9/11/2012
Chapter 13
Detailed Physical Examination
Slide 1
Overview

Patients Needing a Detailed Examination

Examination Procedure

Assessing Vital Signs
Slide 2
Detailed Physical Examination

Patients needing a detailed examination

Patient- and injury-specific (e.g., cut finger would
not require a detailed physical exam)
 Patients with significant injuries, significant
mechanisms of injury, and unresponsive patients
require a detailed physical exam
Slide 3
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Ideally, the detailed examination should
be performed en route to the
appropriate facility.
This assessment should be performed
on unresponsive patients (trauma and
medical), provided that life threats are
managed.
Slide 4
Examination Procedure


Perform a detailed physical
examination on the patient to gather
additional information
As you inspect and palpate, look
and/or feel for the following examples
of injuries or signs of injury








Deformities
Contusions
Abrasions
Punctures/penetrations
Burns
Tenderness
Lacerations
Swelling
Slide 5
This assessment is similar to the
rapid trauma assessment. The
detailed physical examination
should be tailored to fit the needs of
each individual patient.
Slide 6
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Detailed Physical Examination
Procedure
Assess the head;
inspect and palpate
for injuries or signs
of injury


DCAP- BTLS
Slide 7
Detailed Physical Examination
Procedure

Assess the face;
inspect and palpate
for injuries or signs
of injury

DCAP-BTLS
Slide 8
Detailed Physical Examination
Procedure

Assess the ears; inspect and palpate for injuries
or signs of injury

DCAP-BTLS
• Drainage
Slide 9
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Detailed Physical Examination
Procedure

Assess the eyes;
inspect for injuries
or signs of injury

DCAP-BTLS
• Discoloration
• Unequal pupils
• Foreign bodies
• Blood in anterior
chamber
Slide 10
Detailed Physical Examination
Procedure

Assess the nose; inspect and palpate for
injuries or signs of injury

DCAP-BTLS
• Drainage
• Bleeding
Slide 11
Detailed Physical Examination
Procedure

Assess the mouth;
inspect for injuries
or signs of injury

DCAP-BTLS
• Teeth
• Obstructions
• Swollen or lacerated
tongue
• Odors
• Discoloration
Slide 12
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Detailed Physical Examination
Procedure

Assess the neck; inspect and palpate for
injuries or signs of injury

DCAP-BTLS
Jugular vein distention
 Crepitation

Slide 13
Detailed Physical Examination
Procedure

Many cervical collars have openings
large enough to allow the EMT to
assess the neck without removing
the collar.

If the collar obstructs the view,
manually stabilize the head and
open the collar.
Slide 14
Detailed Physical Examination
Procedure

Assess the chest;
inspect and palpate for
injuries or signs of injury

DCAP-BTLS
Crepitation
 Paradoxical motion
 Breath sounds in the
apices, midclavicular line,
bilaterally and at the
bases, midaxillary line,
bilaterally

Slide 15
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Detailed Physical Examination
Procedure

Assess the abdomen,
inspect and palpate
for injuries or signs of
injury

DCAP-BTLS
Firm
 Soft
 Distended

Slide 16
Detailed Physical Examination
Procedure

Assess the pelvis; inspect
and palpate for injuries or
signs of injury

DCAP-BTLS
If the patient does not complain of pain or is unresponsive,
gently flex and compress the pelvis to determine stability.
Slide 17
Detailed Physical Examination
Procedure

Assess the legs;
inspect and palpate
for injuries or signs of
injury

DCAP-BTLS
Distal pulses
 Sensation
 Motor function

Slide 18
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Detailed Physical Examination
Procedure

Assess the arms in
the same manner
as the legs
Slide 19
Detailed Physical Examination

Roll with spinal precautions and assess
posterior aspect of body; inspect and palpate
for injuries or signs of injury

DCAP-BTLS
Slide 20
Vital Signs
Slide 21
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Vital Signs

Assess baseline vital signs

Breathing
Skin
 Pupils
 Blood pressure

Slide 22
Summary

Patients Needing a Detailed Examination

Examination Procedure

Assessing Vital Signs
Slide 23
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