General Examination

I was engaged in quite a bit of clinical teaching over the last couple of weeks and one thing that I noticed was that most students and doctors were confused about the exact nature of a general examination.
This was across a broad range of experience- second year students , final year students and senior house officers.
When asked to perform a general examination they would look for jaundice, anaemia, clubbing, cyanosis , oedema and lymphadenopathy.
When questioned from where they would perform the general examination , they would all say that this would be done from the end of the bed.
The next question would be how they would assess clubbing and lymphadenopathy from the end of the bed. This not possible. Even to say a patient has oedema one would need to demonstrate pitting and this cannot be done from the end of the bed.
General examination is the visual survey one performs from the end of the bed.
Do not attempt to examine a lot at this point.
Stick to assessing the patient's clothing and grooming, the posture of the patient, the state of growth , development and metabolism and look for any major changes in the integument.