Site Map	Examine the CVS Including Peripheral Pulses

• Introduce yourself and check the patient's identity
• Establish rapport with patient
• Ask permission to examine & explain examination
• Position patient correctly
• Examine Hands
  • Nails
    • Perfusion / Capillary refill
    • Clubbing
    • Splinter haemorrhages
    • Nicotine stains
  • Palms
    • Janeway lesions
    • Oslers nodes
• Check pulses
  • Radial
    • Rate
    • Rhythm
    • Radial-radial delay
    • Collapsing
  • Brachial
    • Character
  • Carotid
    • Character
• Ask to check blood pressure
• Check for
  • Central cyanosis
  • Clinical anaemia
  • Mediastinum displacement
  • Jugular venous pressure
    • Hepatojugular reflex
• Inspect precordium
• Palpate precordium
  • Locate apex beat
  • Heaves and thrills
• Auscultate
  • Heart sounds
  • Radiation of murmurs
    • Particularly axilla & carotids
    • Time murmurs against a central pulse
  • Lung bases
• Look for oedema
  • Peripheral
  • Sacral
• Check for hepatomegaly
• Examine peripheral pulses
  • Femoral
  • Popliteal
  • Feet
  • Brachiofemoral delay
• Suggest
  • Temperature
  • Pulse oximetry
  • Urine dipstick
• Summary and analysis of findings

	Any comments or feedback please contact me by email: Tom Williams