Summary Respiratory Examination OSCE checklist (second year medical school)

OSCE Checklist: Respiratory Examination

Introduction
-​ WIPE
-​ Position the patient at 45 degrees
-​ Expose chest
-​ Ask if the patient is in pain


General inspection
-​ Assess the patient’s general appearance (well/unwell, distress, accessory muscle use)
-​ Comment on the patients colour (pallor/cyanosis)
-​ Observe for audible respiratory sounds (stridor, wheezing)​
-​ Look for signs of respiratory distress (nasal flaring, pursed-lip breathing, intercostal
recession)​
-​ Check for bedside items: oxygen therapy, nebulizers, inhalers, or chest drains​


Hands & Upper Limbs
-​ Assess hand temperature (cold suggests poor perfusion)​
-​ Look for cyanosis, tar staining, clubbing, joint swelling and asterixis
-​ Check for bounding radial pulse and note pulse rate


Head & Neck
-​ Check for Central cyanosis, conjunctival pallor, plethoric facies and Horner’s syndrome.
-​ Inspect the neck for elevated JVP, cervical and supraclavicular lymphadenopathy
-​ Check for postnasal drip?


Inspection of the Chest
-​ Assess the chest shape (barrel chest, pectus excavatum/carinatum) and symmetry
-​ Look for scars and observe chest movements with respiration
-​ Check for visible pulsations and prominent blood vessels


Palpation
-​ Assess tracheal position and check for tracheal tug
-​ Palpate apex beat
-​ Assess chest expansion symmetrically
-​ Palpate for tactile vocal fremitus
-​ Check for intercostal tenderness