Station C: Respiratory
Mission: Master the stethoscope to hear the difference between a healthy heart, healthy lungs, and a sick patient.
PART 1: THE VITAL SIGN (Pulse Oximetry)
Start here. It is quick and non-invasive.
1. The Tool:
Clip the Pulse Oximeter onto the patient’s pointer finger.
2. The Data:
Wait for the numbers to stabilize.
SpO_2: This is the Oxygen level. (Normal = 95–100%).
PR / BPM: This is the Pulse Rate. (Normal Resting = 60–100).
3. The Check:
If the number is low (e.g., 92%), ask the patient to sit up straight and take a deep breath. Does it improve?
Stethoscope :: Let's listen
PART 2: THE SETUP (Stethoscope Basics)
Work in pairs. Sanitize the earpieces with an alcohol wipe before every use.
1. The Earpieces: Angle them FORWARD (towards your nose) when you put them in your ears. This aligns with your ear canal.
2. The “Over the Shirt” Technique:
Placement: Do not touch bare skin. Place the drum of the stethoscope on top of the t-shirt.
Pressure: Press FIRMLY against the fabric.
Why? If you press lightly, the fabric will rub against the metal and sound like “crinkling paper.” Firm pressure isolates the sound inside the body.
PART 3: THE HEART EXAM (The Pump)
Listen to the rhythm.
1. Placement: Place the stethoscope on the front left chest, just below the collarbone or near the sternum (breastbone).
2. The Sound: You are listening for a rhythmic “LUB-DUB… LUB-DUB.”
Lub: The top valves closing (filling the heart).
Dub: The bottom valves closing (pumping blood out).
3. The Challenge: Close your eyes. Count the beats for 15 seconds. Multiply by 4. Does it match the number on the Pulse Oximeter?
PART 4: THE LUNG EXAM (The Bellows)
Listen to the airflow.
1. Placement: Have the patient sit on a chair backwards or lean forward. Place the stethoscope on the upper back, between the shoulder blade and the spine.
2. The Action: Tell the patient: “Take a deep, slow breath in through your mouth.”
3. The Sound: You should hear a soft, hollow “WHOOSH” of air. This is called “Clear Air Entry.”
4. The Comparison:
Listen to the Left side (take a breath).
Move to the Right side (take a breath).
Do they sound the same? (They should!)
CLINICAL NOTE: What if they were sick?
Since your partner is healthy, you should only hear clear “whooshes.” If they were sick, here is what you would listen for:
Wheezing: High-pitched whistling (Asthma).
Crackles: Sounds like Velcro ripping (Pneumonia/Fluid).
Silence: Air is not moving at all (Collapsed Lung).