An overview of recommended practices and behaviors during the physical exam, covering optimizing the environment, chaperones, communication, draping and gowning, and the examination of patients with obesity or a disability.
When Dr. Strong covers a topic, rest assured it is covered perfectly. I personally love it when you go for an overkill in a topic, so much that your video becomes a reference of its own.
Thank you for finally acknowledging what I said from the beginning. I don't drink alcoholic beverages or smoke, don't do drugs, don't drink soda, am not overweight, have no STI's, no STD'S, no HIV, no AIDS and no diabetes or Cancer and no COVID-19. It's now 2023 and I still don't have COVID-19. I figured you'd figure it out eventually. Thanks so much. 11-28-2023.
Thank you dr for your limitless and tireless contributions . This is extremely helpful video, and make more as far as you can dr. I am abdilahi greeting you from Somalia
Thank you for the detailed sharing now how to perform a better physical examination. I was wondering if you could share any tips on examining dementia/bedridden/comatose patients, where some communications and specific maneuvers can be hard to execute. Thanks!
Thank you for the video! One small thing I am missing is how to do a lung exam on an elderly patient who is unable to sit up. I often find it difficult to do a proper auscultation and have seen many clinicians only do it on the patient's side of the chest while the patient is still lying on their back, which I find not good enough.
i need to commend you dr strong, the depth and level of details to cover all different cultures is not something easy but well covered, thank you for putting out a course as good as this one
i would advise against having a family member as chaperone because if there's any complaint they have a personal interest in siding with the patient. An impartial healthcare professional is a far better choice. Not to mention this avoids the rather uncomfortable situation of "niece seeing grandma getting a rectal exam" for example.
Thank you for bringing this up. A family member is definitely not as good an option as a healthcare professional, and if a colleague is available and the patient has no objection, you should definitely use another healthcare professional. Unfortunately, the reality is that in some clinical settings, a colleague isn't always available to chaperone. I've also had the occasional patient who actually prefers their family member stay in the room for the exam (almost always a mother and adult daughter). Depending on the situation, I think that is sometimes an acceptable, though less desirable, option. Or, if there was a particularly sensitive situation, there could be both a family member and a second healthcare worker in the room, so everyone is as protected as possible.
what if the patient is comatose in the ER for example or in the ICU how would you ensure the privacy for him/her ? should i need Chaperone or not ? and what about the examination of the areas like the Genitals ?
I would approach it similarly to if the patient was not comatose: If you are a part of the treatment team, and you need to perform a breast, pelvic, or rectal exam - for purposes directly related to patient care and not just your own education - then you should use a chaperone. If you are a part of the treatment team, and you need to perform another part of the exam, you do not need a chaperone, with the caveat that you do need to consider the patient's cultural norms/expectations here, balanced with gathering data in a timely fashion. And if you are not a part of the treatment team, or if the exam would only be for your educational benefit, then you should not perform any exam, unless the family has consented to it.
As in non-binary individuals and individuals who identify as a man, but who have feminine secondary sex characteristics. The preferred terminology may be different in other parts of the world, but in the US this is consistent with general principles of inclusive language.
