OSCE Checklist: Respiratory Examination
Introduction
- WIPE
- Position the patient at 45 degrees
- Expose chest
- Ask if the patient is in pain
General inspection
- Assess the patient’s general appearance (well/unwell, distress, accessory muscle use)
- Comment on the patients colour (pallor/cyanosis)
- Observe for audible respiratory sounds (stridor, wheezing)
- Look for signs of respiratory distress (nasal flaring, pursed-lip breathing, intercostal
recession)
- Check for bedside items: oxygen therapy, nebulizers, inhalers, or chest drains
Hands & Upper Limbs
- Assess hand temperature (cold suggests poor perfusion)
- Look for cyanosis, tar staining, clubbing, joint swelling and asterixis
- Check for bounding radial pulse and note pulse rate
Head & Neck
- Check for Central cyanosis, conjunctival pallor, plethoric facies and Horner’s syndrome.
- Inspect the neck for elevated JVP, cervical and supraclavicular lymphadenopathy
- Check for postnasal drip?
Inspection of the Chest
- Assess the chest shape (barrel chest, pectus excavatum/carinatum) and symmetry
- Look for scars and observe chest movements with respiration
- Check for visible pulsations and prominent blood vessels
Palpation
- Assess tracheal position and check for tracheal tug
- Palpate apex beat
- Assess chest expansion symmetrically
- Palpate for tactile vocal fremitus
- Check for intercostal tenderness
Introduction
- WIPE
- Position the patient at 45 degrees
- Expose chest
- Ask if the patient is in pain
General inspection
- Assess the patient’s general appearance (well/unwell, distress, accessory muscle use)
- Comment on the patients colour (pallor/cyanosis)
- Observe for audible respiratory sounds (stridor, wheezing)
- Look for signs of respiratory distress (nasal flaring, pursed-lip breathing, intercostal
recession)
- Check for bedside items: oxygen therapy, nebulizers, inhalers, or chest drains
Hands & Upper Limbs
- Assess hand temperature (cold suggests poor perfusion)
- Look for cyanosis, tar staining, clubbing, joint swelling and asterixis
- Check for bounding radial pulse and note pulse rate
Head & Neck
- Check for Central cyanosis, conjunctival pallor, plethoric facies and Horner’s syndrome.
- Inspect the neck for elevated JVP, cervical and supraclavicular lymphadenopathy
- Check for postnasal drip?
Inspection of the Chest
- Assess the chest shape (barrel chest, pectus excavatum/carinatum) and symmetry
- Look for scars and observe chest movements with respiration
- Check for visible pulsations and prominent blood vessels
Palpation
- Assess tracheal position and check for tracheal tug
- Palpate apex beat
- Assess chest expansion symmetrically
- Palpate for tactile vocal fremitus
- Check for intercostal tenderness
