General Survey and Measurement

Definition: The general survey is an overarching, systematic assessment of the whole person that begins at the very first moment of clinical encounter.
Core Domains of Assessment:
- Physical Appearance: Evaluation of visual attributes including age, sex, level of consciousness, skin color, facial features, and overall appearance.
- Body Structure: Evaluation of anatomical build including stature, nutritional status, symmetry, posture, position, and body build or contour.
- Mobility: Observation of gait, range of motion, and physical movement.
- Behavior: Observation of facial expression, mood, affect, speech, dress, and personal hygiene.

Age: Evaluation of whether the person appears their stated age or visually appears older or younger.
Sex: Assessment of sexual development appropriate for age and stated gender.
Level of Consciousness: Assessment of alertness, orientation to person, place, time, and situation, as well as responsiveness to external stimuli.
Skin Color: Observation of skin tone evenness, pigmentation, cyanosis, jaundice, pallor, erythema, or visible lesions.
Facial Features: Inspection of facial symmetry, features at rest, and facial movement during speech or expression.
Overall Appearance: Global evaluation for acute distress, wellness, or signs of acute or chronic illness.

Stature: Height within normal age and developmental limits.
Nutrition: Evaluation of weight within normal range for height and body frame, including fat distribution.
Symmetry: Bilateral comparison of body parts for equal size, proportion, and position.
Posture: Observation of standing or sitting alignment and spinal curvature.
Position: Observation of how the person positions themselves naturally and comfortably (e.g., sitting comfortably vs. tripoiding or lying rigid).
Body Build and Contour: Assessment of physical proportions and proportions of limbs to trunk.

Weight Assessment Protocol:
- Preparation: Direct the individual to remove shoes and heavy outer garments (such as coats or jackets) prior to stepping onto the balance scale.
- Serial Weight Monitoring: When taking sequential weight measurements over time, obtain measurements at approximately the same time of day each time and with the individual wearing identical or similar clothing.
- Documentation: Record measured weight values in both kilograms ( $\text{kg}$ ) and pounds ( $\text{lb}$ ).
Height Assessment Protocol:
- Equipment: Utilize a wall-mounted measuring device or the stadiometer pole attached to a standing balance scale.
- Technique:
- Ensure the individual is shoeless.
- Have the person stand straight, looking directly ahead.
- Position the person so that heels, buttocks, shoulders, and head contact or align with the vertical plane.
- Lower the extended horizontal headpiece until it rests flat against the crown of the head.
Body Mass Index (BMI):
- Clinical Function: Serves as a practical clinical index of optimal body weight relative to height.
- Diagnostic Utility: Acts as a reliable indicator for assessing obesity, overweight status, ideal weight maintenance, or protein-calorie malnutrition.