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Value of Bedside Exam for ICU Patients Discussed

Despite lack of evidence, authors recommend use of checklist-based bedside examination

TUESDAY, Oct. 20, 2015 (HealthDay News) — A checklist-based bedside physical examination in the intensive care unit (ICU) is suggested as clinically useful in spite of a lack of evidence demonstrating this, according to a commentary published in the October issue of the Annals of the American Thoracic Society.

Thomas S. Metkus, M.D., and Bo Soo Kim, M.D., from Johns Hopkins Hospital in Baltimore, examined the value of the comprehensive physical examination and bedside assessment in the ICU.

The researchers note that there are limited data relating to the clinical usefulness of bedside diagnosis in the modern ICU and no clinical guidelines addressing its use in critically ill patients. Bedside assessment and physical examination are used in a heterogeneous manner across institutions and in ICUs within the same institution. A checklist-based approach to the physical examination is suggested as being clinically useful. Examination of the patient with the entire care team provides an opportunity for multidisciplinary teaching, learning, and collaboration. Bedside diagnosis also allows for contextualization of data from monitors and images that could yield misdiagnosis if interpreted in isolation.

“In conclusion, we believe that even in the modern ICU, the physical examination retains value and merits further scholarly work,” the authors write. “We can learn a lot by watching.”

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