physical examination of the patient Flashcards
(46 cards)
what are we expected to be able to examine
- Physical Examination Pulse
- Oxygen Sats
- Aural/Tympanic Temperature
appropriate greeting to patient
professional:
- say good morning
how do we introduce ourselves to the patient
by name AND as the pharmacist
“Good morning, my name is Heer and I will be your pharmacist for today”
How are you today?
What do we do after we introduce ourselves
Confirm patient’s identity (minimum of two patient identifiers)
- ‘Could I just confirm your full name, your address, your age (ask for D.O.B too)
e.g
“Could I just confirm your full name and date of birth, please? And can you also tell me your address [or NHS number], just to make sure I’ve got the correct details?”
how might we then discuss the structure of consultation in the introduction
“Thanks for confirming your details. Just to explain what we’ll be doing today — I’ll be carrying out a short physical examination that involves three routine checks:
First, I’ll use a small device called a pulse oximeter that clips onto your finger. This will measure both your heart rate (or pulse) and your oxygen saturation levels — that tells us how much oxygen is circulating in your blood.
Then, I’ll take your temperature using a tympanic thermometer, which is gently placed in your ear.
It’ll only take a few minutes, and I’ll talk you through each part as we go. If anything feels uncomfortable or you have any questions, just let me know
Explain the procedures for pulse oximeter
- turn on the pulse oximeter
- ensure finger is clean (no nail varnish etc)
- position the probe so it is placed symmetrically on both sides of the finger
- allow up to 30-60 seconds to detect the pulse and calculate oxygen saturation
- record both values accurately
Explain the procedures for the thermometer
- wash your hands
- select an appropriate thermometer and check that it is working correctly
- put probe cover on and thermometer will beep and turn on
- fit the probe snugly into the ear canal and push the start button
- a long beep means it has been measured
What do we have to get before we start the consultation
Seek consent to go ahead with consultation
how can we seek consent to go ahead with consultation
“Do I have your consent / are you happy for me to go ahead with these checks?”
Last thing to do before you start
decontaminate hands e.g. by washing or with sanitiser
what are the ‘vital signs’
- temp
- pulse rate
- respiratory rate
- blood pressure
- O2 saturation
- conscious level
- capillary refill time
why are the vital signs key
do not indicate a specific disease, but together help give warning of a serious illness
calgary-cambridge guide to the medical interview steps
- initiate the session: explain who you are
- gather information: is it the right patient? D.O.B, address, name.
- ask for consent, then gather any medical history and any info about the patient
- explain the procedures for both pulse oximeter and thermometer
- carry out the physical examination
- explanation and planning: e.g. if BP too high, tell them exact number, what range they should be, what it means and what to do
- close the session: any other q’s? give safety netting: that they can come back at any time to ask anything else too
measuring vital signs steps generally:
- wash hands
- introduce self
- confirm patient identity
- explain procedure and gain consent
- take medication history (meds taken & allergies)
- take measurements
- feedback to patient and then thank them
- wash hands again
pulse oximeter analytical check list marks
- turn on the pulse oximeter
- ensure finger is clean (no nail varnish etc)
- position the probe so it is placed symmetrically on both sides of the finger
- allow up to 30-60 seconds to detect the pulse and calculate oxygen saturation
- record both values accurately
aural temp check analytical list marks
- attach a new probe cover
- ensure the thermometer is on and ready to take a reading
- ensure patients feet are together, arms by their side, and facing ahead
- gently pull the pinna of the ear backwards and slightly up
- insert the covered probe into the patients ear
- press the thermometers button to start the reading
- wait for the thermometer to signal a reading has been taken (usually a long beep)
- record the temp accurately
- dispose of the probe cover in clinical waste
what does the oxygen saturation reading mean
oxygen levels in ur blood
measuring temperature: using the digital thermometer steps
- wash your hands
- select an appropriate thermometer and check that it is working correctly
- put probe cover on and thermometer will beep and turn on
- fit the probe snugly into the ear canal and push the start button
- a long beep means it has been measured
normal temperature range:
35.8-37.2 degrees
what if my temp is too high
you may have a fever, so focus on hydrating, resting and you can take otc meds like paracetamol.
when to seek help from a fever
if above 39.4 degrees, persists for more than a few days, or is accompanied by other symptoms like a rash
what if my temperature is too low?
e.g. if below 35, seek medical health as could be hypothermia which needs to be treated promptly
what does a series of short bleeps (temp measuring) indicate?
that the probe is not positioned correctly, or the ear canal was moved during measurement
what is pulse oximetry a method to measure
the oxygen saturation of the blood
