A graphic method for illustrating auscultatory findings is offered here, not only as a means of keeping records as conveniently and efficiently as possible, but also as an aid in learning auscultation. One such "auscultogram" (see figures) can equal a 629-word description of the auscultatory findings. The graph can tell the story at a glance once the symbols are understood.
Filling in such auscultograms serves a self-teaching function in training a person in auscultation, because one is forced to dissect out and listen separately to each component of the cycle, a method that is the hallmark of a good auscultator. Although listening to the total effect of all the sounds and murmurs as a single unit is also important, beginners tend to listen this way to the exclusion of the dissection method.
The writing and listening should be done simultaneously (i.e., with the stethoscope in one hand and a pen in the other, the auscultator fills in the auscultogram). The auscultogram is used for the purpose of improving the ability to auscultate and providing an accurate record; the art of fine auscultation should not be a memory test. Performing auscultation is one of the few times when it is best for a right-handed physician to carry out the examination from the patient's left side, because this position allows the stethoscope to be held with he left hand while writing with the right.
Simultaneous writing and listening is the key to this method of ear training and accuracy of recording.
It is convenient to print auscultogram pads that are small enough to fit on about half a hospital chart page. The auscultograms illustrated at the beginning of this chapter are the actual size.
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