During the physical examination of an MSK trauma patient, what should the examiner avoid?

The focus during a physical examination of an MSK trauma patient is to assess any injuries accurately and efficiently while ensuring patient comfort and safety. Beginning the exam with the patient fully clothed is typically discouraged because it may hinder the ability to effectively assess the affected areas for signs of injury, such as swelling, bruising, or deformity. Appropriate exposure of the injured site is often essential to make a proper evaluation and diagnosis.

Inspections for open wounds are critical to identify any immediate threats to vascular structures or potential infections. Documenting findings during the assessment is crucial for legal, medical, and continuity of care purposes, ensuring that all observations are recorded accurately for future reference. Moreover, providing warmth to prevent hypothermia is typically a key consideration in trauma care, as exposure to cold can be detrimental to a patient's condition.

Therefore, starting the exam while the patient is fully clothed can obstruct needed areas of examination, making it less effective in determining the extent of musculoskeletal injuries.