Abdominal Assessment Post Surgery

Hey guys, it’s Sheri with ATL Clinical Workshop. I had a question online the other day where a student said, “What if my patient had surgery and they had this big, bulky dressing on their stomach, how am I supposed to do an abdominal assessment? Do I have to remove the bandage to listen to the abdomen?”

It’s real simple. The only time we ever remove bandages is if you’re assigned wound management, if you’re changing a dressing; does that make sense? If we have to look at a wound, then we would be assigned wound management.

It goes back to me saying Simon says; Simon didn’t say take off the wound dressing and do a management. Simon said, “Check the abdomen out.” All we’re going to do is check the abdomen where we can. We’re going to look around the dressing. We’re going to look at the surrounding tissue. We’re going to look at the bandage itself to see if it’s draining but by no means are we taking it off if Simon doesn’t tell us to do it.

Then when it comes time to listening to the abdomen, well if there’s a big bulky dressing, you’re not going to listen on top of the dressing. You don’t know what’s hidden under there. You might put pressure accidentally and hurt the patient because you don’t have that superman x-ray vision where you know exactly where to place that stethoscope when you can’t see what’s under that bandage.

The other thing is too, we always use a stethoscope directly on skin, so if you go put it on a bandage, it makes a scratchy sound, a staticky sound and you can’t hear adequately to have a proper assessment so you listen outside of the bandage; wherever you can get closest to the bandage, that’s where you’re going to listen, but never do you put a stethoscope on the bandage and never do you take the bandage off at all unless Simon tells you do to so.

There’s your tip for a big bulky dressing on the abdomen. For more information, check out our website www.ALTClinicalWorshop.com.

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