Learning to count newborn heart rate

Nursing Students Student Assist

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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.

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

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

When in doubt and you have one available it is helpful to correlate the two to verify your results. A second opinion. Children's anatomy/compensatory mechanisms are different than adults. Children increase their heart rates to increase cardiac output as the normal response...unlike adults that can have stronger more forceful contractions.

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Specializes in maternal child, public/community health.

Thanks for all the tips. I am a public health nurse in a home based program for teen moms and babies. I generally see healthy babies (and do not have pulse ox or other technology) but have baby now with cardiac issues. I knew some of you here would be a great help. Thanks for all the ideas.

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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

Agree - a split S2 is normal in a neonate. Sometimes it just sounds like a slurred or prolonged second sound rather than a distinct split, but it's normal.

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