Examination Technique:

• explain to the patient that you will be drawing a number in the palm of their hand.
  
  
• explain to the patient what is up and down, the distal side is usually up as this is a typical orientation of the palm.
  
  
• demonstrate with eyes open.
  
  
• ask the patient to close their eyes.
  
  
• with a blunt item such as your fingertip draw a number across the palm and ask the patient to identify it.