newborn examination of the heart

Examination of the heart
When I start to touch a baby, it is my preference to perform the cardiac examination first. This is because reliable auscultation of the heart is the one part of your total examination of the infant which is most dependent on having a quiet baby. However, if the baby is screaming, you can either delay the cardiac exam until later in the process, or you can swaddle the baby with a blanket and cradle/rock it in your arms, as this will often soothe her/him.
Observe the precordium for any signs of palpitations or visible pulses. Remember to warm the stethoscope e.g. by holding it between your hands - a cold instrument is more likely to startle the baby.
Start by localizing the heart sounds. Are they shifted to right or left, or are they compatible with a normal localization of the heart? What is the heart rate? Auscultation of an infant's heart is quite difficult, and requires a lot of practice. Because the heart rate is usually quite fast compared to bigger children and adults, I advise you to focus on one element at a time: 1st heart sound, 2nd heart sound, systolic interval, and diastolic interval. * 1st heart sound - is it single or is it split? * 2nd heart sound - is it single or is it split? * Systolic interval - is there a murmur? If so, is it continuous/long, or decrescendo/short? Is it quite loud, or barely audible? Does it vary with respiratory phase? Systolic murmurs are not unusual in newborn infants, and the majority are due to a persistent shunting through the ductus arteriosus, in which case they will typically disappear in a couple of days. Unless the infant presents other signs/findings indicative of congenital heart disease, or the murmur has characteristics which make a PDA unlikely, our practice is to follow up with a new auscultation the next day. What the 'correct' management is in these situations, will depend on local circumstances, such as e.g. the availability of pediatric cardiology services. * Diastolic interval - is there a murmur? Unless this represents the continuation into diastole of a systolic murmur due to a PDA, it is an unusual finding which probably calls for further investigations.

Category:

Education

Tags:

• Examination of the heart
• newborn heart exam
• cardiac exam
• palpitations
• 1st heart sound
• 2nd heart sound
• Systolic interval
• ductus arteriosus
• Diastolic interval
• systolic murmur
• murmur

[loreyn16]

wearing gloves depends on an institutions policy..

besides in the hospital im working, you only have to wear gloves when the baby have'nt have a bath yet, the baby might have some body fluids residue from her mom... =)

[mailslayer]

Unprofessional examination....

[NycAttentionWhore]

gloves?

[AvgnFanSite]

It truly is amazing what kind of smut finds it's way on YouTube.