Help! Can't hear BP sounds

RN 2005 · Sep 19, 2003

Hi Leigh,

I am a first semester student myself but this was one of my biggest fears going in. When we had the chance to try taking BP's in A&P I could not hear a thing! I was so worried about this going into this semester. I bought my own cuff and started practicing this summer. I had alot of anxiety but I just played with it in a quiet room and with my daughter as my patient. All I can say is if I could do it you can. I have no real constructive tips besides relax and practice, practice, practice! Good luck to you -

Kris

rpbear · Sep 19, 2003

Make sure you are using a good stethoscope. Also, make sure the ear pieces are pionted a little towards the front when you put them in your ears, and lean you head down, it makes the ear pieces fit better in you ears. And calm down! Try listening on as many people as possible, some will be easier to hear than others.

If your hearing loss is the problem there are special scopes that amplify the sounds, but they are very expensive I think about $300. My MD uses one because he is almost totaly deaf.

Good luck.

twarlik · Sep 19, 2003

I'm also a first year student. I became really frustrated when we started checking BP in lab. I couldn't hear a thing, until suddenly I heard it. I really think that once you hear it, you'll understand. My problem is that I just didn't know what to listen for. I heard it once and now I hear it every time.

Also, try using the bell side of your stethoscope. Most people use the diaphragm, but I hear BP better using the bell.

Good luck and just keep working at it!

salgal · Sep 19, 2003

I had a difficult time hearing at first also. I went and checked everyones BP that would allow me, until finally it clicked. Now I can hear it all the time. I think the anxiety makes it very difficult when you are just learning. Practice as much as you can to gain confidence, and it will get easier. Also the double headed student stethescopes are really difficult to hear with.......is that what you are using in lab? relax.....it will get better!

PJMommy · Sep 19, 2003

What helped me was getting everything settled and still before inflating the cuff... It's amazing how hard it can be to hear the sounds if the steth tubing is jiggling or bumping, or your hand holding the steth is shaky...

Also, make sure you are palpating the brachial artery before placing your steth so you know you have it in the perfect location.

bedpan · Sep 19, 2003

Make sure that you are pressing firmly - I just use my thumb so as to cut down on sounds from the movement of my fingers on the side - and DON'T let yourself unconciously begin easing off the pressure as you get near the end - I noticed this while observing several others in our class and realised I was doing it also! You can easily do this and miss the last sounds!

I too have a hearing loss and was worrying myself half to death that this was going to be impossible for me! As a matter of fact, I was so worried that during checkoff (we partnered up and checked off on each other using the double steth while the Instructor listened also) that my blood pressure was 150/90 !!!! My instructor was worried about me LOL

But I nailed it and it does get easier the more you do it (Since then I have bought a Littman tho - The cheap scope that came in our Nursing kit just didn't allow me to hear like I need to)

colleen10 · Sep 19, 2003

Hi Leigh,

Do not worry, I repeat, Do not worry.

I just got checked off on Vitals earlier this week and last week posted a message similar to yours.

My biggest problem was finding the brachial pulse!!!! If you can get that far you don't have much to worry about.

A few suggestions that might help.

Before you look for the brachial pulse have the patient put their arm up in the air for a minute or so, then have them bring their arm down. This will make it easier to locate exactly where the pulse is so you can get right on top of it.

Make sure you put the cuff on nice and tight and do not be affraid to really press your fingers and steth. over the artery, it's not going to hurt them.

Get yourself a good steth. Seriously, it makes an incredible difference. I have a Littman Master Classis II. It was close to $90.00 but it is an incredible steth. If I can't feel a persons brachial pulse I can actually put the steth. on the area and hear it and find it that way.

I do not know what type of steth you have but it may be worth it to get a better one, especially if you know you have some hearing loss.

Also, you may want to stay away from the double steths. The one's at my school are horrible. They don't fit in your ears correctly and even if they did you can't hear a darn thing anyway.

Trust me, if you have a good steth. you will hear that pulse loud and clear, no mistaking it.

I'm wondering if there are any websites out there that have audio on what the pulse will sound like through the steth. I know there are sites listed in the sticky at the top of the page that have heart and lung sounds, maybe one has a BP pulse sound.

Good luck and don't worry, just practice every chance you get, that helps too!!!

blkdawn · Sep 19, 2003

One thing that a classmate just figured out yesterday (after trying to listen to BPs for two weeks now)....He had his stethoscope turned OFF. Yes, there is an ON and an OFF. Make sure yours is ON.

Obviously this is not the case if your instructor was able to hear the sounds using the learning stethoscope.

Altra, BSN, RN · Sep 19, 2003

Thank you all SO much ...

I bought a sphygmomanometer on my way home from class and this weekend I'm going to practice on all the family & friends I can get my hands on until either I get it, or their arms fall off, whichever comes first!

I'll let you know how it goes, and thanks for the encouragement - boy that feels good.

:)

Leigh

PS - colleen10 - where in Pittsburgh are ya?

Marie_LPN, RN, LPN, RN · Sep 19, 2003

Phillips makes a steth that you can turn the volume on up and down. A float nurse at work has this, cost over 300 dollars, but she said it was worth it. I'm going to try it a few times before i invest in anything like that. I am 50% deaf in my right ear.

RN_N_05 · Sep 19, 2003

I'm in my first semester of nursing classes and we did VS last week. I had so much trouble hearing, especially since I had practiced using my own steth and we had to use the double ones for test out. Like someone else said, once you hear it, you know what it sounds like, and it will be hard to miss later. One thing I realized was if I use the other ear pieces (the ones that are kind of flat on one side - kind of disc shaped) I can hear much better. Good luck to you. I'm sure once you hear it, you'll wonder how you could have missed it. (I know I did!)