Lung Auscultation in pediatrics

Brian, ASN, RN · Mar 26, 2010

Welcome to AN! I moved your question to the Pediatric Nursing Forum. For questions on how to use AN, I would suggest the Help section in the upper right hand corner below the search box. There are several helpful hints and tips there. Good Luck.

Pediatric Critical Care Columnist · Mar 26, 2010

It wouldn't be wrong to simply describe what you're hearing. I have never actually used "rales and rhonchi" when charting breath sounds and I have only rarely seen them in charts at all. We typically use coorifice crackles, fine crackles, inspiratory wheeze, expiratory wheeze, inspiratory stridor, expiratory stridor and referred upper airway sounds to describe what we're hearing, then give it a location. An example might be, " Air entry audible to bases bilaterally with scattered coorifice crackles to the right upper lobe, fine crackles to lower lobes bilaterally, faint inspiratory wheeze and referred upper airway sounds. Air entry slightly decreased to left base." Then you'd go on to describe work of breathing.

Coorifice crackles are easy to recognize. Fine crackles sound a lot like sand being poured into a foil pie plate or rubbing hair between your fingers. Wheezes are squeaky and vary in pitch depending on how constricted the airways are. Stridor is more of a crowing sound and is usually audible without a stethoscope. Referred upper airway sounds are more of a gurgly noise and are often also audible without amplification.

Does that help?