Is it possible to treat babies without auscultation?

[Andre]

Hi everyone!
I'm a Portuguese physio student and I'm currently in a period of training in pediatrics. I was lucky (or not) to be placed at a pediatrics hospital with international accreditation.
Nevertheless most of the physios working at this hospital tend to treat all the babies with respiratory problems without auscultation.
Regardless of the babies' problems, the intervention is almost always the same.
It looks like no one at that hospital has had a little time to read a few things in the past ten or fifteen years.
I'dd like to know what you think about this.
Are we going to be the person who squeezes the babies and claps their chest, or are we going to base our practice in some evidence, and guide our intervention on a problem-oriented basis??

Similar Threads:

• Chest physiotherapy for babies with gastric reflex
• Babies process language in a grown up way.
• examination of newborns and premature babies

[somasimple]

Hi Andre,

With an little 25 yo experience, I would say, yes, because your hands feel exactly where it snoozes. Many young patients/babies are simple cases for us but I use ever my stethoscope when I'm not sure about my hands diagnosis. A simple examination (colour, breathing pattern, awake?) show the emergency which is not so common!

By the way, there is actually a large consensus showing that clapping is ineffective and must be replaced by an increased expiratory flux. If some PTs in your hospital are doing such old things, thus there is a problem!

[Andre]

Hi Bernard, maybe you could explain to me exactly how you do that, because my training monitor does just the same. Nevertheless,a Belgium Professor, Guy Poustiaux, says otherwise. I agree that we can use our hands to feel the secretions, but how do you locate where they are in the respiratory/bronchial tree without a stetho??

How would you treat a 8 month baby with a right lower lobe pneumonia, with no secretions?

[somasimple]

Hi Andre,

I was a little restrictive in my post and said that it does not work for all cases. It will be so good!

I learnt with Philippe JOUD in Lyon who is a respiratory PT specialist. I learnt firstly with a stethoscope but I put immediately my hands to feel the sound of secretions. With time comes experience.
Normally a lung sounds and if it doesn't then you have a big problem => pleurisy, pneumonia...

Listen to the medical context (tooth...) and look carefully to the baby. A baby which is crying is rarely so ill as we were told => complete by an examination.

[Andre]

Thanks for your comments, Bernard.
The main reason I posted in the first place was the fact that my training monitor doesn't auscultate at all!!
I talked to some other physios and realized that this isn't the rule at this hospital. I guess one doesn't account for all of them.
I believe the reason for this is the fact that my monitor has a special interest in neurology, and was temporarily placed on a nursery because of the amount of babies with respiratory pathology this time of the year.