Integrated Patient Management

From FK Wiki
Jump to navigation Jump to search
Lymph nodes to palpate
Abdominal exam: auscultation is done before palpation and percussion to avoid disturbing the intestines, which can induce abdominal sounds.
13 points to percuss during abdominal examination

The IPM station appears in every OSCE and gets more and more complex in senior years. An integral part of IPM is the anamnesis. The anamnesis needs to be thorough and you should reconfirm everything at the end of the anamnesis, similar to how a waiter repeats your order: "So, you ordered two friend chickens, one mango juice, and one rice, right?" After the anamnesis comes the examination but the examination cannot happen without informed consent. Explain what you want to do, why it's a good idea to do it, and then ask if the patient is okay with it.

Often, the patient will have more than one complaint. For example, the patient may have a primary complaint of abdominal pain but also complain of difficulty walking. That means, in addition to the abdominal exam, you must also do a general physical exam that includes checking the patient's legs and feet thoroughly. Palpate the patient's legs and feet and ask for pain sensation and report capillary refill time. You may also choose to do a quick range of motion exam and even ask the patient to stand and walk a bit around the room. Always ask the patient, "any other problems?" ("Ada keluhan lain?" in Indonesian) before reconfirming/recapping the anamnesis.

Always ask the patient if they have any questions at the end ("Ada pertanyaan?" in Indonesian).