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  1. a feeling of extreme excitement, usually caused by something pleasant: the thrill of winning a competition. So why do people still go hunting - is it the thrill of the chase? It gave me a real thrill to see her again after so many years. The video shows the thrills and spills (= excitement and accidents) of motor racing. Synonym. frisson.

  2. a strong feeling of excitement or pleasure; an experience that gives you this feeling. thrill (to do something) It gave me a big thrill to meet my favourite author in person. She gets an obvious thrill out of performing. They were just in search of cheap thrills (= excitement that has no real value).

    • Introduction
    • General Inspection
    • Hands
    • Pulses and Blood Pressure
    • Jugular Venous Pressure
    • Close Inspection of The Chest
    • Auscultation
    • Final Steps
    • To Complete The Examination…

    Wash your hands and don PPEif appropriate. Introduce yourself to the patient including your name and role. Confirm the patient’s name and date of birth. Briefly explain what the examination will involve using patient-friendly language. Gain consentto proceed with the examination. Adjust the head of the bed to a 45° angle. Adequately expose the pati...

    Clinical signs

    Inspect the patient from the end of the bedwhilst at rest, looking for clinical signs suggestive of underlying pathology: 1. Cyanosis:a bluish discolouration of the skin due to poor circulation (e.g. peripheral vasoconstriction secondary to hypovolaemia) or inadequate oxygenation of the blood (e.g. right-to-left cardiac shunting). 2. Shortness of breath:may indicate underlying cardiovascular (e.g. congestive heart failure, pericarditis) or respiratory disease (e.g. pneumonia, pulmonary emboli...

    Objects and equipment

    Look for objects or equipmenton or around the patient that may provide useful insights into their medical history and current clinical status: 1. Medical equipment:note any oxygen delivery devices, ECG leads, medications (e.g. glyceryl trinitrate spray), catheters (note volume/colour of urine) and intravenous access. 2. Mobility aids:items such as wheelchairs and walking aids give an indication of the patient’s current mobility status. 3. Pillows:patients with congestive heart failure typical...

    The handscan provide lots of clinically relevant information and therefore a focused, structured assessment is essential.

    Radial pulse

    Palpate the patient’s radial pulse, located at the radial side of the wrist, with the tips of your index and middle fingersaligned longitudinally over the course of the artery. Once you have located the radial pulse, assess the rate and rhythm.

    Carotid pulse

    The carotid pulse can be located between the larynx and the anterior border of the sternocleidomastoidmuscle.

    Jugular venous pressure(JVP) provides an indirect measure of central venous pressure. This is possible because the internal jugular vein (IJV) connects to the right atrium without any intervening valves, resulting in a continuous column of blood. The presence of this continuous column of blood means that changes in right atrial pressure are reflect...

    Closely inspect the anterior chest

    Look for clinical signs that may provide clues as to the patient’s past medical/surgical history: 1. Scars suggestive of previous thoracic surgery:see the thoracic scars section below. 2. Pectus excavatum:a caved-in or sunken appearance of the chest. 3. Pectus carinatum:protrusion of the sternum and ribs. 4. Visible pulsations:a forceful apex beat may be visible secondary to underlying ventricular hypertrophy.

    Auscultate the four heart valves

    A systematic routine will ensure you remember all the steps whilst giving you several chances to listen to each valve area. Your routine should avoid excess repetitionwhilst each step should ‘build’ upon the information gathered by the previous steps. Ask the patient to lift their breast to allow auscultation of the appropriate area if relevant. 1.Palpate the carotid pulse to determine the first heart sound. 2. Auscultate ‘upwards’ through the valve areas using the diaphragmof the stethoscope...

    Sacral oedema

    Inspect and palpate the sacrum for evidence of pitting oedema.

    Legs

    Inspect and palpate the patient’s ankles for evidence of pitting pedal oedema(associated with right ventricular failure). Inspect the patient’s legs for evidence of saphenous vein harvesting(performed as part of a coronary artery bypass graft).

    Explain to the patient that the examination is now finished. Thank the patientfor their time. Dispose of PPE appropriately and wash your hands. Summarise your findings.

    • Dr Lewis Potter
  3. If something gives you a thrill, it gives you a sudden feeling of great excitement, pleasure, or fear.

  4. a feeling of extreme excitement, usually caused by something pleasant: the thrill of winning a competition. So why do people still go hunting - is it the thrill of the chase? It gave me a real thrill to see her again after so many years. The video shows the thrills and spills (= excitement and accidents) of motor racing. Synonym. frisson.

  5. 1. a sudden sensation of excitement and pleasure. seeing his book for sale gave him a thrill. 2. a situation producing such a sensation. it was a thrill to see Rome for the first time. 3. a trembling sensation caused by fear or emotional shock. 4. pathology.

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  7. a strong feeling of excitement and pleasure: It was a big thrill meeting the stars of the show. [ + of + doing sth ] the thrill of winning a competition. thrill. verb [ T ] uk / θrɪl / us. to make someone feel excited and happy: Woods thrilled the golf world with his performances.

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