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

[nurseshepherd]

Postpartum C/sections are the ones I percuss as part of an abdominal assessment, especially those who were slept (general anesthesia rather than spinal). Those who are tympanic in the upper quadrants benefit from early interventions if your HCP's will let you give them simethecone and get them ambulating.

[GOMER42]

I think it is next to worthless considering we have ultrasound if there is a concern.

[Penelope_Pitstop, BSN, RN]

the vast majority of my nursing career has included a seven patient assignment, so as much as i would love to do a full head-to-toe assessment like we did on each other sophomore year of nursing school, i don't think i've percussed since then.

jess

[Xbox Live Addict]

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. :)

As part of my physical exams for plasma donors, I assess the liver edges using a 2-handed palpation technique that is the official company practice (it absolutely has to be done this way if any auditor is watching, or we get written up.)

But never used percussion, and I've never seen a physician use percussion, or had percussion used on me.

[TiredMD]

But never used percussion, and I've never seen a physician use percussion, or had percussion used on me.

I'll use it in a couple of circumstances:

- decreased breath sounds and I'm curious if there's a pleural effusion present

- used to use it to assess liver size, but I no longer trust it

- typanitic abdomens; not for any clinical utility, it just amuses me to hear that "drum" sound

Also, when you percuss, it makes people think you're really smart because no one has ever done that on them before.

[Xbox Live Addict]

I'll use it in a couple of circumstances:

- decreased breath sounds and I'm curious if there's a pleural effusion present

- used to use it to assess liver size, but I no longer trust it

- typanitic abdomens; not for any clinical utility, it just amuses me to hear that "drum" sound

Also, when you percuss, it makes people think you're really smart because no one has ever done that on them before.

I think most people would probably just wonder what the hell I thought I was doing to them.

You just gave me an image of a long-ago Saturday Night Live Christmas show in which Chris Farley played "The Little Drummer Boy" on his abdomen.

[justme1972]

We have a ACNP for an instructor in our health assessment class that I finished this summer.

She was a cardiac nurse for 8 years before she got her NP.

She said that she uses percussion on every non-life threatening case that comes into the ER. She said that not everyone will have an ultrasound and not everyone is going to have an x-ray...and it's a good way to spot a potential problem that may not have anything to do with what they came into the ER for.

We practiced and practiced to where we could do the entire assessment in 5 minutes....percussion and all.

[justme1972]

But never used percussion, and I've never seen a physician use percussion, or had percussion used on me.

Ok...I had to throw this out there...b/c it's funny.

When we first started our class this summer, we were having trouble getting the "flow" of how we were supposed to do it.

So someone asked our instructor, "Mrs. Smith...could you please take a student, as if she were a patient, and just go through the entire assessment so we can see it done once. We just haven't seen a nurse do one that complete before."

...and then someone else chimed in...

"...or a doctor."

:chuckle