Chest Auscultation

Front 1

Prepare patient

Back 1

1. Explain procedure and reassure.
   
2. Position sitting upright (if possible).
   

Front 2

Prepare Equipment

Back 2

1. Ensure stethoscope chest piece is set to listen through the diaphragm. *
2. Ensure chest piece is warmed (by light rubbing on palm of hand) before placing on patient.
3. Position ear pieces facing forward in the ear canal.
   

*Diaphragm is best for most lung sounds.

Front 3

Auscultate Chest

Back 3

1. Instruct patient to breathe deeply and slowly through their mouth.
2. Press diaphragm firmly enough upon their back to leave an indented ring on skin after removal.
3. Keep stethoscope still and tube clear of contact with objects during auscultation.
4. Listen to both sides of the chest in a methodical manner:
   - apices to bases, or bases to apices;
   - listen to two or more full respiratory cyclesat each point.
5. Note the quality and intensity of the lung sounds during inspiration and expiration,
   listening for the following:
   - is there air entry;
   - are the lung sounds normal (vesicular);
   - do left and right lungs sound the same;
   - is there a wheeze evident, (insp, exp or both);
   - are there crackles evident;- are the crackles coarse or fine.
   

Front 4

Reassess patient

Back 4

1. Position, rest and reassurance.
2. Continue other elements of the respiratory status assessment.
3. Continuing management, as required.