Sensory SystemTest for sensations using pain, heat or cold, touch, and vibration.
Reflexes-Check deep tendon reflexes, superficial reflexes, and also check the pathological reflexes (i.e., Brudzinskis sign and Kernigs sign). Reflexes are checked to localize nervous system disorders.
After taking the history and performing the physical examination, make an assessment of the patients condition related to all positive findings. Independent duty hospital corpsmen usually have the most modern communications facilities at their disposal and should never have to guess. If you are in doubt as to the diagnosis, seek advice. Ships information such as latitude, longitude, destination, and the like will be provided by the responsible section. Message format is likewise available from the communications section. Where to seek help is an administrative problem since the location of ships with medical officers aboard is not in the purview of the corpsman. However, you are responsible for the content of the message and should provide all essential information. Give the patients full name, rate, SSN, age, mental state, and ship to which attached. List the principal complaint, nature and onset of symptoms, and also their duration. List the associated symptoms, and list personal and work habits that may have a bearing on the case. If injured, give the cause, location, amount of bleeding, deformity, and any other significant signs and symptoms. State the patients vital signs and their trends, if any. List all other pertinent physical findings, results of tests, and any treatment started.
For acute thoracic emergencies:
The following are some of the more commonly encountered diseases of the respiratory tract.
In most cases, the signs and symptoms listed below indicate a severe URI and a need for medical assistance.
An elevated temperature of 101°F or more that has persisted for 3 or more days.
A white or dirty gray exudate in the throat.
Diffuse reddening of the throat.
A persistent cough of 2 or more weeks.
Complicating symptoms that you should be alert for are skin rashes, stiff neck, muscular weakness, and swelling.
ETIOLOGYThis is an acute inflammatory process in the alveolar spaces of the lung. Pneumococcus accounts for approximately 60 to 80 percent of all primary bacterial pneumonias. Because bacterial pneumonias are usually secondary to injury of the respiratory mucosa by viral infections such as influenza and the common cold, they often occur during periods of cold, inclement weather.
SYMPTOMSThere is a sudden onset of symptoms with rapid progression. The condition of the patient deteriorates rapidly. Temperatures range form 100° to 105°F, pulse rate may go as high as 160, and respiration is marked by tachypnea (30 to 40 per minute). Respirations are shallow and a peculiar grunt may be heard upon expiration; the patient will often lie on the affected side in an effort to splint the chest. The patient experiences hard, shaking chills; sharp, stabbing chest pains that are exaggerated by respiration; and a productive cough with rusty colored sputum. Upon auscultation, fine inspiratory rales may be heard, followed by the classic signs of consolidation (absent breath sounds and dullness). Sometimes the abdomen becomes distended and a pleural friction rub may be heard.