Clinical examination is a method of treatment-and-prophylactic care to the population, which includes early detection of diseases, dynamic observation of patients, their active treatment and elimination of adverse factors of work and life affecting the health of persons under medical observation. Clinical examination provides a synthesis of medical care and prevention, which is the main focus of the Soviet health care .
Patients with chronic diseases such as tuberculosis, hypertension , gastric ulcer and duodenal ulcer, coronary disease , rheumatic heart disease, endarterioiom, glaucoma, cancer and other diseases are taken to the dispensary registration to systematically monitor the health of patients and combat the exacerbation of these diseases.
Along with patients under medical supervision in accordance with the existing legislation there are numerous contingents of healthy: children under the age of 3 years, pregnant women, adolescent workers, workers of harmful workshops, athletes, etc.Go
The medical examinations of these contingents are carried out mainly through periodic medical examinations to systematically monitor the physical development of children and adolescents, the course of pregnancy and the early detection of various diseases.
The selection of patients for medical examination is carried out at medical visits in clinics, dispensaries, medical units, as well as periodic medical examinations.
In the medical parts, clinical examination plays a very important role in combating morbidity with temporary disability . According to the dispensary method, women's and children's consultations work (see Consultation).
In polyclinics - the most massive medical and preventive treatment facilities — the clinical examination is carried out primarily by therapists and pediatricians. Doctors of other specialties also carry out clinical examinations, conducting systematic observation and providing active medical care to patients with severe forms of diseases, such as oculists - patients with glaucoma, surgeons - patients with endarteritis , etc. The dispensary method of work in the dispensary is most pronounced (see).
The proper organization of work on the dispensary service of patients is very important.
The attending physician has a card file in which case histories are arranged according to nosological forms in alphabetical order. The card file should be regularly reviewed to ensure the attendance of the patient to see a doctor in a timely manner and to assess the effectiveness of the examination. At least once a year, a stage-by-stage epicrisis is filled in for each patient, where the doctor notes changes in his health.
In conducting clinical examination an important role belongs to the paramedical staff.
1. The nurse of the clinic on the card file identifies patients who did not come to the doctor on time, and takes measures to ensure their attendance at the reception, sending calls or personally visiting patients. With this, the nurse provides dynamic patient monitoring. The same tasks are performed by the visiting nurse in the pediatric consultation, the midwife and the nurse in the antenatal clinic.
2. Nurses in polyclinics, nursing home nurses, midwives, by systematically visiting patients at home, children and pregnant women, become familiar with their living conditions and help to eliminate unfavorable environmental factors. They, along with doctors, hold sanitary and educational conversations on personal hygiene, care for the sick , children, pregnant women, diet, etc.
3. Especially important is the role of average health workers in the conduct of clinical examination in the countryside. The considerable remoteness of the residence of many patients from the district hospital creates great difficulties in monitoring the implementation of the doctor's appointments by patients. Therefore, the paramedic-obstetric point, medical and nursing staff at the nursing staff of the hospital have a special responsibility in monitoring patients who are registered as dispensaries, in ensuring their timely attendance at the doctor’s appointment and in keeping with the regimen prescribed by the doctor.
The average health workers of the village also provide timely examinations by doctors of machine operators, milkmaids and workers in a number of other professions subject to clinical examination (see Rural Medical Site ).