hey everyone welcome back so today I want to talk about boom stethoscopes yeah I remember the first time I got one of these it felt like a Christmas gift all over again I was so excited to put one of these on and walk around clinicals looking all cool and everything but yeah I'm gonna explain to you guys how it works and how simple it is to be honest and you know how to adjust little things here and there um so let me open this alright so this is how it looks I got mine on Amazon I think it was like ninety two hundred dollars I don't remember so I got it last year and then they'll come with this like ear plug that I've never used and this manual because I don't look at manuals so I've never really looked inside of this thing but I'm sure there's some great information here but I'm not gonna read it right now um and then your stuff this go let me put this down um okay so the first thing you want to do is adjust the ear the ear plug you want it to be facing like towards your nose not I don't know if you could see see how it's like facing this way towards my face because from here and you'll get like a clear hearing because it's going directly to your ear canal so you'll be able to hear everything crystal clear and if you're facing it this way it's actually hitting the bone so it's not comfortable at all and yeah you won't be able to hear and it's it's super painful trust me if you try facing it backwards you're gonna be like ah hurts so yeah you want it facing towards your face and then once you have it in you kind of want to you know tap to see if you hear anything and yeah that's about it and once you start going to the hospital just make sure you're disinfecting this always because you don't want to be touching from patient to patient to patient and you don't know if they're on any precautions you always clean grab an aqua all wipe and always wipe it down I'm actually impedes right now so I like to have my kids you know play around with it and like listen to their heartbeat because you create this trust and this bond bond with them and it keeps them calm you know so then you're able to auscultate everything without them being you know scared or screaming things like that so you know be friendly even with older adults I've had them listen just just for fun so that you know they're they're so lonely sometimes so they just want you know like that communication with them okay another thing is that you want to make sure that is the thing I didn't know about this until like later well not later the link you know now you could flip it okay so if you flip it one way it will probably have more sound on the diaphragm and then you could flip it the other way and then you have the sound on the belt and then for the bowel you want to use this for like for pete's or for any breweries murmurs and basically what a brewery is if there's like a narrowing and the artery so you cook like place it here you know like see if there's any abnormal sounds and yeah and then this is a diaphragm they use it you know for the lung sounds the heart and bowel sounds and you want to make sure that you know all the landmarks of the heart you know the aortic pulmonic herbs point tricuspid mitral valve which is you know the the maximum point which is under here it's in the fifth intercostal space intercostal space um yeah and then you have to do the long sounds so what I like to do is like I like to auscultate everything all at once because if you go from like like you have your stethoscope here and then like okay I'm gonna listen to your lungs okay now I'm gonna do capillary refill okay now I'm gonna go listen to your heart like you don't want it to be like back and forth just everything all at once so you get it out of the way and you don't have to keep flipping back and forth and you kind of look disorganized so try to do anything with the stethoscope get that out of the way and you know that's when the patient's calm you know you don't know if they're gonna start talking and you want them you know calm quiet environment so you could really hear what's going on and so for the lungs I like to start off posterior because I get the back out of the way and then I do everything in the front the heart and the bowel sounds so I like to start in the back and make sure when you're auscultate ago across you want to go like right up and then across and then you go down across down across down across that's how you do it because you want to make sure that both sides are even you don't want to start listening to one side and then you can't compare it to the other side so always make sure you go across and then from the back you want to start off quiet think of it like a triangle you want to start like closer and then you start opening up opening like a tree like like you think of like the lungs you know how the lungs are here and then they're like opens up so yeah just keep going getting wider and wider and wider and wider and then same thing with the front and then do the heart sounds the five landmarks and then go into the bowel sounds and with the bowel you want to start on the right lower quadrant right upper left upper and then left lower because you know that's like the shape of the colon and to be honest I've never listened to the vowel sounds for five minutes and that's what they're telling you to do like listen to each side for like a minute or something like that's not gonna happen like I've never seen any nurse do that you don't have time for that they're so busy they're running around like the first hype like first bounce on here like you're good just listen okay good boom you're done because you don't have time to listen for five minutes unless you really don't hear it then you yeah you may have to but like I've never come across that ever and and then regarding the lung sounds there's I I'm sure you guys will learn about this in school or you have which is like you know any wheezing bronchi rails or crackles I like to listen out on YouTube because you know keep listening to it over and over again so you get a feel and then also really I like to listen to myself too so I could remember how a normal lung sound sounds like and yeah so when you go into clinical setting if you hear anything that sounds funny like any like rubbing or loud like whooshing sound or like you're like they're saying like a hair when it's like like you're going like this like that's how um crackle or wheeze I don't know it's just a whole bunch of things going on that anything I've normal that doesn't sound like air there's something wrong you kind of want to listen to it or let the nurse know or the health care provider because you don't want any abnormal lung sounds um okay and another thing is is with the blood pressure it's pretty simple like in school they taught me that you have to like check the radio pulse and then you count for a whole mini and then let's say you have a pulse of 80 so once you put in the blood pressure cuff you have to pump like inflate twenty to thirty like more and I don't do that to be honest like this is all I do because everything in the hospital is so fast paced so you don't have time to you know like do like little things and so basically I grab my my blood pressure cuff or this big momentum um you want to put it above here I'm not gonna put it on the here so this is where you would put it wait with this here and then you're gonna put there I'm just gonna put it in because if not this thing is gonna be falling out okay there we go even though it's not tight on me but I don't know okay and then you're gonna put this on and put the stethoscope right here okay with the diaphragm right there and then what you're gonna do you're gonna grab this thing and you're gonna grab this you're gonna make it tight the right side is a tight side left is loose right tight and you're gonna inflate this okay when it goes all the way up to like 200 I usually go all the way up to 200 like I don't care like I just got to 200 cuz then you're not wasting any time cuz what if the person has high blood pressure and you only go up to like 140 like just go all the way up to 200 and then really slow just go to the left very slow and you're gonna see it like gradually deflate and the very first boom like that love sound that's your systolic okay and that's what all of these are gonna be like even number so yeah so the very first one you're not gonna get like 147 that's not gonna happen my 48 or 146 boom that's your that's your systolic and then you're gonna let it keep deflating it with the left side and it's gonna go all the way down and the last one is the diastolic and then that's it so that's your top number and your bottom number and then boom that's it it's really simple it's not bad I think the hardest part is like the coordination so I'll try to practice on yourself you know like this for me was like the hardest part to get not so much like hearing it but it was like the coordination but yeah it's not bad at all honest with your numbers like don't go into a clinical setting and then like you didn't really hear it and you're just guessing a number like don't do that you kind of want to like if anything told the patient like I didn't get it let me check it again like it's better for you to double-check and be sure of it then just guess and just give any number like you don't want to do that it's not safe like Snap patient advocate advocate so yeah just make sure that you always double-check and then if you need you know someone to give like a second opinion in a second hearing like ask another nurse or your friend or something to see if like you're on the same range cuz you know we're still students we're learning so it's okay to ask they say it's okay to ask I I'm the type of person like I ask questions all the time like I don't get it I need to hear it again can you hear it for me even though I think I'm right but just always ask it's important good for you and always we can get any chance like auscultate as much as you can on every patient you know we're here to learn and then if you hear something like go ask the professor like I'm sure she'll be glad to help you and you know give you like a reasoning behind it or what she hears and compare it and see like go back to their Diagnostics or their diagnosis I'm sorry um yeah and that's about it like it's super fun it's once you get the hang of a girl like do - - like you look so cool and everything with your stethoscope walking around the hospital so yeah it's fun enjoy it um take advantage of every opportunity you gave someone here's like a brewery somewhere or some wheezing like go to that patient you know ask them if it's okay if you couldn't listen to them because you never know but yeah I always ask and then listen because we might get these type of questions on NCLEX so it's better to be prepared well guys I am gonna go back to my studying I have my pity at chicks exam on Monday and on Wednesday so a lot of studying to do but subscribe below leave any questions for me or anything you want me to talk about and I'll be back bye