1. Preparation
Check the equipment:
Make sure the earplugs, hoses and chestpieces (heads) of the stethoscope are not damaged and are tightly connected.
Gently stretch the hose to check for air leaks.
The earplugs should be of the right size to ensure comfortable wearing and good sealing.
Environmental preparation:
Choose a quiet and warm environment for auscultation to avoid external noise interference.
Let the patient stay relaxed and avoid tension or activity, as tension may cause a faster heart rate or shortness of breath.
Patient preparation:
Let the patient undress to expose the area to be examined (such as the chest and back).
The patient can sit or lie down and choose the appropriate posture according to the examination area.
2. Wearing the stethoscope
Wearing the earplugs:
Gently insert the earplugs into the ear canal to ensure that the earplugs fit tightly with the ear canal to avoid sound leakage.
The direction of the earplugs should be toward the tip of the nose to ensure smooth sound transmission.
Hose adjustment:
The hose should droop naturally to avoid twisting or overstretching.
The length of the hose should be moderate. Too long may cause delay in sound conduction, while too short may affect the operation.
III. Inspection method
1. Cardiac auscultation
Location selection:
Cardiac auscultation is usually performed at the second intercostal space on the left side of the sternum (pulmonary valve area), the third intercostal space on the left side of the sternum (aortic valve area), the fourth intercostal space on the left side of the sternum (mitral valve area) and the apex area (the fifth intercostal space on the left clavicle midline).
Operation steps:
Place the chestpiece of the stethoscope gently on the inspection site to ensure good contact.
Press the chestpiece gently with your fingers to avoid excessive force to avoid affecting sound conduction.
Pay attention to the breathing rhythm during auscultation. Usually, auscultation is best when the patient is exhaling.
Record content:
Record heart rate (beats per minute).
Pay attention to the intensity, rhythm (regularity) and presence of murmurs of heart sounds.
If abnormal murmurs are found, record their location, nature (such as systolic murmurs, diastolic murmurs) and intensity.
2. Lung auscultation
Location selection:
Lung auscultation is usually performed at the second, fourth, sixth, and eighth intercostal spaces of the midclavicular line, anterior axillary line, and scapular line.
Operation steps:
Let the patient breathe naturally and avoid deep breathing or breath holding.
Place the chest piece of the stethoscope gently on the examination site to ensure good contact.
Auscultate from top to bottom and from the front chest to the back in turn, paying attention to the comparison between the two sides.
Record content:
Record the type of respiratory sounds (such as clear sounds, dull sounds, moist rales, and dry rales).
Note the intensity, rhythm, and presence of abnormal sounds of respiratory sounds.
If abnormalities are found, record their location and nature.
3. Abdominal auscultation
Location selection:
Abdominal auscultation is usually performed around the umbilicus, upper abdomen, and lower abdomen.
Operation steps:
Let the patient lie flat and relax the abdomen.
Place the chest piece of the stethoscope gently on the examination site to ensure good contact.
Pay attention to the breathing rhythm during auscultation, which is usually best achieved when the patient exhales.
Record content:
Record the frequency of bowel sounds (normal is 4-5 times per minute).
Pay attention to any abnormal sounds, such as vascular murmurs, air passing through water, etc.
4. Vascular auscultation
Location selection:
Vascular auscultation is usually performed on the carotid artery, femoral artery, popliteal artery, etc.
Operation steps:
Place the chestpiece of the stethoscope gently on the examination site to ensure good contact.
Pay attention to the breathing rhythm during auscultation, which is usually best achieved when the patient exhales.
Record content:
Record the nature of vascular murmurs (such as systolic murmurs, diastolic murmurs).
Pay attention to any abnormal sounds, such as arterial murmurs, venous murmurs, etc.
