kity
NO PAIN.. NO GAIN..
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What if a pt winces on superficial palpation of RUQ & we say sorry, dont we palpate deeply there? as it will cause pain again to the pt & we are not supposed to repeat painful procedures..
like suppose in gall bladder disease, pt says he feels pain on superficial palpation there.
Then should we do
1.purcusssion for liver span?? and
2.murhpys sign..
3.deep palpation??
pt will have pain 4 times then.. What do we do????
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STEP1 99, STEP 2 91, CERTIFIED, STEP 3 SECOND ATTEMPT 81, 2 MONTHS EXTERNSHIP, 2 WEEK OBSERVERSHIP, 2006 GRAD
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| DrVirgo
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Do slightly deeper palpation (but not too deep).
Murphy sign lightly as well.
The SP will show it with light palpation.
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| kity
NO PAIN.. NO GAIN..
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hey drvirgo.... what if pt winces on superficial palpation itself. then pt will wince on others too. .
do we do these then also??? 'cos it will cause pain so many times then..
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STEP1 99, STEP 2 91, CERTIFIED, STEP 3 SECOND ATTEMPT 81, 2 MONTHS EXTERNSHIP, 2 WEEK OBSERVERSHIP, 2006 GRAD
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| DrVirgo
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It's an SP- remember that he is only "acting"... If you don't palpate too hard you are not really causing him much discomfort. Just avoid very DEEP palpation or pressing TOO hard. But if you get +RUQ pain on soft palpation, you MUST check for +Murphy's Sign -It's important to check for cholecystitis so you can say that in your DD.
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Our greatest glory is not in never falling, but in rising every time we fall.
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| kity
NO PAIN.. NO GAIN..
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Thnax Drvirgo.. so we should try to do it anyways!!
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STEP1 99, STEP 2 91, CERTIFIED, STEP 3 SECOND ATTEMPT 81, 2 MONTHS EXTERNSHIP, 2 WEEK OBSERVERSHIP, 2006 GRAD
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| DrVirgo
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Yes! Because if there is a +Murphy's Sign, and you don't find it and write it in your note, you won't get the point for it.
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