CHEST PAIN
Experience Overview
FOCUSED EXAM: CHEST PAIN
Patient: Brian Foster
Inspected face
1 of 1 point
Appearance (1/1 point)
• No visible abnormal findings
• Rash or lesion
• Cyanosis
• Pallor
• Redness or flushing
• Evidence of trauma (scar, laceration, or bruising)
Inspected for jugular venous distension
1 of 1 point
Height Of Venous Pressure (1/1 point)
• 4 cm or less above the sternal angle
• More than 4 cm above the sternal angle
Inspected chest
1 of 1 point
Symmetry (1/2 point)
• Symmetric
CHEST PAIN
,CHEST PAIN
• Asymmetric
Appearance (1/2 point)
• No visible abnormal findings
• Rash or lesion
• AP diameter abnormal
• Intercostal retraction while breathing
• Excessive use of accessory muscles while breathing
• Pectus excavatum
• Skin growths (freckles or moles)
• Evidence of skin trauma (scar, laceration, or bruising)
Inspected hands and fingernails
1 of 1 point
Right: Appearance (1/4 point)
• No visible abnormal findings
• Redness
• Moles or skin tags
• Masses (warts, cysts, or tumors)
• Freckles, birthmark, or other discoloration
• Excessive dry or flaking skin
• Purpura
• Scarring
• Laceration, lesion, or wound
• Bruising
• Rash
Left: Appearance (1/4 point)
• No visible abnormal findings
• Redness
• Moles or skin tags
• Masses (warts, cysts, or tumors)
• Freckles, birthmark, or other discoloration
• Excessive dry or flaking skin
• Purpura
• Scarring
• Laceration, lesion, or wound
• Bruising
• Rash
Right: Nail Changes (1/4 point)
• No visible abnormal findings
• Pallor
• Cyanosis
• Splinter hemorrhages
• Clubbing
Left: Nail Changes (1/4 point)
• No visible abnormal findings
CHEST PAIN
,CHEST PAIN
• Pallor
• Cyanosis
• Splinter hemorrhages
• Clubbing
Inspected lower extremities and toenails
1 of 1 point
Right: Appearance (1/4 point)
• No visible abnormal findings
• Visible distortion or swelling
• Brownish pigmentation
• Skin thickening
• Ulceration
• Varicose veins
Right: Nail Changes (1/4 point)
• No visible abnormal findings
• Pallor
• Cyanosis
• Splinter hemorrhages
• Clubbing
Left: Appearance (1/4 point)
• No visible abnormal findings
• Visible distortion or swelling
• Brownish pigmentation
• Skin thickening
• Ulceration
• Varicose veins
Left: Nail Changes (1/4 point)
• No visible abnormal findings
• Pallor
• Cyanosis
• Splinter hemorrhages
• Clubbing
Inspect lower extremities for edema
1 of 1 point
Right: Edema (1/4 point)
• No edema
• Pitting
• Non-pitting
Right: Severity Of Edema (1/4 point)
• No edema
• 1+ Slight pitting
• 2+ Deeper pit, disappears in 10 to 15 seconds
CHEST PAIN
, CHEST PAIN
• 3+ Noticeably deep pit that lasts more than a minute
• 4+ Very deep pit that lasts 2 to 5 minutes
Left: Edema (1/4 point)
• No edema
• Pitting
• Non-pitting
Left: Severity Of Edema (1/4 point)
• No edema
• 1+ Slight pitting
• 2+ Deeper pit, disappears in 10 to 15 seconds
• 3+ Noticeably deep pit that lasts more than a minute
• 4+ Very deep pit that lasts 2 to 5 minutes
Tested capillary refill
time 1 of 1 point
Fingers (1/2 point)
• Less than 3 seconds
• Greater than 3 seconds
Toes (1/2 point)
• Less than 3 seconds
• Greater than 3 seconds
Palpated carotid arteries
1 of 1 point
Right: Vibration (1/4 point)
• No thrill
• Thrill
Right: Amplitude (1/4 point)
• 0 Absent
• 1+ Diminished or barely palpable
• 2+ Expected
• 3+ Increased
• 4+ Bounding pulse
Left: Vibration (1/4 point)
• No thrill
• Thrill
Left: Amplitude (1/4 point)
• 0 Absent
• 1+ Diminished or barely palpable
• 2+ Expected
• 3+ Increased
• 4+ Bounding pulse
Palpated PMI
CHEST PAIN
Experience Overview
FOCUSED EXAM: CHEST PAIN
Patient: Brian Foster
Inspected face
1 of 1 point
Appearance (1/1 point)
• No visible abnormal findings
• Rash or lesion
• Cyanosis
• Pallor
• Redness or flushing
• Evidence of trauma (scar, laceration, or bruising)
Inspected for jugular venous distension
1 of 1 point
Height Of Venous Pressure (1/1 point)
• 4 cm or less above the sternal angle
• More than 4 cm above the sternal angle
Inspected chest
1 of 1 point
Symmetry (1/2 point)
• Symmetric
CHEST PAIN
,CHEST PAIN
• Asymmetric
Appearance (1/2 point)
• No visible abnormal findings
• Rash or lesion
• AP diameter abnormal
• Intercostal retraction while breathing
• Excessive use of accessory muscles while breathing
• Pectus excavatum
• Skin growths (freckles or moles)
• Evidence of skin trauma (scar, laceration, or bruising)
Inspected hands and fingernails
1 of 1 point
Right: Appearance (1/4 point)
• No visible abnormal findings
• Redness
• Moles or skin tags
• Masses (warts, cysts, or tumors)
• Freckles, birthmark, or other discoloration
• Excessive dry or flaking skin
• Purpura
• Scarring
• Laceration, lesion, or wound
• Bruising
• Rash
Left: Appearance (1/4 point)
• No visible abnormal findings
• Redness
• Moles or skin tags
• Masses (warts, cysts, or tumors)
• Freckles, birthmark, or other discoloration
• Excessive dry or flaking skin
• Purpura
• Scarring
• Laceration, lesion, or wound
• Bruising
• Rash
Right: Nail Changes (1/4 point)
• No visible abnormal findings
• Pallor
• Cyanosis
• Splinter hemorrhages
• Clubbing
Left: Nail Changes (1/4 point)
• No visible abnormal findings
CHEST PAIN
,CHEST PAIN
• Pallor
• Cyanosis
• Splinter hemorrhages
• Clubbing
Inspected lower extremities and toenails
1 of 1 point
Right: Appearance (1/4 point)
• No visible abnormal findings
• Visible distortion or swelling
• Brownish pigmentation
• Skin thickening
• Ulceration
• Varicose veins
Right: Nail Changes (1/4 point)
• No visible abnormal findings
• Pallor
• Cyanosis
• Splinter hemorrhages
• Clubbing
Left: Appearance (1/4 point)
• No visible abnormal findings
• Visible distortion or swelling
• Brownish pigmentation
• Skin thickening
• Ulceration
• Varicose veins
Left: Nail Changes (1/4 point)
• No visible abnormal findings
• Pallor
• Cyanosis
• Splinter hemorrhages
• Clubbing
Inspect lower extremities for edema
1 of 1 point
Right: Edema (1/4 point)
• No edema
• Pitting
• Non-pitting
Right: Severity Of Edema (1/4 point)
• No edema
• 1+ Slight pitting
• 2+ Deeper pit, disappears in 10 to 15 seconds
CHEST PAIN
, CHEST PAIN
• 3+ Noticeably deep pit that lasts more than a minute
• 4+ Very deep pit that lasts 2 to 5 minutes
Left: Edema (1/4 point)
• No edema
• Pitting
• Non-pitting
Left: Severity Of Edema (1/4 point)
• No edema
• 1+ Slight pitting
• 2+ Deeper pit, disappears in 10 to 15 seconds
• 3+ Noticeably deep pit that lasts more than a minute
• 4+ Very deep pit that lasts 2 to 5 minutes
Tested capillary refill
time 1 of 1 point
Fingers (1/2 point)
• Less than 3 seconds
• Greater than 3 seconds
Toes (1/2 point)
• Less than 3 seconds
• Greater than 3 seconds
Palpated carotid arteries
1 of 1 point
Right: Vibration (1/4 point)
• No thrill
• Thrill
Right: Amplitude (1/4 point)
• 0 Absent
• 1+ Diminished or barely palpable
• 2+ Expected
• 3+ Increased
• 4+ Bounding pulse
Left: Vibration (1/4 point)
• No thrill
• Thrill
Left: Amplitude (1/4 point)
• 0 Absent
• 1+ Diminished or barely palpable
• 2+ Expected
• 3+ Increased
• 4+ Bounding pulse
Palpated PMI
CHEST PAIN
