Lung sounds?

[mycrofft]

Doing sick call (where I had the options of calling in the MD later, starting a standardized procedure, or yelling "NEXT!!"), I'd take vitals and primary complaint while looking and listening. Any resp c/o or any resp sign I saw, I'd do a quick ausc of the bilateral bronchial areas; I could from that get an apical pulse, and hear what generally was going on respiratorially, and expand or move on based on what I heard/saw/felt. (also gave me a chance to "squeeze in" a sternal compression to help r/o costrochondritis). Rarely did I need to completely ausc every single field; wheezes were wheezes, rales were rales, silent resps were trouble (or feigned), and I could document and either treat, or refer.

 

[Aprz]

I wonder if that nurse read this post. He insisted on having me do lung sounds on all our patients today, lol. It was really odd to me.

 

[Veneficus]

I wonder if that nurse read this post. He insisted on having me do lung sounds on all our patients today, lol. It was really odd to me.

Good, it is nice to know somebody here listens from time to time.

 

[mycrofft]

Another closet EMTLIFE lurker?

 

[Aprz]

Possibly. I didn't ask, but I did tell him about the site awhile ago so maybe.

 

[Brandon O]

When are these checked? Do you check them as part of respiratory vitals or initial assessment of breathing? For both Trauma and medical

A quick listen to both sides during your rapid trauma assessment (as you move down the chest) would be wise to rule out pneumothorax.

For a focused medical assessment in a respiratory complaint, do it early.

For a general and unrelated medical complaint, do it whenever, if at all (i.e. as part of your detailed assessment).

 

[ZootownMedic]

I'm with you here. I listen to every one of my patients. Depending on the nature of their illness determines when. Respiratory complaint it's near the top of my list, something unrelated I'll get to it at some point but always get to it.

I listen to heart tones all the time too...

How is the heart tone listening coming?? I am not knocking it, in fact I think its great. I just find it incredibly hard to differentiate normal and un-normal heart tones. Almost every ER physician I know says its takes years and thousands of patients to become proficient(which is why its great you do it now). Other than Beck's triad...I don't see how it could really help us out anyways as far as field treatment or diagnosis goes. I guess my question is....how has it been working for you, and has it changed anything you have done for your patients? Since I can't really tell normal vs un-normal I just don't do it....and I doubt it would change my care as a pre-hospital provider anyways even if I could.