Even if it’s not cold it’s a nice gesture of special care. Warm up the cold stethoscope by rubbing the membrane. If the patient is not able to sit up, roll the patient to each side to examine the back. Female patients should have only front or back of the chest exposed at once. Room should be quiet and patient sitting up, decently exposed. Any kind.Įxcept for the last step, the sequence is the same as in Lung Auscultation – Normal Breath Sounds. The key to detailed and correct examination is systematic approach. Some physicians prefer to listen back to front, top to bottom or vice versa. There is no best way of listening to the lungs. The physician is listening to the body wall indirectly through the stethoscope which is composed of the bell or membrane, the tubing and the earpieces. It’s the method of auscultation as known today. However, since the discovery of stethoscope this method was replaced by more accurate, convenient and hygienic mediate auscultation. In this method the physician is listening to the body wall directly with the unaided ear. There are two methods of auscultation – the immediate and mediate auscultation. In 2000 the European Respiratory Society defined lung sounds based on their computerized analysis. In 1977 the American Thoracic Society proposed the terminology that was later in 1987 presented at the symposium of the International Lung Sounds Association and adopted for clinical practice. Studies show physicians use up to 16 different terms to describe similar sounds. However, all the terms are still used today in medical textbooks and clinical practice as well. To distinguish them he used adjectives like “moist”, “dry”, “crepitus” or “sibilus”, only to substitute it later for rhonchus so the patient would not mistake it for death rattle.Īt later date terms wheeze and crackle were introduced, proposed for continuous musical and discontinuous sound, respectively, replacing the old rale and rhonchus. He identified five adventitious sounds and all of them called rales (from French word râle – to rattle). The first one to describe auscultatory findings was René Laennec, the inventor of stethoscope, in his monography A Treatise on the Disease of the Chest and on Mediate Auscultation. Lung Auscultation – Adventitious Breath Sounds.Lung Auscultation – Normal Breath Sounds.
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