I can't hear a thing! Re: Percussing lung fields

nurseprnRN, BSN, RN · Mar 2, 2012

you're gonna think this is silly, but practice on things that you see in the grocery store. they're familiar, inside and out, so you have a visual frame of reference as well as a base to listen/feel. really. you think i'm kidding, but i'm not.

listen to and feel the difference between a watermelon and a honeydew. a deep thump that almost echoes versus a shorter, higher-pitched sound. which one is denser inside? i'm betting the honeydew.

move on to the meat department-- try the roasting chickens versus the stuffed ones-- you can hear and feel the hollow vs the not-so-hollow. ok, so you may have to buy this stuff and take it home (you can't make this work on a frozen carcass), but you get my meaning.

move on to the difference between a full milk carton and a half empty one. now you're cooking. well, not exactly, but at least you're out of meats and produce.

now you're ready for some real chests and bellies. do you have a significant other who would be willing to doff a shirt and let you pound on his/her back with a deep breath in it and then fully exhaled? and maybe chug a beer or a bottle of soda, jump up and down(no burping! your buddy should lie down on the right side so the gas rises and distends the stomach but doesn't go up the esophagus), and in a few minutes let you percuss over the (gas-filled) stomach, and later maybe let you try again after a big meal? this will start making sense to you when you have some really extreme examples, like these, for contrast.

have fun!

acerbia · Mar 7, 2012

This was awesome and very helpful! I will definitely give this a try. Thank you

Cuddleswithpuddles · Mar 7, 2012

Hello,

I would like to know what kind of nursing program you are in. Percussion is usually considered an advanced practice technique that is more in the realm of NPs, PAs, MDs and DOs. In my experience, most RNs do not use percussion and would be befuddled as you are right now, myself include hehe.

A huge chunk of nursing skills will be confounding and awkward at the first semester. Skill and confidence require consistent practice on real patients over the long haul.

Basically, I have no advice for you other than be kind to yourself! :)

mindlor · Mar 7, 2012

They taught us percussion in semester 1 as well. Be advised that percussion is mainly BOLLOCKS.

Not once have I seen a nurse, a doctor, ARNP, PA, RT, or anyone else do this.

Why dont they do this? Because it is subjective, plain and simple. Go through the motions in class and take solace in the fact that you will probably never use this technique in real world practice.....

Esme12, ASN, BSN, RN · Mar 7, 2012

Hello,
I would like to know what kind of nursing program you are in. Percussion is usually considered an advanced practice technique that is more in the realm of NPs, PAs, MDs and DOs. In my experience, most RNs do not use percussion and would be befuddled as you are right now, myself include hehe.
A huge chunk of nursing skills will be confounding and awkward at the first semester. Skill and confidence require consistent practice on real patients over the long haul.
Basically, I have no advice for you other than be kind to yourself! :)

I disagree......even 33 years ago we were taugh percussion as a part of assessment and yes I have used it, not extensively, over the years.

nurseprnRN, BSN, RN · Mar 7, 2012

beg to differ, too. i did percussion often as part of my phyical examination of a patient. once you hear and feel the difference between a big rounded abdomen full of gas from an intestinal obstruction and one that is full of blood from a leaking aneurysm, you won't forget it. i know you can listen to a chest full of pneumothorax air, hear nothing, and not need to percuss it, but if there's any doubt in your mind (no tracheal shift? obstruction? consolidation? et tube down the mainstem bronchus?) a quick percussion will tell you all you need to know.

part of using percussion to its best advantage is remembering that you are feeling as well as hearing.

Cuddleswithpuddles · Mar 8, 2012

Grntea and Esme12,

Thank you for your posts. I am a relatively new nurse ('bout six years) and I was coming from that limited perspective.

The Youtube video had very crisp sound quality, thank you.

LemonIndiscretion · Mar 13, 2012

AUgh. I just wrote a huge post that I somehow deleted it. I was taught percussion by finding studs in a wall. Totally works. The same clinical professor taught me everything I know about lung sounds. But try finding the studs its a great way to practice at home. WARNING only works if your walls are sheet rock- lol