Why is that a lot of healthcare professions assess lung sounds diagonally?

[patzyboi]

Rather than side by side? I was taught to auscultate lung sounds side by side, in comparison with one another.

Why is that doctors and nurses auscultate at one point, then move diagonal on the opposite side?

 

[wanderingmedic]

You should be listening left side and then on the right side to compare between the left and right lung.

Docs and nurses are typically listening for things EMT's are not always trained to listen for, particularity abnormal heart sounds. Cardiac auscultation is what you might be seeing them perform, and it's quite different in terms of stethoscope bell placement.

 

[Akulahawk]

Sounds a lot like you're describing possibly cardiac auscultation. If I'm listening to the heart, it looks a bit different than it would if I were listening to lungs.

 

[Clipper1]

It depends on the level of assessment being done. Some just need to know if the pt has breath sounds and a general type of sound for the lobes. Others will do the 5 (10 total) anterior positions, 9 (18) posterior and 4 (8) axillary. If they hear something abnormal they will get more specific to following the segments for more detailed documentation. Many nursing and RT flow sheets have the option for a very detailed assessment. Pulmonologists and cardiac physician s will also document in detail. This ia a great baseline and eliminates the need for multiple xrays during a hospital stay. Vessel anomalies are also noted especially in some stridor cases which are not related to the usual throat causes. Cardiac sounds are also assessed including a HR for correlation to what is seen on the monitor and palpated.

 

[mycrofft]

It's like putting on a sock and a shoe, then a sock and a shoe.
http://www.youtube.com/watch?v=ZFuniFSP2fo

(NO that is not me with the gray hair).

Yeah, zone versus zone, or lung versus lung. Just have to remember what was what, and the best way to do that is do it the same way each time.

 

[ThadeusJ]

As Clipper1 states, it may be understood a bit better if you look at the lung anatomy and see how the lobes slide behind one another. For example, if you look at the right lung the upper lobe almost touches the lower lobe and the middle lobe is almost all in the front. One can't just divide the anatomy as lower, middle and upper based on where it is on the chest. This is a common error where people will chart auscultating the right middle lobe from the back which it is extremely difficult to do.

 

[mycrofft]

A BLS field provider coming in documenting lung sounds defined by each lobe is going to get talked about at coffee break. Not necessarily a bad thing.

 

[Akulahawk]

A BLS field provider coming in documenting lung sounds defined by each lobe is going to get talked about at coffee break. Not necessarily a bad thing.

A BLS provider correctly documenting lung sounds in each lobe would probably be talked about for a while.

 

[Bullets]

This is why they teach BLS to do lung sounds on the back, it hits 4/5th of the lobes of the lungs, and if a BLS provider can state they heard abnormal lung sounds in the bases or peaks, thats enough for ALS or the hospital to focus their exam.

I have never seen an EMS provider indicate lobes, even i dont, but that has more to do with our charting software than anything

 

[Brandon O]

Rather than side by side? I was taught to auscultate lung sounds side by side, in comparison with one another.

Why is that doctors and nurses auscultate at one point, then move diagonal on the opposite side?

You may be merely referring to the movement one makes AFTER listening to identical points on both lungs.

When you move down to the next level, you can either go straight down, or reset to the other side as you do. If the former you draw square shapes; if the latter, there's a diagonal in there.

L, R, down; R, L, down; no diagonal
L, R, down; L, R, down; diagonal.

Same effect either way, just a matter of preference.

Sometimes there IS a simple answer...