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    I'm a bit confuzzled, just doing some tad reading on asessing patients etc, and it says when asessing the abdomen

    look, listen feel
    check for distension/scars
    listen for bowel sounds
    Percuss (dulln ess, tympany and flatness)

    THEN it says "start in least painful area" how would you do this then? Surely when asessing a patient and feeling areas this can cause more pain? Plus how can do you this with an incoherant patient?
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    If a patient has pain in the stomach then you will find 'guarding' is present. In other words they won't want you to touch sensitive areas. That should help you to identify exactly which areas are most painful.

    Even an incoherant patient will show the same 'guarding' as it is an innate reaction to protect a painful area.

    Obviously, if a patient shows that an area is painful then you would refrain from applying pressure in that area.

    You could also watch for signs such as reddening or heat which could denote infection.


    In most cases once the painful area has been located then x-rays or other investigations will be done to identify the specific bit that needs fixing!
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    We are told ask them to point where it hurts, and start away from that area working towards it and doing it last.
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    (Original post by terpineol)
    We are told ask them to point where it hurts, and start away from that area working towards it and doing it last.

    oh ok, so why would you work towards it and do it last? Like whats the evidence for it?
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    (Original post by Subcutaneous)
    oh ok, so why would you work towards it and do it last? Like whats the evidence for it?
    In terms of EBM I've no idea.

    I'd guess not going straight for the painful bit helps them relax a bit, and lets you look forward to seeing them hit the roof when you hit that spot with some deep palpation.
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    (Original post by Subcutaneous)
    oh ok, so why would you work towards it and do it last? Like whats the evidence for it?
    If you start in the most painful area then they will be more likely to tense and you won't feel as much as you would if you start somewhere where it doesn't hurt.

    Once someone touches you and they've caused pain, you naturally remain tensed.
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    Cheers thanks
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    (Original post by terpineol)
    In terms of EBM I've no idea.

    I'd guess not going straight for the painful bit helps them relax a bit, and lets you look forward to seeing them hit the roof when you hit that spot with some deep palpation.
    Well, I hope that you are not around the next time I have a flare-up of Crohn's Disease. Try that trick on me and you might find yourself with a mouthful of broken teeth as my knee hits you smack in the mouth!
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    Like whats the evidence for it?
    The evidence for it, is suprisingly this thing called "common sense". You poke somebody where its painful first, you get one piece of info: its painful. You start with the least painful/swollen/red point and work towards the most severe to gauge where the pain/swelling/redness starts, whether its uniformly distributed, whether its consistent etc.
 
 
 
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