Chatting with the patient will also help the RT to assess the patient’s level of consciousness and respiratory pattern and rate. Does the patient become short of breath just because they are answering questions? Does the patient behave appropriately? Does it seem as though the patient is engaged in self care such as grooming? Using only observation and inspection an RT can learn quite a bit before moving on.
Palpation is an important skill in assessing the symmetry and volume of a patient’s breath. Placing hands in a butterfly pattern on the posterior chest wall and moving near the base of the rib cage while asking the patient to take a deep and forceful breath will show the RT if the lung expansion is equal and bilateral. Palpation is also performed to get a sense of the vibrations transmitted through the thorax while the patient is breathing and speaking. Changes in vibrations felt beneath the palms of the examining RT, known as fremitus are noted as increased or decreased and can help determine the presence of consolidations or trapped air in the thorax.
A complete chest assessment would be finalized by listening to the patient’s breath sounds and comparing what you are hearing to what was found previously. Armed with the findings an RT will be able to discern the patient’s progress and/or offer additions or changes to the patient’s treatment plan.
References
Butler, T. J. (2013). Laboratory exercises for competency in respiratory care. Philadelphia, PA, PA: F.A. Davis.
Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: diagnosis and management. Am Fam Physician. 2013 Jul 15;88(2):102-10. PMID: 23939641.
Lim, S. J., Kim, J. Y., Lee, S. J., Lee, G. D., Cho, Y. J., Jeong, Y. Y., Jeon, K. N., Lee, J. D., Kim, J. R., & Kim, H. C. (2018). Altered Thoracic Cage Dimensions in Patients with Chronic Obstructive Pulmonary Disease. Tuberculosis and respiratory diseases, 81(2), 123–131. https://doi.org/10.4046/trd.2017.0095