HEAD-TO-TOE ASSESSMENT CHECKLIST Breath sounds – Anterior _____________

Assessment conducted Posterior _________ Lateral __________

by:________________________________ Chest symmetry _____________________
Level of consciousness Sin turgor (Clavicle) ___________________
Alert Drowsy Lethargic Abdomen
Orientation Inspection

Person __________________________ Auscultation

Place _____________________________ o LUQ _______

o RUQ _______
Time _______________________________ o LLQ _______
Orientation _________________________ o RLQ _______

Vitals Palpation ___________________________

Pulse___________ RR ____________ Upper Extremities

BP _____________ Pulse ox ________ Radial pulse eqal, +2

Head o Other: ___________________________

R
Hair ____________________________ Grip equal and strong _________________

PERLA ____________mm Capillary refill <3 seconds

Nose _____________________________ Vein filling rapid

Ears _____________________________ Lower Extremities

V
Mouth ____________________________ e Hair present Edema

o Midline tongue ___________________ Foot strength Nails _____________

E
o Moist ___________________________ SKIN ASSESSMENT (NOTE SKIN ABNOMALITIES
o Lesions _________________________ F SCARS, WOUNDS, DISCOLORATION,
E.G.
o Dentition ________________________ STRIAE, SWELLING, BRUISES )
Neck _______________________________________
Carotid Pulse _______ Trachea midline _______________________________________
_______________________________________
Chest _______________________________________
Apical pulse _________ Muffled _______________________________________
______________________________________
Arrhythmia