Overview
Clinical Orientation
The first look at a patient’s face, voice, breathing pattern, and exposed skin can show whether a routine assessment is appropriate or whether an immediate threat needs attention.
The first look at a patient’s face, voice, breathing pattern, and exposed skin can show whether a routine assessment is appropriate or whether an immediate threat needs attention. HEENT findings may signal airway obstruction, impaired oxygenation, neurological change, or sensory loss. Skin findings may reveal altered perfusion, fluid imbalance, infection, pressure damage, or failure of the protective barrier. The assessment is therefore a sequence of observations linked to decisions, not a list of body parts. Begin by observing the patient before touching them. Note distress, work of breathing, voice quality, facial symmetry, colour, level of consciousness, and obvious swelling or bleeding. Then use a consistent head-to-toe sequence: inspect and palpate the head, scalp, face, and hair; assess vision and pupils; examine the ears and hearing; inspect the nose and oral cavity; assess the throat and neck; and complete a systematic skin review. Compare bilateral structures and compare current findings with the patient’s baseline whenever possible [1]. Explain each manoeuvre, provide privacy, use hand hygiene and appropriate precautions, and stop if the examination increases pain or threatens airway stability. An RPN...