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Old 01-13-2016
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Default How complete do our examinations need to be

I am reading FA here and am freaking out. Aside from getting a full history in 8 minutes how can we be expected to perform a "full physical" in some cases. case in point taken from FA of a guy who lost consciousness. they ask to do

Head and neck exam
Inspection (head, mouth), carotid auscultation and palpation, thyroid exam

CV exam
Palpation, auscultation, orthostatic vital signs

Pulmonary exam

Palpated peripheral pulses

Neurologic exam
Mental status, cranial nerves (including funduscopic exam), motor exam, DTRs, cerebellar, Romberg test, gait, sensory exam

I mean seriously??
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Old 01-14-2016
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you do NOT need to do a complete exam - there's absolutely no time for that!

your exam has to be focused, pertinent to the CC/HPI. Always also do CV/pulm (it takes 5 seconds)... doing irrelevant exams is going to waste time.

In the case of the guy who fell unconscious, I'd do pulm/cv and a quick screening neurological exam (CNs, motor strength, reflexes, maybe gait if i have time, that's it).
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medlightning (01-16-2016)
Old 01-16-2016
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I agree, there just isn't time. No human could do a complete PE in the time allotted. Everyone would be faced with the same problem, and if a full PE were required, everyone would fail the exam! So I think we do what we can with the time allotted, doing the most important stuff first. I suppose we could throw in some less-important stuff if we really felt like we had extra time, which is likely never the case.
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Old 01-16-2016
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You can do almost all of it. As long as you are highly efficient. In longer cases like dm fu or neuro if you practice you will be able to general heart and lung and a full neuro specific to the cs exam. Pm me I'm doing free tutoting for a few weeks. I can give you some tips. You need a partner to keep doing it over with to get your timing just right
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