Assess heart rate, skin colour and mental status.Assess air entry, chest expansion and oxygen saturations.Is there nasal flaring, grunt, tracheal tug or subcostal/intercostal recession?.Systematically compare posterior lung fields side to side for the equality of breath sounds and presence of adventitious sounds.Systematically compare anterior lung fields side to side for the equality of breath sounds and presence of adventitious sounds. ![]() Breath sounds of toddlers are generally more intense and bronchial sounding than adults, with expiration more pronounced than inspiration. Listen to the full inspiration & expiration of a cycle before moving the stethoscope abnormal sounds can be generated in one portion of the cycle. Use a pediatric stethoscope (diaphram) when listening to the chest of infants and young children. Audible sounds: vocalisation, wheeze, stridor, grunt, cough - productive/paroxysmal.Use of accessory muscles: intercostal/subcostal/suprasternal/supraclavicular/substernal retractions, head bob, nasal flaring.Respiratory retraction: supraclavicular, intercostal, subcostal.Respiratory effort: mild, moderate, severe, inspiratory/expiratory ratio, shortness of breath.Respiratory rate, rhythm and depth (shallow, normal or deep).Adventitious Breath Sounds: Stridor, Wheezes / Rhonchi, Crackles / Rales and Pleural Rub | (Ausmed Jan 20, 2020).Atopic diseases such as asthma, hay fever and eczema.Infectious diseases such as tuberculosis (remember high-risk groups).Respiratory diseases with a genetic component - eg, cystic fibrosis, emphysema (alpha-1-antitrypsin deficiency).Onset and duration of signs and symptoms,. ![]()
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