Why can't you hear late decels with a doppler?

SmilingBluEyes · Dec 12, 2003

you CAN hear late decels, (as well as early and variable), if, you know how to palpate and auscultate, but documentation, well that is another matter.

if you go to AWHONN FHM classes, you have to learn this skill and trace it on paper. Yes you can hear them, but documenting them may be trickier. You have to be VERY careful to be descriptive, using standardized terms when doing so.

geekgolightly, BSN, RN · Dec 12, 2003

Originally posted by SmilingBluEyes
you CAN hear late decels, (as well as early and variable), if, you know how to palpate and auscultate, but documentation, well that is another matter.

if you go to AWHONN FHM classes, you have to learn this skill and trace it on paper. Yes you can hear them, but documenting them may be trickier. You have to be VERY careful to be descriptive, using standardized terms when doing so.

thank you. i thought that you could. my midwife (CNM) was an LD nurse for 8 years and has been a midwife for 13 years, and I assume she knows how to monitor (although I will ask her, because I like to bother her with a million questions. She is so patient with me!).

I've though about becoming an LD nurse; it seems so exciting, but I don't think I could handle the death of an infant. I bawl just thinking about it. I do enjoy being an RN in Neuro.

My hats off to all LD nurses.

bagladyrn, RN · Dec 13, 2003

The difficulty I would see in defining late decelerations with a doppler is the subjectivity of defining the peak/end of a contraction subjectively by palpation/pt. report while correlating to the pattern of deceleration of the FHR. Not impossible, but difficult and even harder to document as stated above.

geekgolightly, BSN, RN · Dec 13, 2003

Originally posted by bagladyrn
The difficulty I would see in defining late decelerations with a doppler is the subjectivity of defining the peak/end of a contraction subjectively by palpation/pt. report while correlating to the pattern of deceleration of the FHR. Not impossible, but difficult and even harder to document as stated above.

gotcha. ive been paying lots of attention to my braxton hicks contractions and can feel for myself when the contraction is letting up by palpation. so i hope that my experience with my body along with my midwifes experience, we will be able to tell when the heart rate is low even after the contraction has ended.

at your cervix · Dec 14, 2003

The most ominous late declerations are the subtle ones and because they are so subtle, you may not recognize them by auscultation alone. Naturally, if you are low risk and no problems during labor, you wouldn't anticpate having late decelerations, but this is the only problem that I could see. If you begin to notice decreased long term variability during auscultation, you would want to be especially careful to listen for the very subtle late decelerations.

geekgolightly, BSN, RN · Dec 15, 2003

Originally posted by at your cervix
The most ominous late declerations are the subtle ones and because they are so subtle, you may not recognize them by auscultation alone. Naturally, if you are low risk and no problems during labor, you wouldn't anticpate having late decelerations, but this is the only problem that I could see. If you begin to notice decreased long term variability during auscultation, you would want to be especially careful to listen for the very subtle late decelerations.

thank you so much. :kiss

mother/babyRN, RN · Dec 17, 2003

You surely CAN....In fact, I just did....Went to the ER to do a fh and it is my custom to palpate the abdomen at the same time and definitely heard a decel after the uc which was repetative...Got her upstairs, on the monitor and we ended up doing a csection....

PegRNBSN · Dec 17, 2003

I believe it is very difficult to hear late decels that are SUBTLE. A persistent lack of variability in the fhr should be a warning and an indication for electronic fetal monitoring.