• Clubbing
• Cyanosis: are hands cold or warm?
• Stigmata of endocarditis
  1. splinter haemorrhages
  2. Osler's nodes
  3. Janeway lesions
• Nicotine stains
• Capillary refill time

Carefully examine the radial artery

1. Compress the radial artery with your index and middle fingers
2. Note whether the pulse is regular or irregular
3. Count the pulse for 15 seconds and multiply by 4
4. Count for a full minute if the pulse is irregular

• Raise the arm and determine whether the pulse is collapsing or bounding
  (if it is, it becomes much more obvious when the arm is raised)

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