Physical:

*ask patient if they want to be sick OOC - When giving physicals, you should page the person and see if they want to be found healthy or have some sort of issue.

*ask patient IC if they have any pertinant history - family history or personal history of illness or injuries lately that you should be aware of before you start, when their last physical was, remind them that they should be an annual occurance.

*have them sit on a cot - give "stylish" gown & sheet (to cover themselves with), pull curtain for privacy (You should be redwarting your hands at this time)

Remember, for ease of giving physical, keep first in mind the patient's position: sitting, lying down, standing. Then the instrument you use, then finally go from head to toe (upper body to lower body). Keeping these in mind, the physical will go faster. This is the way I do them:

Sitting:

Listening Tube

*warm listening tube (cold tube on warm skin is not nice!)

*listen to lungs: chest & back - (Listen for abnormal sounds - rubbing, wheezing, bubbling/popping)

*heart - check to see that it is beating regularly... no murmers, etc.

*check the diaphragm. You ask your patient to hold their breath. While they are exhaling, if you listen closely, you'll be able to hear the lungs expanding with no clicks or rubbings.

Glowstick

*ears - look for infection (bulging eardrums filled w/fluid)

*eyes - have them stare at wall opposite while you look.and check pupil reaction

*nose - check for abnormalities, swelling, congestion, etc...

*mouth - check for certain odors (sweet can be diabetes, really bad could mean sinus infection, ect.), check teeth & tongue too.

Mallet

*check knee jerk reaction

Lying down:

Palpation/Hands:

*examine by feeling abdomen for abnormalities - lumps, hernias,

*then the old 'turn your head and cough routine' for guys - hernia & prostate check (This is in Standing)

*do internal exam for females - health check/pregnancy check

Finally, ask about sexual activity, give contraceptive draught females - once/month, males - once/week. Apprentices get it whether they want it or not.