Respiratory Exam

Intro

Candidate introduces self with full name and role

Adheres to appropriate infection control measures

Asks the patient if they are in any pain prior to beginning examination

Gains consent

Initial Inspection

Assesses patient from the end of the bed

Identifies findings around the examination space e.g. inhalers

Peripheral Examination: 

Checks hands and nails

Tests cap refill

Checks skin turgor

Palpates radial pulse

Checks for asterixis

Checks eyes

Checks mouth

Palpates cervical and supraclavicular lymph nodes

Checks JVP

Requests a set of observations including resp rate and O2 sats

Respiratory - Look

Adequately exposes patient and visualised chest

Assesses respiratory rate

Comments on shape of chest / accessory muscles / respiratory distress

Respiratory - Feel

Palpates tracheal position

Palpates chest expansion

Offers to perform tactile vocal fremitus

Percussion of chest - ensure percussion over entire chest including supraclavicular

Respiratory - Listen

Auscultates anteriorly and posteriorly including over apices, chest wall, bases and axilla

Listens on each side alternately to compare sounds

Auscultates for vocal resonance

Peripheral Examination continued

Assess the calves for signs of Deep vein thrombosis

Checks for sacral oedema and peripheral oedema in legs

Complete Examination

Prompts patient to redress

Summarises by stating they would complete a full respiratory history, review the patients notes, and offers to discuss with senior

Diagnosis and Interpretation

Requests appropriate investigation (Bedside, Bloods, Imaging, Special tests)

Gives appropriate differential

Management

Offers an appropriate management plan

Submit