I. Preparation
1. Check the Stethoscope: Ensure the earplug fits snugly in the ear canal, the chest piece (bell-shaped or diaphragm-shaped) is clean and intact, and the tubing is free from twisting or damage.
2. Environmental Requirements: Choose a quiet, warm environment, avoiding external noise interference.
3. Patient Position: Adjust the patient's position (e.g., sitting or lying down) according to the auscultation site, fully exposing the auscultation area.
II. Wearing and Positioning
1. Correct Wearing: Tilt the earplug forward 15 degrees and insert it into the external auditory canal, ensuring a tight seal; gently press the chest piece against the skin, avoiding forceful pressure.
2. Positioning the Auscultation Areas:
Cardiac Auscultation: Includes the mitral valve area (apex of the heart), pulmonary valve area (left sternal border, 2nd intercostal space), and aortic valve area (left sternal border, 3rd intercostal space).
Lung Auscultation: Multiple areas need to be compared and auscultated on the anterior chest, lateral chest, and back. III. Auscultation Techniques
1. Key Points of Technique: The bell-shaped chest instrument is used for low-frequency sounds (such as mitral murmurs), and the diaphragm-shaped instrument is used for high-frequency sounds (such as aortic murmurs).
Concentrate during auscultation and eliminate interfering sounds (e.g., ignore heart sounds when auscultating the lungs).
2. Time and Content: Each auscultation area should last approximately 30 seconds, paying attention to rhythm, murmurs, breath sounds, and other abnormalities.
When auscultating children, soothe their emotions; distract them with toys and warm the auscultator head beforehand.
IV. Precautions
Auscultate directly on the skin, avoiding clothing, to reduce murmurs.
Disinfect the earplugs and chest instrument with alcohol after auscultation and store them separately to prevent cross-infection.
