Proper Exam Techniques - Expose or Fail

[spenac]

I bring this up because I see so many Parmedics and especially basics that do not at least move clothes to do lung and heart sounds. Surprisingly I see many that just feel over the clothes for trauma. If you do not put your stethoscope on skin you fail as a provider. If you do not at least expose the area of complaint for a trauma patient you need to get out this profession now or get your money back from the school that failed to give you any training or education.

[fiznat]

lol, okay. Thanks for the rant!

[natacha]

I bring this up because I see so many Parmedics and especially basics that do not at least move clothes to do lung and heart sounds. Surprisingly I see many that just feel over the clothes for trauma. If you do not put your stethoscope on skin you fail as a provider. If you do not at least expose the area of complaint for a trauma patient you need to get out this profession now or get your money back from the school that failed to give you any training or education.

really? ! I agree, this is the least to do when using the stethoscope or looking for trauma or injury... well, this is concerning!!!

[spenac]

It just aggravates the heck out of me that people do not understand that we are a hands and eyes on Medical Profession, not a taxi service. To many people seem to just want to load and go w/o any kind of a proper exam.

So do you guys all expose and look and listen? Do you ignore your own bashfulness and do the job as a true medical professional?

[Dustdevil]

On another forum, in a thread about stethoscopes (thank God we haven't had one of those threads here lately!), people keep raving about how great their stethoscope is because they can auscultate through clothes with it. So yes, this is obviously a problem in the field if that many people think it is acceptable to do this. The bigger, and more frightening problem is that they were not taught better in EMT school. Although, it is certainly no surprise to me that EMT training sucks in this country.

[JPINFV]

Wait, you mean I don't have to touch the patient with my scope to do a proper assessment? Awesome!

/sarcasm.

[ambodriver]

If you look hard enough, there's a video out there somewhere of several AMR crews (Massachusetts, I think) that were joyriding in the snow, dragging some of the personnel behind one of the ambulances on a chain of backboards.

This reminds me of one time we had our regular asthma guy (20ish y/o male, mild resp. distress, no other hx.), and I put the scope on the bottom right lobe and heard wheezing with good air flow. So I stopped and threw him on a neb. My partner blew up at me for not listening to all the fields before giving the neb.

Spenac, was he right?

p.s. for the record I always use the scope on bare skin---my preceptor in school made sure I learned that good habit.

Edited March 17, 2009 by ambodriver

[mobey]

This reminds me of one time we had our regular asthma guy (20ish y/o male, mild resp. distress, no other hx.), and I put the scope on the bottom right lobe and heard wheezing with good air flow. So I stopped and threw him on a neb. My partner blew up at me for not listening to all the fields before giving the neb.

Spenac, was he right?

Yes I know I am not spenac.

Yes he was right, if your going to treat the respiratory system, assess the resiratory system.

p.s. for the record I always use the scope on bare skin---my preceptor in school made sure I learned that good habit.

Gawd that sickens me....... Didactic, FAIL

[bball160]

lol i learned that habit in those exact words "expose or fail, your choice"

[natacha]

It just aggravates the heck out of me that people do not understand that we are a hands and eyes on Medical Profession, not a taxi service. To many people seem to just want to load and go w/o any kind of a proper exam.

So do you guys all expose and look and listen? Do you ignore your own bashfulness and do the job as a true medical professional?

Yes absolutely. At least, that's what I have been taught to do.