Learning to count newborn heart rate

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Specializes in maternal child, public/community health.

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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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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.

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Specializes in NICU, ICU, PICU, Academia.

Tapping my finger is what I do >> and for 15 seconds, then multiply by four.

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Specializes in Complex pedi to LTC/SA & now a manager.

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)

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Especially with the variance (acceleration/deceleration), which is a normal anomaly, of the heart beat in children that coincide with the respiration.

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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.

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Specializes in NICU, PICU, PACU.

You may be hearing a murmur, which can be common in the first 24 hours.

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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...

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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

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Specializes in Gerontological, cardiac, med-surg, peds.

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.

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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.

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Specializes in Complex pedi to LTC/SA & now a manager.
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.

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