How to do respiratory auscultation with a stethoscope?

respiratory auscultation in a dog with stethoscope

Respiratory and lung auscultation is one of the most important diagnostic tools when it comes to many diseases affecting the airways. The point of auscultation is to assess the airflow through the trachea-bronchial branches and distinguish whether the sounds are normal or abnormal. It takes a bit of experience to but when done often you will soon learn how to notice pleural rubs, crackles, and wheezes as pathological indicators. Keep in mind that auscultation shouldn’t be solely performed to diagnose disease and must be combined with anamnesis and other laboratory tests.

How is the stethoscope used during respiratory auscultation?

First of all, you need to choose a quiet room to perform auscultation and you can be either sitting or standing. The cold stethoscope headpiece must be warmed before you begin the examination. You can do this by rubbing it with your hands or against the patient’s body.

Auscultation starts at one point of the body by putting the diaphragm between the ribs. Start at the back of the patient’s chest and move forward and afterward down until no sound is present. Make sure that you covered the whole area where breathing sounds are evident. Hair rubbing on the diaphragm may get you confused at first but you will learn how to distinguish it from actual breathing sounds.  

You should never perform auscultation only on one side of the body. The same procedure has to be repeated on the opposite side. With this in mind, you can always compare the symmetrical points on each side of the body and spot abnormalities. What you as a clinician must look for is the quality of the sounds, their intensity, and the possible presence of abnormal sounds.

In the beginning, everything will appear so messy and you will think to yourself that there is no way you are able to distinguish between sounds, but with a little bit of practice and comparison of sick and healthy patients, you will get the idea. This is something you can always work on to improve your diagnostic qualities. Physicians and vets use auscultation as the single most safe, non-invasive, easy, and inexpensive procedure to suspect on or out rule pulmonary diseases of different kinds.      

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