What sections are in a respiratory exam?
Initial Assessment Introduction and Consent General Overview Hands Head Neck Front of Chest Back of Chest Closure
What do you do in the initial assessment and introduction of a respiratory exam?
- does patient need life-saving intervention?
- are they well enough to proceed with examination?
- inspect environment (oxygen, vomit, sputum, medication)
- Clean hands
- My full and role
- Check patient’s full name and date of birth
- Confirm with wristband
- Explain procedure and obtain informed consent
- Position bed at appropriate height and patient at 45deg
- Check charts if available
What are you looking for in the hands during a respiratory exam?
Tar staining Peripheral cyanosis Clubbing CO2 retention - flapping tremor - warmth/pinkness
Pulse and respiratory rate
What are you looking for in the head and neck during a respiratory exam?
Central cyanosis in tongue
Conjuctivae for pallor
Assess tracheal position
Nodes if asked
Distance from laryngeal prominence to sternal notch
What is the procedure for inspecting the front of the chest during a respiratory exam?
- lesions, dilated veins
- Apex beat
- expansion (upper and lower)
- clavicle + 3 + axilla
- breathing in same areas as percussion
- deep breaths through mouth
- vocal resonance in same areas
- listening for vesicular vs bronchial
- sound intensity
- added sounds (rub, wheeze, crackles)
- inspiratory or expiratory sounds?
What is the procedure for inspecting the back during a respiratory exam?
Same as front
- upper and lower expansion on palpation
- percuss/auscultate each lobe