Major body system examination

1 Major body system examination




Clinical Tips



• The initial physical examination should focus on the major body systems, namely the cardiovascular, respiratory and central nervous systems, as severe abnormalities in these systems have the potential to be rapidly fatal. This approach is somewhat different from the head-to-tail physical examination commonly performed that is only appropriate for non-emergency patients.

• Pain assessment is also a high priority in the initial evaluation.

A considerable amount of invaluable information can be obtained from the physical examination of the emergency patient. The initial priority is to identify any potentially life-threatening problems so that immediate intervention can be provided. As such the initial physical examination (primary survey) should focus on the major body systems, namely the cardiovascular, respiratory and central nervous systems, as severe abnormalities in these systems have the potential to be rapidly fatal. Abdominal palpation and measurement of body temperature are also important. Once measures have been taken to stabilize abnormalities in the major body systems a more comprehensive physical examination (secondary survey) can be performed. This approach is somewhat different from the head-to-tail physical examination commonly performed that is only appropriate for non-emergency patients.



Cardiovascular System


The most important questions to be answered when examining the cardiovascular system are, does the patient have signs of compromised systemic perfusion, and is there any evidence of primary cardiac disease? The following should be examined during evaluation of the cardiovascular system:


• Heart rate, sounds and rhythm

• Pulse quality and rate (are there pulse deficits?)

• Mucous membrane colour and capillary refill time

• (Mentation)

• (Temperature of the extremities).

All of the information obtained from this evaluation should be used to guide subsequent therapy. For example, a patient with severe hypovolaemia will require aggressive fluid administration (see Ch. 4). However a more conservative approach may need to be taken if a non-physiological heart murmur is detected during initial evaluation. The most common cause of hypoperfusion in the emergency patient is hypovolaemia (see Ch. 2). Cardiovascular abnormalities may also be seen for example with heart failure (see Ch. 31), anaemia (see Ch. 19) and systemic inflammatory response syndrome (SIRS) or sepsis.

Only gold members can continue reading. Log In or Register to continue

Related posts:

  1. Jaundice
  2. Sudden loss of vision
  3. Pelvic limb paresis and paralysis
  4. Ocular emergencies

Stay updated, free articles. Join our Telegram channel
Tags:
Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Major body system examination

Full access? Get Clinical Tree
Get Clinical Tree app for offline access