I might go as far as saying percussion has almost no role in the practice of medicine in developed nations in the 21st century. Here's why: 1. There is virtually no clinically significant finding that percussion will pick up that wouldn't either be picked up on history or on auscultation.* 2. Anyone with new respiratory symptoms (e.g. dyspnea, hemoptysis) on history, or with an abnormal auscultation should get a chest X-ray. (may not be standard practice in resource-limited areas). 3. There is no pathology that percussion provides additional information to a chest X-ray. 4. Until recently, percussion still had a role in identifying the location of a known effusion at the bedside immediately prior to thoracentesis. But now we use ultrasound for that. (This is obviously not available in all parts of the world.) * The one debatable exception would be picking up hyperresonance in someone with subclinical (i.e. presymptomatic) COPD/emphysema. Although this possible role is suggested by the literature, I'm underwhelmed by its usefulness because the only treatment for subclinical COPD is smoking cessation, which a doctor should be recommending to their patient anyway, irrespective of chest percussion findings.
Very nice! Thank you very much!
Thats's so kind of you.
Thank you for the demonstration... Very informative video
Hello, Dr Strong!
First to watch 😊
🙏
Thanks so much...why new videos don't come out?
You're welcome. New videos haven gotten posted yet because they take time to research, film, and edit; and I have a completely separate full time job.
When would you percuss? Only if you hear something abnormal on auscultation?
I might go as far as saying percussion has almost no role in the practice of medicine in developed nations in the 21st century. Here's why:
1. There is virtually no clinically significant finding that percussion will pick up that wouldn't either be picked up on history or on auscultation.*
2. Anyone with new respiratory symptoms (e.g. dyspnea, hemoptysis) on history, or with an abnormal auscultation should get a chest X-ray. (may not be standard practice in resource-limited areas).
3. There is no pathology that percussion provides additional information to a chest X-ray.
4. Until recently, percussion still had a role in identifying the location of a known effusion at the bedside immediately prior to thoracentesis. But now we use ultrasound for that. (This is obviously not available in all parts of the world.)
* The one debatable exception would be picking up hyperresonance in someone with subclinical (i.e. presymptomatic) COPD/emphysema. Although this possible role is suggested by the literature, I'm underwhelmed by its usefulness because the only treatment for subclinical COPD is smoking cessation, which a doctor should be recommending to their patient anyway, irrespective of chest percussion findings.
It might be helpful to explain, perhaps parenthetically, what you are testing for with each step.
He's done that in another video