Tools On Physical Assessment

 

TOOLS ON PHYSICAL ASSESSMENT

Inspection/Observation

    Observe the overall appearance of the child: alert, orientated, active/hyperactive/drowsy, irritable.
    Colour(centrally and peripherally): pink, flushed, pale, mottled, cyanosed , clubbing
    Respiratory rate, rhythm and depth (shallow, normal or deep)
    Respiratory effort (Work of Breathing WOB): mild, moderate, severe, inspiratory: expiratory ratio, shortness of breath
    Use of accessory muscles (UOAM): intercostal/subcostal/suprasternal/supraclavicular/substernal retractions, head bob, nasal flaring
    Symmetry and shape of chest
    Tracheal position, tracheal tug
    Audible sounds: vocalisation, wheeze, stridor, grunt, cough - productive/paroxysmal
    Monitor for oxygen saturation

Auscultation

    Listen for absence /equality of breath sounds
    Auscultate lung fields for bilateral adventitious noises e.g.: wheeze, crackles etc

To assess bowel sounds, vascular sound; in pregnancy, FHT’s are heard.

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Palpation

    Bilateral symmetry of chest expansion
    Skin condition – temperature, turgor and moisture
    capillary refill (central/peripheral)
    Fremitus (tactile)
    Subcutaneous emphysema

Percussion

To identify organ size and detect fluid, gas or masses.