Academic Day Seminar #3: Patient Assessment

Day 4: Dr. Zahra Kanji’s ADS was about conducting a patient assessment with a head-to-toe approach. I found this session very useful as it gave me a better idea of what to look for under each system.¬†Dr. Kanji also provided several examples on how to use a head-to-toe approach¬†(e.g. to assess volume status). The examples elucidated how this approach can be useful in drawing connections between each system, and the patient’s overall picture and therapy.

Some points that I took away from this session were:

  • Being able to effectively use a head-to-toe approach requires ongoing practice!
  • The approach may differ depending on the rotation and individual patient
  • MAP = (2*DBP+SBP)/3 as the heart spends twice the time in diastole than in systole
  • For cardiac murmurs, also consider the timing within the cycle, intensity over time, location, radiation, grade, pitch and quality
  • Troponin-I can be detectable for up to 5-9 days after an acute event, making it difficult to assess the onset of the heart muscle damage
  • Important to consider what could have caused any abnormal labs, signs and symptoms (e.g. a high blood pressure –> could it be due to a small cuff? white coat syndrome? timing of medications? patient’s activity?)

In my future clinical orientations, I will:

  • Work-up all my patients from a head-to-toe approach
  • Look for connections between trends in their lab values/conditions and the information I have gathered from systematically going from head-to-toe
  • When planning my monitoring parameters, systematically go from head to toe to ensure that my monitoring plan is comprehensive
  • Ask my preceptor how they conduct patient assessments and understand how it is appropriate for the field they are working in
  • Take opportunities to learn about physical assessment and diagnostic tools