The
Clinical Approach to the Acutely Ill Patient- history and examination
Diagnosis
The
Use of Guidelines and Algorithms
The
Emergency Setting
History
Physical
Examination
Primary
Survey
Secondary
Survey
Laboratory
Testing
Imaging
Sonography
Plain
Abdominal Films
Intravenous
Pyelography
Computed
Tomography
Magnetic
Resonance Imaging
Chest
X-Ray
History:
patient, family members, the
rescue staff, or the operating team.
The
AMPLE history (Allergies, Medications,
Past medical history, time of Last meal, Events preceding the injury)
Urgent
history: localization, time dimension,
intensity and mitigating التخفيف / inducing factors of the current
problem
Physical
Examination
Primary
Survey
Vital
signs of blood pressure, pulse rate, respiratory rate, temperature and general
assessment of the patient (i.e. toxic or well appearing). After the vital signs, the initial assessment
follows.
Secondary
Survey
If
possible, the physical examination should be conducted in a systematic way in a
fully exposed patient. In trauma patients, the risk of hypothermia must be
considered even in the warmer months; nevertheless, it should not hinder
complete exposure for examination and it will be reduced by warm infusions and
by covering with external warming devices after assessment. With the exception
of life-threatening emergencies requiring immediate evaluation and therapy, the
secondary assessment should include organ systems other than
those
assumed to be affected. This will allow the discovery of physical signs not
necessarily linked to the working hypothesis, as well as those arising from any
additional disease (e.g., discovering a melanoma in a patient presenting with
renal colic).
