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Auscultation

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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

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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