The Paramedic Cardiac Exam


This is a quick summary of the minimum physical exam that is appropriate for a non-traumatic patient complaining primarily of chest pain.  For full details of the exam items listed below, and for links to other focused physical exams, go here.

Head and Neck Exam

  1. Assess if pupils are equal and reactive to light (PEARL)

  2. Assess pupils for midline, conjugate gaze

  3. Assess pupils for nystagmus

  4. Asses for speech deficits or abnormalities

  5. Assess mucous membranes for moistness and colour

  6. Assess for JVD

  7. Assess for tracheal deviation

Chest Exam

  1. Assess for lesions (DCAP-BTLS)

  2. Be alert for subcutaneous emphysema

  3. Assess chest wall respiratory movement

  4. Assess Anterior/Posterior ratio

Respiratory Exam

  1. A   Assess for Accessory muscle use

  2. B   Assess Breath sounds

  3. C   Assess Colour and condition of skin

  4. D   Assess word Dyspnea

  5. E   Assess for Extending position

  6. F   Assess SpO2 using Finger probe

  7. G   Assess end tidal CO2 Gas values and waveforms

  8. H   Heart Rate

  9. I   Assess the inspiratory/expiratory ratio (“i/e ratio”)

Abdominal Exam

  1. Assess for lesions (DCAP-BTLS)

  2. Assess for shape

  3. Assess for softness / guarding

  4. Assess for ascities/obesity

  5. Assess for abnormal pulsatile masses

  6. Assess for abdominojugular reflux

Extremity Exam


  1. Assess for pulses,

  2. Assess for clubbing of the fingers

  3. Assess for bilaterally equal BPs in arms

  4. Assess for radio-femoral pulse transmission delay

  5. Assess for edema

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