General physical examination is a critical part of medical practice, and it plays an important role in the diagnosis and management of many health conditions. In the UK, the National Health Service (NHS) requires medical students and doctors to demonstrate their competency in conducting physical exams through the Objective Structured Clinical Examination (OSCE). In this blog post, we will provide a step-by-step guide to performing a general physical examination in the NHS for OSCE.
Step 1: Introduction and Preparation: Before beginning the physical exam, it is important to introduce yourself to the patient and obtain their consent. You should also explain the purpose and nature of the exam, and ensure that the patient is comfortable and at ease. Make sure to wash your hands thoroughly and put on gloves before starting the exam.
Step 2: Inspection:
The first step in the physical exam is inspection. This involves looking at the patient's overall appearance and assessing any visible abnormalities. You should look for any asymmetry, deformities, swelling, or discoloration. Observe the patient's posture, gait, and facial expressions to detect any signs of pain or discomfort.
Step 3: Palpation:
Palpation involves feeling for any abnormalities in the patient's body. Start by palpating the peripheral pulses, such as the radial and brachial pulses. Next, move on to palpating the lymph nodes, feeling for any enlargement or tenderness. You should also palpate the abdomen, checking for any masses or tenderness.
Step 4: Percussion:
Percussion involves tapping the patient's body to produce sounds that can help identify underlying structures or abnormalities. You should percuss the chest to assess lung function and the abdomen to identify any fluid or gas accumulation.
Step 5: Auscultation:
Auscultation involves using a stethoscope to listen to the sounds produced by the patient's body. Start by listening to the heart sounds, assessing for any murmurs, gallops, or irregular rhythms. Next, move on to auscultating the lungs, checking for any wheezing, crackles, or diminished breath sounds.
Step 6: Neurological Examination:
The neurological examination is an essential component of the physical exam, and it involves assessing the patient's cognitive and sensory functions, as well as their reflexes. You should test the patient's sensation, motor function, and coordination, and perform the reflex tests to check for any abnormalities.
Step 7: Conclusion and Follow-up:
After completing the physical exam, you should summarize your findings to the patient and discuss any concerns or recommendations. Make sure to answer any questions the patient may have, and provide any necessary referrals or follow-up appointments.
In conclusion, performing a general physical exam in the NHS for OSCE requires a systematic and thorough approach. By following these step-by-step guidelines, you can ensure that you perform a comprehensive and accurate exam that meets the requirements of the NHS and demonstrates your competency as a medical professional.
Dr.Muhammad Arsalan Khan
Diabetes Specialist
MBBS, MSc (Diabetes & Endocrinology) - DUHS
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