Synopsis
Perform a reproducible respiratory examination that first detects physiological danger, then integrates inspection, palpation, percussion and auscultation into a testable anatomical and clinical synthesis rather than a list of signs.
- Observe before touching: respiratory rate, speech, posture, pattern, accessory-muscle use, symmetry, audible sounds, cough, sputum and oxygen device often reveal severity immediately.
- Record oxygen saturation, device and target alongside pulse, blood pressure, temperature and mental state; an examination without physiology cannot grade acute illness.
- Hands can show clubbing, nicotine staining, peripheral cyanosis, fine beta-agonist tremor or coarse carbon-dioxide-retention flap, but each sign needs clinical context.
Key red flags
Stridor, drooling, inability to speak, silent chest, paradoxical breathing, exhaustion, falling respiratory rate or reduced consciousness indicates threatened airway or ventilation. Routine examination should stop while help and respiratory support are mobilised.
Investigation priorities
Quantify physiological severity and trigger the appropriate acute response.
Management branches
Every respiratory examination, especially an acutely unwell patient.
- Observe from the end of the bed, assess speech, breathing effort, pattern, colour, posture and equipment, then measure observations and identify the prescribed oxygen target.
- If airway, ventilation or circulation is threatened, switch immediately to ABCDE, call help and treat; do not complete an examination sequence for presentation's sake.
A stable patient requiring a full respiratory examination.