newborn heart rate - why auscultate at the junction of the umbilical cord & skin?

  1. I'm reading about rating the newborn at 1 minute after birth aand again at 5 minutes, and the textbook says that the heart rate is auscultated or palpated at the junction of the umbilical cord and skin.
    Why is this site used rather than the apical rate?
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    About GingerSue

    Joined: Oct '04; Posts: 1,975; Likes: 254
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    13 Comments

  3. by   rpbear
    You can palpate this easily because the cord is usually still pulsing, I have never tried to auscultate the rate at this site. The only reason I could think that this would be a good site to auscultate is that the baby should be crying and the HR is difficult to hear over the crying.
  4. by   KRVRN
    Well apical rate CAN be used, but palpating is quick and easy to do without going through the trouble of putting your stethoscope in your ears.
  5. by   GingerSue
    this is from the maternal-newborn textbook, in the section about Apgar scoring (and it doesn't even mention taking an apical rate - only the site at the junction of the umbilical cord & skin).

    thanks for the input
  6. by   crissrn27
    Quote from GingerSue
    this is from the maternal-newborn textbook, in the section about Apgar scoring (and it doesn't even mention taking an apical rate - only the site at the junction of the umbilical cord & skin).

    thanks for the input
    Hi, wow that is kind of weird, I have been going to deliverys for a while and have taken alot of classes and never have heard of listening at the base of the the cord, just palpating. I'll try it tonight and see if its better than apical and let you know. BTW, the AAP in their NRP guidelines says you can just assume the rate is above 100 if the baby is crying, pink, etc
    crissy
  7. by   dawngloves
    That's new to me too. I always just grab the base of the cord.And if that fails I just do apical.
  8. by   SmilingBluEyes
    I have never auscultated heart rate at the base of the umbilical cord. Only palpated it when I could not hear apical rate for some reason.
  9. by   GingerSue
    thanks if you have an opportunity to check how the apical compares to the umbilical junction site

    I went back and read that section again, and this is what it says to do "the heart rate is auscultated or palpated at the junction of the umbilical cord and skin" and the apical isn't mentioned at all in the section about the Apgar scoring system
  10. by   TiffyRN
    Quote from GingerSue
    the textbook says that the heart rate is auscultated or palpated at the junction of the umbilical cord and skin.
    I don't know; maybe it's me but the way I read it is: (paraphrased)

    for a newly born infant there are two ways to get a heart rate:

    1. Auscultate (no site specified; but I would assume apical)
    2. Palpate at the base of the cord.

    Do you think this is what they meant as none of us have heard of auscultating the base of the cord.
  11. by   dawngloves
    Quote from TiffyRN
    I don't know; maybe it's me but the way I read it is: (paraphrased)

    for a newly born infant there are two ways to get a heart rate:

    1. Auscultate (no site specified; but I would assume apical)
    2. Palpate at the base of the cord.

    Do you think this is what they meant as none of us have heard of auscultating the base of the cord.
    What's the name of that book? "The Panda Eats, Shoots and Leaves." ?
    I think it's all in how you read it.
  12. by   Gompers
    Quote from TiffyRN
    I don't know; maybe it's me but the way I read it is: (paraphrased)

    for a newly born infant there are two ways to get a heart rate:

    1. Auscultate (no site specified; but I would assume apical)
    2. Palpate at the base of the cord.

    Do you think this is what they meant as none of us have heard of auscultating the base of the cord.
    That's how I read it, too.

    When I go to a delivery with the NICU team, I rarely use my stethescope to auscultate - it's just easier to use the pulsing cord. This way everyone can still have a clear view of the baby's chest to watch for retractions without my arm in the way, I can count even if the baby is crying, and frankly, my stethescope doesn't get covered in vernix or meconium!!!
  13. by   GingerSue
    Quote from dawngloves
    What's the name of that book? "The Panda Eats, Shoots and Leaves." ?
    I think it's all in how you read it.

    name of the book is Maternal-Newborn Nursing & Women's Health Care by
    Olds, et al
  14. by   MemphisOBRNC
    I have never heard of auscultation at the junction, either. I must say I'll
    have to try it (I'll try just about anything once; twice if I like it )

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