PDA murmurs

Sweeper933 · Mar 16, 2009

Sometimes they are really hard to hear. Especially if the baby is crying or making lots of other noises when you're trying to listen. My tip would be to just try and get them as quiet and calm as possible - try giving them a paci to suck on while your listening. When you hear it, you'll know - a nice "whoosh"

Pediatric Critical Care Columnist · Mar 16, 2009

Listen just below the left clavicle. It sounds quite mechanical or machinery-like. The way I distinguish murmurs from other sounds is to isolate the things I hear one at a time. Okay, that's a glob of secretions, okay that's a breath sound, okay that's a wheeze, okay that's a murmur.

Imafloat, BSN, RN · Mar 20, 2009

Listen just below the left clavicle. It sounds quite mechanical or machinery-like. The way I distinguish murmurs from other sounds is to isolate the things I hear one at a time. Okay, that's a glob of secretions, okay that's a breath sound, okay that's a wheeze, okay that's a murmur.

Thank you jan for this tip, I tried it and it worked. It felt so good to hear the very small murmur that I was told existed.

Pediatric Critical Care Columnist · Mar 20, 2009

Way to go! Hearing murmurs is a difficult skill to learn, but once you know what you're listening for it gets a LOT easier.

prmenrs, RN · Mar 20, 2009

Seems like it took for-evv-er for me to hear murmurs. When I finally did, it was a real whooshy type. Eventually, I've learned to hear 2 types of murmurs: the washing machine variety and one that sounds like a 3rd "click" sound between the main sounds.

Close your eyes, IMO, that helps.

Don't forget that the loudness of the murmur does not [usually] correlate to size of the defect--a little tiny hole makes a huge sound!

Pediatric Critical Care Columnist · Mar 20, 2009

Close your eyes, IMO, that helps.

Too right it does!

RN4Little1s · Mar 21, 2009

Ask nurses you are working with if any of their babes have a whopping murmur, and take a listen so you can start with a loud one and work your way to recognizing smaller ones. And yes, I had to learn that the as the PDA closes it gets louder and louder with the pressure in that tiny hole. Until poof it's gone!

You can also hear a good loud murmur on a kid who may be post-op fluid overlaoded who had a defect with a murmer beforehand.

Imafloat, BSN, RN · Mar 22, 2009

Ask nurses you are working with if any of their babes have a whopping murmur, and take a listen so you can start with a loud one and work your way to recognizing smaller ones. And yes, I had to learn that the as the PDA closes it gets louder and louder with the pressure in that tiny hole. Until poof it's gone!
You can also hear a good loud murmur on a kid who may be post-op fluid overlaoded who had a defect with a murmer beforehand.

I can hear the whopping murmurs just fine, I guess I am at the point where I want to start hearing the little ones. I was talking to a resident about it the other day and she told me that with a PDA, you can sometimes feel a pulse in the palm of their hand too.

2curlygirls · Mar 22, 2009

Yeah, the whoppers are no problem. I always check for palmar pulses if the pulse pressures are wide. I *think* I'm improving. But I feel like I should have this down by now gosh darn-it!

prmenrs, RN · Mar 23, 2009

You'll get it, no worries! Be patient.