auscultation
Last reviewed 01/2018
Auscultation of the chest in a child can be difficult; time and patience can be needed to keep the child relatively quiet. The subsequent interpretation of breath sounds and additional noises can also pose problems, and a careful listening is needed to note differences rather than absolute signs. This particularly applies to signs such as bronchial breathing; often this is a comparative finding in a small child, where most of the breathing would appear bronchial to the adult physician.
Specific sign may include:
- crepitations in bronchiolitis or rarely heart failure
- coarse intermittent noises secondary to debris from infections
- wheezing, and, often more helpful, prolonged expiratory time in asthma
- the silent chest is an emergency in an ill child
- stridor may be heard in upper airway obstruction:
- subtle stridor on a noisy ward can be heard by holding the stethoscope near the mouth
- however, beware the child who wants to render the examiner deaf