Be familiar with routine tests, such as vision and hearing testing. Review procedure and unexpected patient reactions. Know when and to whom to report abnormal results.
Vision testing includes such tests as Snellen test, Ishihar (color), Pelli-Robson, Jaeger car, E chart, as well as tests for ocular pressure and visual fields. Be familiar with testing procedures and abnormal measurements.
Hearing tests may be performed on any age group. You should be familiar with pure tone audiometry, tympanometry, and speech and word recognition. Know testing procedures and special considerations when working with children or hearing impaired individuals.
Allergy testing includes scratch testing and intradermal testing. Know procedure for each. Be familiar with RAST and MAST testing. Be able to identify and perform allergy injections.
Be familiar with respiratory testing. This may include pulmonary function testing. Know how to respond to unexpected situations, like respiratory distress.
The medical assistant often helps the provider administer exams of varying purposes. It is important to understand the various procedures so that you will know what to do. Here are some of the skills you’ll need to have and the types of exams in which you might assist.
Depending on the procedure being performed, the patient may need to be positioned a certain way. You also need to know the draping method for each position.
(1) Sims—patient must be side-lying, with the knee pulled upward toward the chest
(2) Fowler’s—patient sits upright, at a 90 degree angle to the surface upon which he/she is sitting
(3) Supine—patient lies flat on his or her back
(4) Knee-chest—patient gets on his or her hands and knees, then lowers the upper half of the body and rests on the chest.
(5) Prone—patient lies face down
(6) Lithotomy— also known as the child-birthing position, patient lies in supine position with legs elevated in stirrups
(7) Dorsal recumbent— patient lies supine with the knees bent, feet flat on surface
Be familiar with basic examination methods and recognize abnormal findings.
(1) Auscultation—stethoscope is used to listen to heart, lung, or bowel sounds
(2) Palpation—hands or fingers are used to feel organs or body parts
(3) Percussion—tapping on a surface to feel what lies underneath
(4) Mensuration—mathematics referring to body measurements
(5) Manipulation—moving a body part for treatment, as used to fix a dislocated limb
(6) Inspection— observation of the patient
When assessing an infant, length, weight and head circumference should be taken. Be familiar with Apgar scoring in infants.
The MA assists the physician when performing pelvic exams, breast exams, and prenatal/postpartum exams. Be familiar with PAP smear procedure and know how to calculate fundal height and listen for fetal heart tones. You may also need to assist with ultrasound exams and pregnancy tests (urine and serum).
You need to be familiar with other exams in order to assist practitioners. These are two commonly-performed exams.
Proctology— Review proctology exams, such as, proctoscopy, sigmoidoscopy and colonoscopy. Know how to obtain occult blood tests and what is involved in guaiac stool examination.
Urology— Know proper procedure for obtaining urine specimens for urinalysis (sterile, clean catch, etc.) Also, be familiar with cystoscopy procedure.
The MA may be responsible for performing or assisting in radiologic procedures. Review diagnostic imaging procedures for an X-Ray, CT, and MRI.
There are now many procedures that are performed during regular doctor office visits and you may be responsible for performing them or assisting a doctor with them, as a medical assistant. Become thoroughly familiar with these procedures, including the supplies and equipment needed, common techniques, and sterile preparation for them.
Suture/staple removal— requires use of a suture/staple removal kit and specific procedures for using its elements
Ear irrigation— removes excess ear wax or foreign bodies from the ear
Eye irrigation— flushes the eye of foreign particles or chemicals
Wound care/dressing changes— requires knowledge of supplies, terms, and procedures
Immobility support application— splint application on wrist and ankle
Oxygen therapy— requires familiarity with types of oxygen delivery systems (nasal cannula, venturi mask, etc)
Spirometry— use of respiratory devices like an incentive spirometer, PLT, and peak flow meter
Nebulizer treatments— used to administer breathing medication to patients
First aid, BLS, and rapid response measures— includes how to use an automated external defibrillator (AED) and how to perform CPR and the Heimlich maneuver
Therapeutic interventions can also aid in healing, pain relief and overall wellness. These include heat and cold treatments and exercises.
Heat Treatments— Heat treatments can aide in pain relief and prepare muscles for exercise. These include hot baths, hot packs, and moist compresses, as well as paraffin and whirlpool baths.
Cold Treatments— Cold treatments, such as ice packs or cold compresses, can reduce swelling and aid in pain relief.
Ultrasound Treatments— Ultrasound wands are used with ultrasound gel on the skin’s surface. They are intended to help with muscle strains and other minor injuries. Review the proper methods for performing ultrasound therapy.
Range of Motion Exercises— Range of motion helps maintain flexibility and muscle tone. Know the correct way to perform passive range of motion on the body.
Isotonic and Isometric Exercises— Isotonic exercise is any moving exercise (running, weight training, etc.). Isometric exercise involves no muscle movement (planks, wall sits, etc.). Know the indications and procedure for these exercises.