 Welcome to Nursing School Explained, and today's video on chest percussion. Remember that we always want to auscultate and percuss our patients when we have actually actual skin exposure, so we're going to go ahead and ask to remove the gown off of our patient. And there are two different techniques which are direct and indirect percussion methods, and I'll be demonstrating both. Hi, can we take down your gown, please? Sure. Thank you. So direct percussion only involves using one hand. It's a little bit more awkward to me personally. That's why I always use two, and the one-handed percussion technique basically just involves using your hand as a drum like this, and you kind of have to have a wrist flick. I personally always liked it better. My right hand is my dominant hand. I will use my left hand to have contact with the patient, and the most important part is that you actually find the intercostal space, so in between the ribs, and then I usually use my middle finger to place it flush with the patient's skin, and then use my dominant hand to use it as this percussion hammer that will allow me to listen what's underneath. So let's do this here. So this is pretty hollow, so this is that resonance that we're looking for. Now it sounds a little bit more dull, but that's because I've put my finger on the patient's rib, so I'll reposition here, find the intercostal space, and I hear this hollowness again. And so I want to stay away from the clavicles and the sternum here. Also, the breast tissue, it specifically comes into play in female patients because the breast tissue might be larger, and we want to basically use the same spots like I've drawn up here on our patient, both anterior and posterior, as we would in the auscultation technique. So you would start your way all up here, and then work your way down, and then remember to alternate left and right and compare the two sides, as well as march out all the way down here to listen what's going on underneath these lower lobes, specifically in the mid-axillary line on the patient's right side, because of that right middle lobe of the lung, we want to make sure that we don't miss anything. So please go ahead and practice the skill. So it can be a little bit daunting at first, but again, the most important part, place your non-dominant hand, probably the middle or index finger, flush to the patient's skin, make sure you're in the intercostal space, and then use your dominant hand as the percussion hammer. So this is that resonance, and then if I would put it over the sternum, it sounds much more dull because now I'm over the bone again like I was on the ribs, and that is the two different sounds that we expect to hear. And then hyper resonance would be the third sound, which would be for these hyper-inflated lungs that we might encounter with patients who are having COPD or an asthma attack. Once we complete the percussion in the front, we always want to percuss the patient's posterior chest, staying away again from the bony structures that underlie the chest or the torso, which are in the back, the shoulder blades as well as the ribs and the spine. But the same technique really applies, and the more you practice, the better you get at it. And once we're done with our procedure, we'll make sure we'll take care of our patients, getting them covered and comfortable, following all the other elements that we have to follow our nursing skills. Please also watch my other videos in the basic assessment skills playlist, as well as the one specifically on percussion, where I explain the different sounds that you hear on chest and abdominal percussion. Thanks for watching Nursing School Explained. See you soon.