Opening 1.Introduction (3rd year medical student etc and clarify patients details) 2.Obtain consent 3.State purpose of interaction Inspection 1.End of Bed (resp rate/distress/comfort etc) 2.Detailed hands (make it obvious), face, jaundice, anaemia etc 3.Detailed target area e.g. precordium Pulse 1.Radial – rate and rhythm 2.Brachial/Carotid – Character 3.Radial-radial, Radial – femoral 4.State that would like to measure all pulses even if don’t e.g. popliteal, femoral, foot pulses JVP – neck needs to be relaxed e.g. support head with pillow Palpate 1.Feel for apex beat 2.Feel for heaves and thrills Auscultate 1.Use bell to listen to mitral and accentuate murmur by rolling patient over on L. 2.Listen at all other areas with diaphragm 3.Accentuate aortic regurgitation by getting pt. to sit forward 4.Listen to lung bases To complete the examination 1.Take BP 2.ECG 3.Check for peripheral and sacral oedema 4.Take Temperature 5.Dip urine If have extra time and talk to patient 1.Inform patient of results of examination e.g.”I am delighted to inform you that the examination revealed that your CVS is normal” 2.If abnormal test result was given to patient explain to them that a single result is not conclusive and may not be a true representation of what’s going on 3.Propose relevant investigations (e.g. as above – ecg etc) 4.State importance of further investigations to properly ascertain a diagnosis

 Respiratory examination Student info: this pt has a long hx of cough, sputum and SOB. Please conduct and examination of the resp system. Describe to the examiner what you are doing as you go alo