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Discussion

lOOKING FOR FEEDBACK . . .

does anyone else out there auscultate lung sounds from the bases up ?

i realize when being taught textbook physical assessment ~ they teach to listen from the apexes down; however as long as you are comparing sounds on each side (that is for example listening to the right base followed by the left base on up...)

why would this be of great significance ?

i was recently criticized by a collegue, this has been my practice for lung sound assessment throuhout my 15 year career as an rn. to my knowledge i have always been correct at determining adventicious lung sounds or lack there of.

all comments are welcomed!

many thanks ~

elicia rn

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I was always taught to start at apices and work down to bases. I believe the answer is that, after instructing the pt to breath in and out while you are ausculating, the pt's presumably deeper breaths increase ventilation to the bases and therefore you should be able to auscultate them more accurately. Vice versa does not apply due to anatomical and gravitational influence.

Unless someone can stir up some evidence-based results of the contrary, I see nothing fundamentally wrong w/ assessing from bases up. Just 'cause we all do it one way, doesn't automatically mean it's the only right way. A strong case can be made for assessing each l/r fields in pairs, then moving on down (in your case, up).

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