Nerd_Slayer Posted July 31, 2011 Share Posted July 31, 2011 Hey guys, basic asking a dumb question. Can you hear and identify an arrhythmia using only a stethoscope? I know this seems stupid. I tried googling around but I couldn't find a good answer. Link to comment Share on other sites More sharing options...
ShockDoctor Posted July 31, 2011 Share Posted July 31, 2011 (edited) Yeah, depending on the arrhythmia and if you know what you're listening for. It's way easier to EKG that stuff, though. This being said, why would you want to do listen for an arrhythmia? If a patient has an arrhythmia, you should be hooking them up and getting them ready for a shock (not sitting and listening for abnormalities in their heart beat). If you don't have a defibrillator, you probably should be doing compressions, not listening for abnormalities in their heart beat. So yes, theoretically you can, although there's no practical reason to do this. EDIT: Grammar. Edited July 31, 2011 by ShockDoctor 1 Link to comment Share on other sites More sharing options...
medicgirl05 Posted July 31, 2011 Share Posted July 31, 2011 Yeah, depending on the arrhythmia and if you know what you're listening for. It's way easier to EKG that stuff, though. This being said, why would you want to do listen for an arrhythmia? If a patient has an arrhythmia, you should be hooking them up and getting them ready for a shock (not sitting and listening for abnormalities in their heart beat). If you don't have a defibrillator, you probably should be doing compressions, not listening for abnormalities in their heart beat. So yes, theoretically you can, although there's no practical reason to do this. EDIT: Grammar. Do you know the definition of arrhhythmia SD? Any abnormal heart rhythm. Don't chew the poor kid out for wanting to listen to them...I have never shocked or done compressions on many arrhythmias; including A-fib and the occasional PVC. Nerd-yes occasionally you can hear an arrhythmia. A-fib has an irregular beat which you can usually hear. Now I wouldn't document an irregular rhythm from auscultation, as I don't know how precise it would be without special training. The only dumb question is the one that goes unasked. 2 Link to comment Share on other sites More sharing options...
ShockDoctor Posted July 31, 2011 Share Posted July 31, 2011 I wasn't chewing him out, I actually think it's a good question. Yeah, the hard definition of "arrhythmia" is any abnormal heart rhythm, but I figured he meant something like v-fib or v-tach considering he's an EMT-B, not a cardiologist. All this being said, you should probably be doing something else if you suspect an arrhythmia. 1 Link to comment Share on other sites More sharing options...
BAYAMedic Posted July 31, 2011 Share Posted July 31, 2011 I had wondered what your pioneering work was. Since your the cardioausculatologist, could you share some of your ground breaking work? How can I differentiate between Puseless electrical activity and asystole? I work in heavy equipment before I got into ems and I fear I may miss the subtlety. Now does v fib just have the sound of electrical vibration? Like standing next to a transformer? Nerd, the sound you are listening to are the sounds of the heart beat. You can call a tachycardia if its too fast, or a Bradycardiac if its too slow. If your really good you may hear murmurs or gallops but those are mechanical problems with the structure of the valves. Dysrhythmias are an electrical problem. So essentially you would be using a plumbers tool to do an electricians job. Great question though. Apparently it will educate others of the limitations of our tools. Fireman1037 Link to comment Share on other sites More sharing options...
BushyFromOz Posted July 31, 2011 Share Posted July 31, 2011 (edited) I wasn't chewing him out, I actually think it's a good question. Yeah, the hard definition of "arrhythmia" is any abnormal heart rhythm, but I figured he meant something like v-fib or v-tach considering he's an EMT-B, not a cardiologist. All this being said, you should probably be doing something else if you suspect an arrhythmia. Of course, he couldn't possibly be asking a technical question, being an EMT-B and all Nerd, i dont really have an answer for you, but to add to what fireman said above, experience would show me that you can occasionally take an educated guess to make some very broad statements about rate and rhythm based on auscultation. Having said that you probably cant really say more than regularly irregular or irregularly irregular You can pobably pick Atrial fib with a resonable level of confidence. Anything regularly irregular would be just a guess as there are a few different rhythms that will have that very broad description. Of course you could make the same generalisations from palpating a pulse, but both would be inadequate assessment and you should either have a look at their ECG or find someone who can. Happy to stand corrected though Edited July 31, 2011 by BushyFromOz Link to comment Share on other sites More sharing options...
DwayneEMTP Posted July 31, 2011 Share Posted July 31, 2011 I will bet you a month's wages that you can hear tachycardia, bradycardia, PVCs, A-fib...and often I won't do anything about any of those rhythms. It's easier to feel those things in the pulse, but they can certainly be heard.. SD, you go back and forth from me looking forward to your posts to me wanting to kick you right in the balls...But hey, you always generate discussion and don't cry like a little girl when you do get bit...so I remain happy that you're here.. :-) Dwayne 1 Link to comment Share on other sites More sharing options...
chbare Posted July 31, 2011 Share Posted July 31, 2011 To answer your question; yes, it is possible with some dysrhythmias. Do some research into the second degree type 1 AV block. I believe Dr. Wenkebach described this type of block initially based on auscultation and the term Wenkebach phenomena was coined. Take care, chbare. Link to comment Share on other sites More sharing options...
Nerd_Slayer Posted July 31, 2011 Author Share Posted July 31, 2011 This being said, why would you want to do listen for an arrhythmia? If a patient has an arrhythmia, you should be hooking them up and getting them ready for a shock (not sitting and listening for abnormalities in their heart beat). If you don't have a defibrillator, you probably should be doing compressions, not listening for abnormalities in their heart beat. As others have noted this is a technical question. Don't worry. If I have a patient who needs defibrillating, I'll be hooking him up to an AED. You don't have to worry about me wasting time with my stethoscope. Have some faith in me SD. Link to comment Share on other sites More sharing options...
Katiebug Posted July 31, 2011 Share Posted July 31, 2011 I had wondered what your pioneering work was. Since your the cardioausculatologist, could you share some of your ground breaking work? How can I differentiate between Puseless electrical activity and asystole? I work in heavy equipment before I got into ems and I fear I may miss the subtlety. Now does v fib just have the sound of electrical vibration? Like standing next to a transformer? Fireman1037 LMAO Dwayne, I have to agree with you. I look forward to what SD will come out with next. He can sure keep the sh!t stirred. Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Recommended Posts