…abdominal pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile…

…marked obesity or a stiff chest wall. Glottic or subglottic obstruction — the mask sits above the obstruction and solves nothing. A mouth opening below about…

…stroke call. 2. Establish the time of symptom onset or the time last known to be well. 3. Assess airway, breathing and circulation. 4. Measure…

…passages and choose the more patent one. Ask the patient about a previous nasal fracture or unilateral nasal obstruction. 2. Measure the depth of insertion…

…a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury, anaphylaxis, deep neck infection…

…1 month Neurosurgery or an intracranial aneurysm Contact the responsible specialist An aortic aneurysm 6 cm Relative — avoid forced manoeuvres An ongoing respiratory infection with…

…loosened or avulsed nail plate, or a damaged nail fold edge Nail avulsion and inspection of the nail bed, with suture of any nail bed…

…heart rate, ECG. References Narula et al: Time to Add a Fifth Pillar to Bedside Physical Examination: Inspection, Palpation, Percussion, Auscultation, and Insonation. JAMA Cardiology.

…in the broader assessment of peripheral arterial and aortic disease; planned surgery, especially carotid endarterectomy (CEA), coronary artery bypass grafting (CABG), or major non cardiac…

…transmitted infection — although chlamydia and gonorrhoea can be tested on urine or a self taken vaginal sample without a speculum. Routine gynaecological examination of asymptomatic…