References
Clinical exam: an introduction
Abstract
The clinical examination is an important part of any patient consultation. After the primary survey and patient history, a more in-depth examination of the patient is required in order to aid the working diagnosis and help negate other differential diagnoses. The extent of this depends on the stability of the patient condition and may not be possible in time-critical circumstances. However, it is becoming an increasing part of paramedic practice due to continued expansion of the scope of the paramedic role, both in urgent and emergency care. Educational delivery of clinical examinations of each of the main body systems is now an integral part of undergraduate paramedic curricula.
The forthcoming Clinical Examination series will provide a step-by-step overview for each of the main body systems. Continuing professional development (CPD) is an essential requirement for all clinicians in order to maintain and demonstrate currency and advancement within their roles (Health and Care Professions Council (HCPC) 2018). This series will therefore provide an overview of each examination to support students, newly qualified paramedics, and paramedics wishing to utilise these as a CPD development activity and an aide-memoire for clinical practice. This article will provide an introduction to the series, a guide to the intended use and an overview of initial examination considerations, including first impressions.
The articles are intended to support clinician development and to assist in the overall assessment of patient presentations. The information should be used to support consideration of differential diagnoses in situations where life-threatening conditions have been ruled out. The extent and explanation of each examination will not be to the depth of those provided in core literature texts, so further reading and consolidation is advised to support understanding, supplemental to these articles. Key questions will be included for reader consideration and to direct further study.
Most examinations are taught in a very rigid format; however, in clinical practice, the clinician needs to be able to be flexible and adapt their approach depending on the presenting condition and circumstance. There is no single way to approach each of these examinations; however, working within a good structure will reduce omissions and errors, and support the gathering of information to inform patient care.
Contemporary texts will provide the underpinning reference sources throughout this series, as many of the examination processes and techniques are universally applied. Differences will however be highlighted. Readers will be signposted to these key texts for each clinical examination. The following systems will be included as part of this series:
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