Answer:
Head – inspect for any bleeding and obvious deformity. Check the ears for blood, fluid or bruising. Check the eyes for reactivity to light and equal size pupils. Check the nose for bleeding or deformity. Check the mouth for missing teeth, clench their teeth (to see if the top meets the bottom) and anything blocking the airway. Listen to them speaking for any hoarseness or other abnormalities. Palpate the skull, feeling for any soft boggy areas or crepitus.
Neck – inspect for any bruising, bleeding or deformity. If trained, palpate for a carotid pulse.
Chest – inspect for equal rise and fall, paradoxical movement (normally, when you breath in and out your chest rises and falls respectively. With paradoxical movement, you breath in and your chest falls, breath out your chest rises. This is indicative of a flail chest injury.), bleeding, bruising, accessory muscle use (think asthma). Palpate for tenderness and crepitus.
Abdomen – inspect for bruising, bleeding, penetrating injuries, distention, priapism (spinal injury). Palpate for pain/tenderness, guarding, rigidity, rebound tenderness (this is when you push down, no pain, release suddenly and they have pain).
Pelvis – inspect for bruising, bleeding and deformity. Palpate for tenderness along the bone, but DO NOT SPRING THE PELVIS (i.e. push down on both sides of the pelvis. If they have a pelvic fracture, this will make things a whole lot worse).
Arms and legs – inspect for bleeding, bruising, deformity, range of motion. Palpate for strength/weakness, sensation/touch/temperature, pulses, crepitus.
Back – inspect for bleeding, bruising, deformity. Palpate for pain/tenderness.
Now that we’ve had a good look at our patient, they may have identified some pain when you’ve done your inspecting and palpating. It’s important to really question your patient about their pain as this can provide a lot of valuable information. The acronym (or mnemonic) that we use for pain assessment is OPQRST.
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