Learning to count newborn heart rate Learning to count newborn heart rate | allnurses

Learning to count newborn heart rate

  1. 0 I am not a student but thought someone here might be able to help.

    I find it hard to count a newborn's heart rate because it is so fast. I have seen sites for learning breath and heart sounds and wonder if there is one for counting newborn's HR. I'm sure there are hints on how to do it and am hoping for somewhere that I can count & see how accurate I am. Any other hints would be welcome.
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  2. 15 Comments

  3. Visit  Esme12 profile page
    #1 0
    Remember it is fast.....give the baby something to suckle on so they are not crying.....I tap my toe/finger to the beat and count for full min. Correlate with a pulse ox.
  4. Visit  meanmaryjean profile page
    #2 1
    Tapping my finger is what I do >> and for 15 seconds, then multiply by four.
  5. Visit  JustBeachyNurse profile page
    #3 1
    Finger tapping. Works also with worked up infants/toddlers. You'll learn to quickly assess if it's too fast or too slow. I tap out for the first 15 seconds or so, then start counting for at least 30 seconds (I prefer to do a full minute on an initial assessment)
  6. Visit  Esme12 profile page
    #4 0
    Especially with the variance (acceleration/deceleration), which is a normal anomaly, of the heart beat in children that coincide with the respiration.
  7. Visit  jt43 profile page
    #5 1
    I'm a student and was wondering if it's normal to hear a split S2 sound on newborns? Sometimes when I'm auscultating and counting, it seems to me like there is an occasional 3rd sound. I asked a floor nurse about it and she thought that possibly I was getting confused hearing the couplets (lub-dub) because the heart rate was so fast. My perception was that there was definitely a third sound.
  8. Visit  NicuGal profile page
    #6 1
    You may be hearing a murmur, which can be common in the first 24 hours.
  9. Visit  Twinmom06 profile page
    #7 1
    Quote from jt43
    I'm a student and was wondering if it's normal to hear a split S2 sound on newborns? Sometimes when I'm auscultating and counting, it seems to me like there is an occasional 3rd sound. I asked a floor nurse about it and she thought that possibly I was getting confused hearing the couplets (lub-dub) because the heart rate was so fast. My perception was that there was definitely a third sound.
    its not uncommon for young children to have an S3 sound when they are normally healthy...I always heard murmurs as a swishing along with the s3 - my 6 year old has an s3 and the ped (and research I've done) says that its normal in healthy children and athletes...
  10. Visit  jt43 profile page
    #8 0
    Thanks for the feedback. I really appreciate it. It definitely wasn't a swishing sound. More of a lub-dub-dub. I feel so inadequate when it comes to heart sounds
  11. Visit  VickyRN profile page
    #9 1
    Practice, practice, practice. This is a skill which takes much practice, so don't be discouraged if you don't learn to do this overnight. Take every opportunity to use your stethoscope to count apical heart rate on neonates or infants. Be sure to count for a full minute.
  12. Visit  nurseprnRN profile page
    #10 4
    My pediatrician told me the trick is to count by fours, tapping a finger on each group as if you were tapping your toes to music as you listen ... "ONE (two three four), TWO (two three four), THREE (two three four), FOUR (two three four), FIVE (two three four), SIX (two three four), SEVEN (two three four)..." then multiply by four (For example, that was 28 beats.) Even if it's very fast you can keep track that way.
  13. Visit  JustBeachyNurse profile page
    #11 0
    Quote from GrnTea
    My pediatrician told me the trick is to count by fours, tapping a finger on each group as if you were tapping your toes to music as you listen ... "ONE (two three four), TWO (two three four), THREE (two three four), FOUR (two three four), FIVE (two three four), SIX (two three four), SEVEN (two three four)..." then multiply by four (For example, that was 28 beats.) Even if it's very fast you can keep track that way.
    Very helpful! I have a few younger (infant/toddler) patients that when their respirations start climbing due to their disease process so does their heart rate. Because of their underlying condition can't always trust the pulse ox number. It's not a substitute for an apical or even a brachial.
  14. Visit  Esme12 profile page
    #12 1
    Quote from jt43
    I'm a student and was wondering if it's normal to hear a split S2 sound on newborns? Sometimes when I'm auscultating and counting, it seems to me like there is an occasional 3rd sound. I asked a floor nurse about it and she thought that possibly I was getting confused hearing the couplets (lub-dub) because the heart rate was so fast. My perception was that there was definitely a third sound.
    Good ear a split S2 is normal in the newborn due to the galloping cadence (rhythm) of their heart. It is the absence of it that is concern.
    Newborn Cardiopulmonary Exam
    Last edit by Esme12 on Oct 30, '12

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