Who here actually uses percussion when doing assessments?

[student456]

I asked this question to several RN's...and the responses I got were that they don't percuss. Do you use percussion as part of your physical assessments of pts? I was wondering because there are some stuff that they teach us in NS that nurses never seem to do (ex: measure liver spans on patients, etc). I try to practice percussion but I never know what I am hearing or what normal / abnormal sounds like, just what I read in my physical assessment book

[Xbox Live Addict]

I asked this question to several RN's...and the responses I got were that they don't percuss. Do you use percussion as part of your physical assessments of pts? I was wondering because there are some stuff that they teach us in NS that nurses never seem to do (ex: measure liver spans on patients, etc). I try to practice percussion but I never know what I am hearing or what normal / abnormal sounds like, just what I read in my physical assessment book

I had to do a comprehensive head-to-toe exam on a volunteer as part of Nursing Process, which included examination methods such as percussion. I have never done such an exhaustive exam in actual practice, as it took me nearly an hour to do the exam and several hours to write several pages' worth of assessment findings. There's no way you can do that with a full load of patients.

[PICNICRN, BSN, RN]

I have to admit, I do not usually percuss during an assessment. I do however, measure liver spans on all of my kids- find this pretty important, especially in my cardiac kidos. Actually, I cannot say that I have ever seen an intensiveist percuss any of my kids either during a "usual" assessment on any random kid. Only when they are complaning of ABD pain do we really do this.

Great question!!!!

[icyounurse, BSN, RN]

I can honestly say that the only time I have really "percussed" or checked for a liver border was in nursing school to pass assessment. I have never done this as a nurse, but I have seen some docs do it with their assessments. I can usually gather what I need to know without doing it and probably wouldnt even know what to listen for while doing it anymore. I personally have never seen another nurse doing it on the job as part of their assessment either. But maybe my experience is unique. :)

[canoehead, BSN, RN]

I've not found that percussion adds to the nursing assessment, although I've checked pediatric liver borders. Usually if someone has poor lung expansion I already know that from their other symptoms, or if they have a pneumo or large mass its suspected, but confirmed by radiology testing. To do percussion is painful at times, and not a substitute for more definitive testing- it doesn't change how I treat the patient while I waiting for radiology results. Plus it's uncomfortable for LOL to maintain position, or people in pain to stay still.

If I was working in an office without radiology it would probably be used more. I'd be interested in hearing from people that use it and in what circumstance.

[nerdtonurse?, BSN, RN]

The only time I've done it outside school was on the lungs and liver. The liver for folks with liver failure/hepatitis etc., and that was more out of curiosity than anything else -- if you've drank yourself to death, your liver's going to be enlarged and hard as a rock, duh....

I've percussed lower lobes of lungs a few times on morbidly obese folks, trying to determine if the "diminished" breath sounds were the lungs not filling all the way down, or just breathsounds muffled by the "fluff." I've also percussed on folks who had partially collapsed lungs to determine the extent of the collapse (which I mark for my benefit, so I can tell if starts getting worse, etc.) But ordinarily, no.

[SDS_RN, RN]

I have not used percussion not even sure what I would be listening for. I've seen one of the nurses I work w/ use it but she's the only one I've seen use it.

[towntalker]

it depends on the patients dx..sometimes it is needed but in most cases it is not

[shannonFNP, BSN, MSN, RN]

At my nursing school, they are getting away from percussion and no longer teach it.

[Zookeeper3]

I spot check percussion. Meaning that if my pt's belly is suspicious I'll percuss, lungs in the obese or thick walled with issues, yes. Thin simple MI nope. I use it as an additional tool where needed for assessment, not part of a standard assessment.

[leslie :-D]

i percuss abds on admission, while i'm doing my head to toe.

i like to get a sense if i'm dealing with tumors/masses in the cavity.

never felt the need to percuss lungs...

i hear what i need to through auscultation.

leslie

[Ahhphoey]

I don't percuss though I have seen many doctors use this when a situation warrents (i.e. not on every patient, every day).