People Eating Tasty Animals?

Today was our second session of the clinical skills lab. These sessions could best be described as trying to teach us how to actually be a doctor. It is here that we learn and practice patient history, vital signs, heart/chest sounds, and all physical exam techniques. The students attend each lab in professional dress (with white coat and stethoscope) and see "patients," actors who have been trained in the proper techniques.

We are currently learning how to measure vitals. There are typically four main vital signs that physicians (or nurses or whoever is seeing you) check.

-Pulse (Heart Rate)
-Blood Pressure
-Temperature
-Respiratory Rate

These signs assess basic bodily function and serve as the first physical step in the clinical process of diagnosis. I say the first physical step of diagnosis as the patient history (as stated in my previous post) typically holds the crown for most important aspect of diagnosis.

Fun fact: while most everyone is familiar with how a doctor will assess your pulse (feeling the radial artery), take your temperature (a thermometer, be it tympanic or oral) and check your blood pressure (a sphygmomanometer and stethoscope), measuring respiration is typically done a little more covertly.

Think about it. Has your doctor every told you she/her is checking your respiration and watched you breathe? The likely answer?

Nope.

When someone knows their respiration is being counted, they inevitably think about breathing and thereby change their normal rate. Doctors typically hold the pulse longer than needed and count breathes or gently place a hand on your shoulder while doing so, allowing them to easily count the number of breaths while also measuring your heart rate.

Of course, a physician can always just watch a patient breathe while taking the history and count the number. Yet, (as one lecturer noted to the awkward laughter of the students) this can be a bit challenging when done on a female patient. Polite society dictates that eyes be up top and not down at chest level, especially during conversation.

Until next time.