Been trying to improve my lung sound assessments in the field, but even after checking old training notes I’m still unclear on how to reliably tell apart rales, crackles, wheezing, and rhonchi. I’m looking for more than just textbook definitions on what they actually sound, like where do you typically hear them, and what do they indicate from an EMS perspective? For example, how do you tell crackles from rhonchi? Any tips or audio references or field tests? Thanks!
Lung sound assessments
- Thread starter fred77
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PulseChaser
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- Joined
- May 16, 2025
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- 5
If you have the chance, try shadowing doctors in the ER. They'll show you how to listen to breath sounds and explain what's going on with patients. It's a really helpful way to learn by doing. Have you ever done that?
Got a few for you, these 3 very common
Crackles: are more like velcro sound at the bases and they don't clear with coughing, in that case you can comfortably guess CHF or fluid in the lungs
Rhonchi: pretty simple and easy, its a wet or gurgly and it changes or clears after coughing, then its usually mucus in larger airways, like in bronchitis
Wheezes: for this its usually caused by airway narrowing, so probably along the line of asthma or COPD
So yeah, to mention a few, have them cough and if it clears up, it's probably rhonchi, if not, then probably the crackles, your ears need to be sharp and retentive
I hope this helps in anyway
Crackles: are more like velcro sound at the bases and they don't clear with coughing, in that case you can comfortably guess CHF or fluid in the lungs
Rhonchi: pretty simple and easy, its a wet or gurgly and it changes or clears after coughing, then its usually mucus in larger airways, like in bronchitis
Wheezes: for this its usually caused by airway narrowing, so probably along the line of asthma or COPD
So yeah, to mention a few, have them cough and if it clears up, it's probably rhonchi, if not, then probably the crackles, your ears need to be sharp and retentive
I hope this helps in anyway
This def helped big time! Thanks for making it so detailed, will write this down on my physical notes.
