Lung sounds free#
Check that the patient is kept warm and the area is free from drafts.Discuss the procedure with the patient and gain informed consent.Ensure your stethoscope has been cleaned following local infection prevention and control guidance.You may need help to support the patient in a comfortable position during the examination. Both these positions will facilitate the assessment (Ferns and West, 2008). However, the patient’s clinical condition and comfort needs to be considered during the examination and some patients may only tolerate lying at a 45° angle. The optimal position for chest auscultation is sitting in a chair, or on the side of the bed. A chaperone should be offered for the assessment if this is considered appropriate. Listening to a patient’s chest to establish breath and any other sounds requires a quiet area, so that health professionals can fully appreciate what they hear and interpret their clinical relevance (Sarkar et al, 2015).Ĭhest auscultation requires the chest and back to be exposed, so measures should be taken to ensure the patient’s privacy and dignity is maintained at all times. Nurses need to assess individual patients for the risk of exposure to blood and body fluids (Royal College of Nursing, 2018) and to be aware of local policies for glove use. Non-sterile gloves are not required routinely for this procedure. Nurses are advised to have a stethoscope for their own use, as sharing equipment may increase infection risk and maintaining clean ear tips can be difficult.
Adherence to local infection prevention and control policies, including the cleaning of equipment between every patient contact, is essential. The stethoscope is an important tool for clinical assessment, but can become contaminated by micro-organisms (Longtin et al, 2014). Fig 3 illustrates parts of the stethoscope. The bell of the stethoscope is generally used to detect high-pitched sounds – at the apex of the lungs above the clavicle its diaphragm is used to detect low-pitched sounds in the rest of the chest (Dougherty and Lister, 2015). Mid zone: level of the hilar structures.Upper zone: below the clavicles and above the cardiac silhouette.Using the four chest X-ray zones can, therefore, be helpful:
It is not always possible to determine from which lobe of a lung a sound is emanating.
Chest auscultation involves listening to these internal sounds to assess airflow through the trachea and the bronchial tree (Sarkar et al, 2015).įamiliarity with the normal vesicular breath sounds found at specific locations on the chest enables health professionals to identify abnormal sounds, which are often referred to as adventitious. These sounds are audible when auscultation is performed using a stethoscope. Vesicular breath sounds occur when the vocal cords vibrate during inspiration and expiration, when the vibrations are transmitted to the trachea and bronchi. Cedar (2018) provides further information on the physiology of breathing. Fig 1 illustrates the anatomy of the lungs and Fig 2 highlights the location of the lung lobes from an anterior chest perspective. To undertake a thorough assessment of the chest, including auscultation, it is essential to understand the anatomy and physiology of the respiratory system. The Nursing and Midwifery Council (2018) has included chest auscultation and interpretation of findings in the Standards of Proficiency for Registered Nurses, and student nurses now learn this skill as undergraduates. This is an example of a systemic assessment tool but other tools are available (Simpson, 2015)
Lung sounds pdf#
Lung sounds how to#
This article explains the clinical procedure for chest auscultation and provides a guide to interpreting findings.Ĭitation: Proctor J, Rickards E (2020) How to perform chest auscultation and interpret the findings.
Chest auscultation is frequently used in the clinical examination of patients.
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