Position/Lighting/Draping
Position - patient should sit upright on the examination table. The patient's hands should remain at their sides. When the back is examined the patient is usually asked to move their arms forward (hug themself position) so that the scapulae are not in the way of examining the upper lung fields.
Lighting - adjusted so that it is ideal. Draping - the chest should be fully exposed. Exposure time should be minimized.
The basic steps of the examination can be remembered with the mnemonic PIPPA:
- Position
- Inspection (for example, "normal effort")
- Palpation (for example, "no tenderness to palpation", "fremitus WNL")
- Percussion (for example, "clear to percussion bilaterally" or "CTP B")
- Auscultation (for example, "clear to auscultation bilaterally" or "CTA B"; "no R/R/W" or "no rhonchi, rales or wheezes")
Inspection of the fingers for cyanosis or clubbing is sometimes included in the respiratory examination.
Read more about this topic: Respiratory Examination
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