How to use a stethoscope to listen to lungs?
Stethoscope, per se, is a widely recognized medical instrument that is worn around the necks of doctors.
Listening to the patient’s lungs through a stethoscope can be difficult and challenging, even if you are in the best circumstances.
But, with frequent practice, you can sharpen your hearing ability to perfectly listen to the lungs’ sounds.
Here are some suggestions on how to perfectly hear those sounds when using a stethoscope.
Before you place the device to your patient’s chest, you must make sure that the environment is quiet.
You should explain to your patient what you have to do. Your patient must be comfortable with the procedure before you even begin to auscultate.
2. Know where the bell and the diaphragm
To better listen to the lung sounds, it is best to use a stethoscope that comes with a bell and a diaphragm.
Now, if you are using an electronic device, it will be a lot easier as you can easily alternate the modes by simply pressing a button.
Why do you need a stethoscope with bell and diaphragm?
This is to properly hear either low-pitched sound or high-pitched sound. The bell will let you hear the former and the diaphragm for the latter.
Then, the stethoscope must fit snugly to your ears. It must be aligned with your ear canals’ angles.
Read More: Best Stethoscope For Nurses
3. Avoid noise
There are many factors that may disrupt you from properly listening to your patient’s lung sounds. One of them is the transmission of extra noise.
Thus, before you begin, you should remove any item that may be hanging on your stethoscope. Do not hang tape, tourniquet or badge on this medical device.
Then, start exposing your patient’s chest before placing the device’s head. This is a must so that the stethoscope will be placed directly on the skin and not through the gown of the patient.
Its tubing must be extended across your patient’s chest when you stand at your patient’s right side.
When the device is on top of your patient’s chest, make sure that the device’s tubing does not touch your patient’s chest. It must not be resting on the side rail or sheets as it may cause extraneous noise disrupting your ability to properly listen to you his/her lung sounds.
4. Begin at the back
When learning how to use this device, you should start at the back.
Make sure that your patient is sitting up and leaning forward. This position will bring his/her scapula up allowing you to better listen to his/her lungs.
In the event that your patient cannot sit up, you should turn him/her from side to side so you could listen to his/her posterior lungs.
Then, place the stethoscope’s diaphragm on the skin of your patient. Auscultate in his/her intercostals spaces by applying firm pressure.
Do not listen over the bone as you will not get anything. Start at the top and move down to the back.
Before you move next to the intercostals space, make sure that you listen on both sides of your patient’s spine.
Listen to both sides of his/her chest to his/her mid-axillary line. This is to assess all lung fields and be able to diagnose properly.
When you are trying to listen to lungs sounds, especially the tracheal breath sounds, you should hear it around the neck over the trachea. The sounds are quite louder and higher in pitch, compared with the vesicular sounds.
Bronchial sounds, on the other hand, are coarse. They are also high-pitched that can be easily heard over the trachea. This type of breath sound is abnormal, which is a common sound that can be heard when the patient has pneumonia.
When assessing lung sounds
When you are listening to your patient’s lung sounds through a stethoscope, you must always start above the clavicle. While listening to the lungs at the back, make sure that your patient is slightly leaning forward. This is to expose his/her triangle of auscultation.
You should listen to the six-paired anterior areas on the patient’s chest. Then, another on the seven-paired posterior areas found on the back.
Before you move down to the next level, you have to make sure that you have made a side-by-side comparison. The differences will be more apparent and you can make a better diagnosis.
The more you practice on how to use a stethoscope to listen to lungs, the easier it will be for you to identify what the lungs sounds signify or suggest. Bear in mind that by simply listening to breath sounds can detect abnormalities that may save patient’s life. Thus, it is a must that you know how to properly auscultate.
Unfortunately, auscultation can still pose a challenge to some medical professionals. Even if you are an experienced medical doctor or nurse, you may still miss something that could have helped in assessing the patient’s condition.
One of the factors that may affect your ability to properly listen to your patients’ lung sounds is their size and weight. Bear in mind that fats in their bodies may affect the transmission of sound, thereby, decreasing their breath or lung sounds.
Apart from knowing where to listen, you should also master when to use diaphragm and bell. As mentioned earlier, the former is used to detect high-pitched sound. Medical doctors and nurses use it to hear breath sounds or lung sounds.
You must apply firm pressure when you hold the device and place it onto your patient’s skin. If you need to hear lowest sounds, place it gently on the skin.
And, of course, make sure that you invest in a quality stethoscope. Although you can easily purchase cheaper units, they will not last long. They may also have weaker sound profiles. As a result, you will not be able to properly hear lung sounds. But do not invest on higher-end stethoscopes either, unless you know that you will be working in emergency cases.
If you wish to learn more about how to use a stethoscope to listen to lungs, watch this video: