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Medical Screening

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Have you ever experienced or been told you have any of the following conditions?
Cancer Chronic bronchitis
Diabetes Pneumonia
High blood pressure Emphysema
Fainting or dizziness Migraine headaches
Chest pain Anemia
Shortness of breath Stomach ulcers
Blood clot AIDS/HIV
Stroke Hemophilia
Kidney disease Guillain-Barré syndrome
Urinary tract infection Gout
Allergies (latex, food, drug) Thyroid problems
Asthma Multiple sclerosis
Osteoporosis Tuberculosis
Rheumatic/scarlet fever Fibromyalgia
Hepatitis/jaundice Pregnancy
Polio Hernia
Head injury/concussion Depression
Epilepsy or seizures Frequent falls
Parkinson's disease Bowel/bladder problems
Have you ever had any of the following procedures?
X-ray Blood test(s)
CT scan Biopsy
Bone scan ECG or stress test
Urine analysis Surgery
Screening for domestic violence:
Do you feel unsafe at home?
Has anyone in your home injured or tried to injure you?

Generalized Systemic Red Flags

  • Insidious onset with no known mechanism of injury

  • Symptoms out of proportion to injury

  • No change in symptoms despite position, rest, or treatment

  • Symptoms persist beyond expected healing time

  • Recent or current fever, chills, night sweats, infection

  • Unexplained weight loss, pallor, nausea, dizziness, vomiting, b&b changes (constitutional symptoms)

  • Headache or visual changes

  • Change in vital signs

  • Bilateral symptoms

  • Pigmentation changes, edema, rash, nail changes, weakness, numbness, tingling, burning

  • Hx of cancer

  • No pattern to the symptoms; unable to reproduce symptoms during the examination

  • > 40 years old, gender, ethnicity, race

  • Night pain

  • Progressive neurology symptoms

  • Cyclic presentation

  • Joint pain with skin lesions

  • (−) Waddell signs

  • Psoas test for pelvic pathology = supine, SLR to 30° & resist hip flexion; (+) test for pelvic inflammation or infection is lower quadrant abdominal pain; hip or back pain is a (−) test

  • Blumberg sign = rebound tenderness for visceral pathology

  • (+) Kehr's sign (spleen) = violent Ⓛ shoulder pain

  • Pain @ McBurney's point = 1/3 the distance from Ⓡ ASIS to umbilicus; tenderness = appendicitis

Signs/Symptoms of Emergency Situations

  • SBP ≥ 180 mm Hg or ≤ 90 mm Hg

  • DBP ≥ 110 mm Hg

  • Resting HR > 100 bpm

  • Resting RR > 30 bpm

  • Sudden change in mentation

  • Facial pain with intractable headache

  • Sudden onset of angina or arrhythmia

  • Abdominal rebound tenderness

  • Black tarry or bloody stools

Normal Vital Signs & Pathologies That Influence Them

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  Normal Values Across the Lifespan Circumstances that may ↑ vital signs Circumstances that may ↓ vital signs
Infant Child Adolescent Adult & Elderly
T 98.2° 98.6° 98.6° 98.6°

Infection, exercise, ↑

blood sugar

↓ H&H, narcotics,

↓ blood sugar, aging

HR 80–180 75–140 50–100 60–100

Infection, ↓ H&H, CHF, ↑ blood sugar, COPD, fever, ↓ fluid volume, anxiety, anemia, pain,

↓ K+, exercise

Narcotics, acute MI, ↑ K+, beta blockers
RR 30–50 20–40 15–22 10–20 Infection, ↓ H&H, pain, ↑ ...

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