Lung sounds

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txemt911

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This is my first time to post something but i was wondering if anyone had trouble hearing lung sounds when they first started out. I dont have a top of the line scope but i think i should still be able to hear them. Any tips would be greatly appreciated.
 
Definitely! Especially in the ambulance. The best thing to do is assess all fields when you make patient contact. And place the bell against the skin, not through clothing. This is probably the only thing that a good stethoscope will come in handy for.. One thing you can do, is put a soft tee shirt over a speaker, or a tape player, and listen to recorded lung sounds with your scope, that way you can more easily identify them in the field. Not every patients wheezing will be the same, some will be less profound, but even if it takes some time, listen to nasty lungs as often as you can. Buddy has the flu? Listen. Practice makes perfect in this case, just remember not to get your face close to theirs when listening. Wear a mask.. or put it on them!
 
Thank you ! That answered my question perfectly. I guess practice does make perfect.
 
Everyone has to learn how to recognize lungs sounds when first starting. It's not always so much the stethoscope as it is knowing what sounds your actually listening for. As a suggestion, start listening to every patients lung sounds so you learn what normal is. You have to know normal before recognizing abnormal. Plus, this will get you into the habit of incorporating lung sounds into your patient assessments.

If your having difficulty hearing air exchange, ask the patient to take a deep breath in and out for ya to increase the volume. This helps sometimes to hear better.
 
Always listen from the pt's back if possible. You can also auscultate the pt's trachea for signs of stridor when indicated.
 
Your welcome.

And Rescue looks like you stole the site I posted. :P
 
txemt911 said:
This is my first time to post something but i was wondering if anyone had trouble hearing lung sounds when they first started out. I dont have a top of the line scope but i think i should still be able to hear them. Any tips would be greatly appreciated.
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Stethescope quality shouldn't matter all that much. You need to practice, practice, practice. Listen to everybody and their grandmother.

Don't let your knuckles move as this sometimes sounds like rales. Place the diaphragm of the stethescope on the pt's bare skin each and every time.

Do this until you're blue in the face. Then do it some more.
 
medic417 said:
Your welcome.

And Rescue looks like you stole the site I posted. :P
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I took Bob's class, so I have the actual CD's he made for us with lung and heart sounds. :P

We had a simulator for lung sounds, but the t-shirt over a speaker will work as well as long as you have the volume down really low. Bob made us listen to the lung sound simulator while he blasted Motley Crue in the background. I really hate Motley Crue.
 
Check your scope and your ears too.

Make sure you scope is patent. My first scope was 2nd hand (from a trashcan) and a spider was living in one of the two tubes leading to the ears.
Make sure the diaphragm is airtight. Get the right eartips for you and if yo personally need to twist 'em to point correctly into your ear canals, do that.

Stop blasting your ears. The tinnitus will distract you and gets worse as you age.
And practice.
 
mycrofft said:
Stop blasting your ears. The tinnitus will distract you and gets worse as you age.
And practice.
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Dude if its to loud you are to old.:P

But actually good point.
 
I just want to reiterate that you should listen to everyone at first. Close your eyes while listening and really focus on what you're hearing.
During clinicals at a busy trauma center, I listened to almost every single patients lungs. After a while, I got pretty good and had xrays to confirm what I heard.
You'll want to become really familiar with the sounds to help you determine just how bad off they are, and how well the treatments are affecting the patient. The pt's back is best, but practice everywhere because the back is not always accessible.
 
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