PREPARATION FOR THE OSCE: PHYSIOLOGICAL MEASUREMENTS

When you are doing the physiological measurements staition on your OSCE remember to firstly, introduce yourself and identify the patient (eg. name & date of birth). Secondly, explain the procedure and establish a valid consent. Thirdly, carry out procedure and follow infection prevention and control policies (eg. hand-washing).

TEMPERATURE

source: https://www.spservices.co.uk/item/Brand_BraunThermoScanPro4000TympanicThermometer_48_0_4807_1.html

—Normal range is between 36.0 and 37.5 degrees C. Temperature can be measured tympanically, orally, axillary or rectally. High temperature can be a sign of infection, arthritis, heat stroke, etc. Some useful terminology: —Hypothermia – a reduced body temperature of 35 degrees or less —Pyrexia – a raised temperature. —The three grades of pyrexia are Low (normal temperature to 38 degrees), Moderate/high (38 to 40 degrees) and hyperpyrexia (40 degrees and over). —Rigor – shaking or exaggerated shivering that occurs with a raised temperature.—

PULSE (rate, rhythm & amplitude)

source: http://img.tfd.com/mk/P/X2604-P-57.png

Normal pulse rate is between 55 ~ 100 beats per minute in people above the age of 10. In children and babies pulse is faster. Various factors can affect pulse rate including: fever, heart problems, infection, pyrexia, hypovolaemia, levels of fitness, anxiety, shock and medications. Useful terminology: —Tachycardia – resting pulse of >100 bpm (beats per minute) in adults. —Bradycardia – pulse of <60 bpm.

RESPIRATION (depth, pattern & sounds) Normal breathing rate is between 12 ~ 20 breaths per minute. Factors affecting the breathing rate include: anaemia, pneumonia,asthma, —COPD, severe bleeding, stress/anxiety, medications etc. Some useful terminology: —Bradypneoa  – slower than the normal   (Tachypnoea  – faster than normal  (>20 resps per   minute) —Dyspnoea – breathing is difficult [conscious patient] —Orthopnoea – dyspnoea occurring when the patient   lies flat —Apnoea – temporary cessation of breathing

BLOOD PRESSURE (BP) (systolic & diastolic) source: http://www.fit8.co.uk/wp-content/uploads/2013/11/blood-pressure-2.jpg

source: http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Bloodpressurechart

Above is a chart explaining the ranges of BP in adults. —Hypertension – BP greater than 140/90mmHg. —Causes include obesity, chronic kidney disease, high alcohol intake, smoking, adrenal/thyroid disorders. —Hypotension – low BP (systolic below 100 mmHg). Causes include pregnancy, dehydration, underactive thyroid, heart failure, blood loss, anaphylaxis

Lastly, record results and take any necessary action.