Clinical Skills

2Cs

Clean and Consent

Consent

Permission obtained before touching a patient or model/fellow student

Hand cleaning

Should be done before and after touching a patient

IPPA

Inspection, Palpation, Percussion, and Auscultation

SOCRATES

Site, Onset, Character, Radiation, Associated features, Timing, Exacerbation, Severity

Stethoscope

Used for auscultation of respiratory and heart sounds

Diaphragm

The side of the stethoscope used for most applications

Blood Pressure

Measure of pressure exerted by circulating blood against arterial walls

Blood Pressure Calculation

Cardiac output x peripheral vascular resistance

Brachial Pulse

The pulse palpated first when measuring blood pressure, stopping at systolic pressure

Diastolic Pressure

The pressure when sounds completely disappear during blood pressure measurement

Korotkoff Sounds

Sounds heard through the stethoscope when measuring blood pressure manually

Sphygmomanometer

Scientific name for a blood pressure monitor

Normal Oral/Ear Temperature

37 degrees C

Radial Artery

Artery located at the radial bone side of the wrist

Brachial Artery

Artery located at the inner side of the biceps

Carotid Artery

Artery on the side of the neck between the larynx and sternocleidomastoid muscle

Femoral Artery

Artery located in the groin

Posterior Tibial Artery

Artery located behind the inner ankle

Resting Heart Rate

60-90 bpm

Bradycardia

Heart rate less than 60 bpm

Tachycardia

Heart rate more than 100 bpm

Atrial Fibrillation

Most common cause of irregularly irregular pulse

Character

Refers to the waveform or shape of the arterial pulse

Volume

Refers to the perceived degree of pulsation reflecting pulse pressure

Pulse Oximeter

Measures arterial oxygen saturation (spO2)

Pulse Oximeter Function

Determines the proportion of hemoglobin that is oxygenated

Normal Oxygen Saturation

90-100%

BMI

Measure using an individual's height and weight to assess health

Urinalysis Uses

Screening for diabetes, diagnosing UTIs, monitoring drug compliance

Urine Dipsticks

Test levels of blood, leukocytes, nitrite, specific gravity, glucose, protein, ketones, and pH

Normal Urine pH

4.5-8

High Glucose Levels

May indicate poorly controlled diabetes

Acetoacetate

Ketone tested for in urinalysis

Ketonuria

Occurs in diabetic ketoacidosis, starvation, alcohol use, and low carb diets

Cloudy Urine

Indicates the presence of leukocytes

High Leukocyte Levels

Detect presence of neutrophils, indicating UTI, inflammation, stone disease, or urothelial cancer

Non-visible Hematuria

Indicated by a blood level of over 1 positive

Positive Nitrites

Indicates bacteriuria

Gloves

Should always be worn when performing a urine dipstick

CBG

Capillary blood glucose measurement

Normal Fasting BGC Level

3.9 mmol/L - 5.6 mmol/L

Blood Glucose < 4 mmol/L

Indicates hypoglycemia

Hypoglycemia Management

Administer glucose immediately

QRISK3

Calculator for assessing risk of heart attack/stroke over the next 10 years

NEWS2

National Early Warning Score

NEWS2 Detection

Monitors deterioration in the health of adults