Discussions
6
Techniques Used in Physical Exam
  • Inspection
  • Palpation
  • Percussion
  • Auscultation
7
Percussion
8
Tools of the Physical Exam
  • Stethoscope
  • BP cuff
  • Otoscope
  • Ophthalmoscope


  • Can you think of any other tools?
9
Other Data Obtained
  • Vital Signs
    • Pulse
    • Ventilations (Respirations)
    • Blood Pressure
    • Temperature
  • Height
  • Weight
  • Spo2
10
Pulse Points
11
Breathing Patterns
12
Elements of the Comprehensive Physical Exam
  • General Survey
  • Mental Status
  • Vital Signs
  • HEENT
  • Neck
  • Chest
  • Abdomen
  • Pelvis (as needed)
  • Posterior Body
  • Extremities
    • Vascular
    • Musculoskeletal
  • Neurologic Exam
13
In the Beginning
  • Begin with Detailed Exam or Focus on CC?
    • What determines the direction you take?
    • Why?
14
Mental Status
  • AVPU vs A&O X 4
    • What’s the difference?
    • When do you use one vs the other?
  • Non-Useful Terms to Avoid
  • What are other ways of assessing?
  • What does mental status tell you about the patient?
  • Group Discussions
15
General Survey of the Patient
  • What should we look for?
    • Why?
    • What do these things tell us?
16
General Survey of the Patient
  • Appearance & Behavior
    • Posture & Motor Activity
    • Dress, Grooming & Personal Hygiene
    • Facial Expression
    • Speech & Language


    • Mood
    • Thoughts & Perceptions
    • Insight & Judgment
    • Memory & Attention
17
General Survey of the Patient
  • Class Exercise
    • You will have 3-5 seconds to view a scene and patient
    • Once you have done this, return to your group and write down everything you know or suspect about the patient
18
 
19
General Survey of the Patient
  • Apparent State of Health
    • Before beginning the actual physical exam,
      • What are the clues?
      • What might they tell you?
      • How would these things affect your physical exam?
  • Group Discussions
20
General Survey of the Patient
  • General Physical Appearance
    • Height, Weight & Build
    • Sexual & Physical Development
    • Posture, Gait & Motor Activity
    • Hair, Nails & Skin appearance
    • Dress, Grooming & Personal Hygiene
    • Odors
    • Facial Expressions & Body Language
21
Additions to the General Assessment
  • Vital Signs
    • Blood Pressure
      • Palp or auscultated
    • Pulse
      • Pulse or Heart Rate
    • Ventilations
      • Ventilations or Respirations
    • Pulse Oximetry
    • Temperature