Can't hear a blood presssure??

nursbee04 · Jan 12, 2003

I had the same problem as you during my first semester skills class, and all I can say is that it took time. Are you sure you can hear well through your steth? I thought mine was ok, but once I adjusted the earpieces a little more it made a big difference. Sorry that I can't be of more help. I'm sure you'll get the hang of it in time. Good luck! :)

luluann · Jan 12, 2003

Excellent question!!! I have the same problem!!

kittyw · Jan 12, 2003

I'm assuming you're not practicing on a mannequin.... so make sure that your stethoscope is placed correctly (check for the pulse) and you're not deflating too quickly. Try taking a BP by feeling for the radial pulse first as you deflate the cuff - then try to listen for the BP (you'll have an idea where the BP should be and thus may have a better chance hearing it until you're used to it.)

OBNURSEHEATHER · Jan 12, 2003

Are you practicing on people at home too? Friends and family and such? This may sound silly, but I find that when I'm nervous my hearing is affected. All that blood rushing to my head makes me deaf I guess. :)

Make sure you're clicked the right way too. Simple thing that slips up the best of us sometimes!

I also suggest soft, cushy, comfortable ear pieces. I paid around $10 for mine, but they're wonderful. They fit better in your ear and create a better seal. Make for better sound detection.

Good luck!

Heather

NurseWeasel · Jan 12, 2003

Talk to your instructor ASAP. They might have one of those dual teaching stethoscopes. Those are really cool because you can both hear the same thing at the same time. If the instructor or whoever is helping you will wag their finger up & down with each 'beat' they hear, you'll have a visual cue to help you pick up on when the sounds are audible.

Another little sneaky trick: watch the gauge. It 'stops' or 'bounces' just a hair with each beat. Think of a second hand on a Timex. Each second it visibly moves to the next notch. A blood pressure gauge will do the same thing.

For me, seeing some visual clue when I was first learning was the all-important part. Once I'd heard it well once, I had it down.

As to the 'clicking', Heather is referring to the metal rod that goes into the flat part of the stethoscope, that you put on the person's skin. It turns on some models so you can hear out of the smaller or the bigger side. If it's turned to the wrong side you won't be hearing blood pressures but room noises (or your finger, lol, if you're plugging the hole!).

Best of luck to you.

Rebeca · Jan 12, 2003

Thank you soooo much for all of your replies. I bought an expensive steth. (Littmann Cardiology III) to make sure I had a good one. I figured out that I had to rotate the diapragm/bell after I spent an entire afternoon thinking there was something wrong with the stethoscope. This is something that takes a lot of hand eye coordination, I am not exactly gifted in that department. I can palpate it without any problems, the hearing it, now there is my problem. I can hear the first thump pretty well, I just keep hearing all the way to zero.

Well, I will just keep practicing, my poor teenage son's arm is already turning blue.....

Thanks again

Rebeca

NurseWeasel · Jan 12, 2003

Hmmm. Definitely sounds like an earpiece or positioning problem then. I bet you're hearing your own heartbeat in your ears or something. Are you making sure that the curves of the earpieces point forward, away from you, before you stick them in your ear? I think your Littman should have come with extra earpiece soft plastic / rubber things. Try switching those.

LOL our lab instructor said that we should practice as much as possible on whoever we wanted outside of school, but warned us that by the end of the semester all our friends, family, and neighbors would RUN when we came toward them with a stethoscope in our hands!

Try those things and let us know. Good luck. I know it's frustrating.

BadBird, BSN, RN · Jan 12, 2003

It could be a number of things, look at your BP cuff, there is usually a mark that says place over arterial pulse, feel for the pulse and line it up properly. Make sure your ear pieces are positioned correctly, if you have a littman lightweight steth. it has a little hole in the middle, make sure your finger covers the hole or you won't hear anything. Practice, practice, practice. Good luck.

Love-A-Nurse · Jan 12, 2003

make sure the tubing on the stethoscope is not rubbing against your clothing, diaphram, etc. as this can make it difficult to hear the true s1, s2, and s3.

practice on yourself is a good way to get it too. remember too, some diastolic pressure may run low.

hang in there, it comes with time and practice.

StudentSandra · Jan 12, 2003

Originally posted by Rebeca
Thank you soooo much for all of your replies. I bought an expensive steth. (Littmann Cardiology III) to make sure I had a good one. I figured out that I had to rotate the diapragm/bell after I spent an entire afternoon thinking there was something wrong with the stethoscope. This is something that takes a lot of hand eye coordination, I am not exactly gifted in that department. I can palpate it without any problems, the hearing it, now there is my problem. I can hear the first thump pretty well, I just keep hearing all the way to zero.

Well, I will just keep practicing, my poor teenage son's arm is already turning blue.....

Thanks again
Rebeca

Hubby gave me his Cardio III when I started clinicals, last semester I finally gave it back to him and went back to using my cheap steth I had for 20 years. I couldn't hear a darn thing with the Cardio III, finally he told me he couldn't either until one of the docs he worked with show him how to use it. It's tricky and has to do with knowing how much pressure to place on the diaphragm.

Good luck, the thing about BP's is once you "get it" you've "got it" some will be loud and some will be very faint.

cpgrn · Jan 12, 2003

If you can, practice on men. They're usually easier to hear (although, not always.) Try to find a normal weight man as heavier people are harder hear - at least that's what I found to work for me. It gets a lot easier the more you do it.