The presence of breath sounds over both sides of the chest is an essential element of the "A" in the ABCs. Inspiration to expiration length ratio is 3:1, or longer: shorter. (Over the trachea, in contrast, the breath sounds are high-pitched and loud over the mainstream bronchi, between the scapulae, and below the clavicles, they are medium-pitched sounds-a combination of vesicular and bronchial-called bronchovesicular sounds.) Normal breath sounds over the lung fields are called VESICULAR breath sounds: low-pitched and soft. This section will begin by reviewing the importance of hearing bilateral breath sounds followed by defining and describing stridor, wheezing, crackles, and several special sounds that may appear on an exam.īreath sounds should be assessed in three locations: the apex of each lung (right above the clavicle), the mid lung (mid sternal), and at the bases (Roughly at the level of the xiphoid process). Regardless of these practical limitations, the description of breath sounds is a vital component of many national registry exam questions and may help guide your care in the field. In the EMS setting the detailed analysis of breath sounds can be restricted by environmental noise, time constraints, and limitations to patient mobility. During both the rapid assessment of a patient's ABCs and the head-to-toe secondary survey the assessment of the patient's breath sounds via auscultation is vital to the recognition and treatment of several emergencies.
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