Techniques of the Comprehensive Physical Examination :Techniques of the Comprehensive Physical Examination EMS Professions Temple College


Objectives :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


Discussion Groups :Discussion Groups Group 1 Daniel, Stephanie, Kristine, Elvie Group 2 Jennifer P, Roy, Jennifer D Group 3 Angela, Crystal, Aaron


Discussion Group Guidelines :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


What is the purpose of a Comprehensive Physical Exam? :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


Techniques Used in Physical Exam :Techniques Used in Physical Exam Inspection Palpation Percussion Auscultation


Percussion :Percussion


Tools of the Physical Exam :Tools of the Physical Exam Stethoscope BP cuff Otoscope Ophthalmoscope Can you think of any other tools?


Other Data Obtained :Other Data Obtained Vital Signs Pulse Ventilations (Respirations) Blood Pressure Temperature Height Weight Spo2


Pulse Points :Pulse Points


Breathing Patterns :Breathing Patterns


Elements of the Comprehensive Physical Exam :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


In the Beginning :In the Beginning Begin with Comp PE or Focus on CC? What determines the direction you take? Why?


Mental Status :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


General Survey of the Patient :General Survey of the Patient What should we look for? Why? What do these things tell us?


General Survey of the Patient :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


General Survey of the Patient :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 desk and write down everything you know or suspect about the patient


General Survey of the Patient :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


General Survey of the Patient :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


Additions to the General Assessment :Additions to the General Assessment Vital Signs Blood Pressure Palp or auscultated Pulse Pulse or Heart Rate Ventilations Ventilations or Respirations Pulse Oximetry Temperature