Clinical Skills

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Put the steps in order for when doing a CVS examination

تطابق النص (انقر واسحب)   

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انقر واسحب

Inspect chest - scars, asymmetries

Cap refill (hold for 5, less than 2 seconds refill)

Radial pulse, radio-radial delay

Palpate apex beat - 5th ICS, mid clavicular

JVP

Auscultate lung bases

Face - eyes for xanthalosma, lips, tongue, teeth for dental caries

Feel carotid and ausculate valves with bell and diaphragm. Listen to axilla with diaphragm (mitral regurg)

Carotid pulses

Collapsing pulse

Listen to carotids with diaphragm/bell whilst patient holds breath

Thank patient and wash hands

Sit patient forward and listen over lower left sternal edge with diaphragm in expiration

Brachial pulse, mention BP

Ask about pain/tenderness

Pre-warn patient of possible discomfort, gain consent, adequate exposure

Feel for thrills (over valves) and heaves (left sternal edge)

Explain reason for exam. and outline what it will consist of

Check for sacral and peripheral oedema

Feel carotids and ask patient to roll on to left side - listen to apex

Hands - clubbing, Janeway lesions, Osler's nodes, splinter haemorrhages, colour, tar

End of bed inspection - GTN, monitors etc, breathless, sweating

Wash hands, introduce yourself, ask patient's name and DOB


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448333
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