Jump to content
Premed 101 Forums

counting baby's heart beat resource?


Recommended Posts

Google 'online metronome' and set it to 120/min and see if you can count it!

 

It is extremely difficult to count a baby's heartrate so don't feel bad if you can't - better to get a sense of what's 'normal' 'too fast' and 'too slow'

 

My peds preceptor told me that if a medical student can count a baby's heartrate he's worried about that baby because their heartrate is too low!

Link to comment
Share on other sites

As a student, it makes me nervous when I keep losing my place while counting beats, and I second guess my assessments. If I figure out a strategy on my own time, I will assess more accurately. Also, it won't hurt to start recognizing what certain heart rate ranges sound like in order to detect tachycardia more quickly. I posted in this forum because I thought more experienced med students might be able to help me out. Thanks for the suggestions :)

Link to comment
Share on other sites

If you have a sick infant your ability to count HR is not going to be very accurate anyway. You should be looking at all the other physical findings of good vs poor circulation and combining it into an overall picture. That's much more important than a single vital sign. I would argue looking at the heart rate on a sat probe or from ECG monitor is going to be more accurate than trying to count a rate anyway (assuming you know how to interpret these). Just my 0.02$.

Link to comment
Share on other sites

Does anyone know an on-line resource to practice counting an infant's heart rate? It's super fast and I'm constantly losing my count. I want to practice at home but don't have any babies around :) Thanks

 

Sure its hard. You won't get it perfect. Write the number you get. Give it your best shot.

What's far more important is the total context.

Sick/healthy baby with

a. Really slow heart rate

b. Kind of slow heart rate

c. Normal heart rate

d. Kind of quick heart rate

e. Way too fast heart rate

 

Through the course of your obstetrics, and peds rotations you should be able to tell the difference between a,b,c,d,e with 6 seconds of auscultation....and no math.

Link to comment
Share on other sites

I posted here to get some advice from experienced med students. I'm a nursing student and, as crazy as it may seem, I do want to ensure accuracy in recording... This doesn't mean that I don't consider the overall picture of health... I just want to make sure that what I hear/see/etc is recorded accurately. Not necessarily dead-on precise, just reasonably accurate, especially for the docs who might be reviewing the vitals I have recorded ;) and also since electronic monitors are not always reliable!

 

As a student, I feel nervous in the clinical setting, and for some odd reason, using the metronome on my own time has helped.

Link to comment
Share on other sites

I posted here to get some advice from experienced med students. I'm a nursing student and, as crazy as it may seem, I do want to ensure accuracy in recording... This doesn't mean that I don't consider the overall picture of health... I just want to make sure that what I hear/see/etc is recorded accurately. Not necessarily dead-on precise, just reasonably accurate, especially for the docs who might be reviewing the vitals I have recorded ;) and also since electronic monitors are not always reliable!

Fair enough. But for what it's worth, the electronic monitors are probably going to be more reliable than you counting it because it might be too fast for a human to calculate properly. You'd be better off doing that than counting manually, although depending on environment you may not have monitoring to use so it's not a bad idea to practice.

 

The caveat to that is knowing how to interpret a monitor properly - eg for a sat probe, does the waveform look reliable? Does the extremity you're using have a good pulse and does it seem to link up with the waveforms? As for the ECG monitor are you getting a good signal with no artifact and is the monitor seem to be capturing all the R waves? Do the ECG + sat + your own measurement correlate? Hopefully that helps.

Link to comment
Share on other sites

Fair enough. But for what it's worth, the electronic monitors are probably going to be more reliable than you counting it because it might be too fast for a human to calculate properly. You'd be better off doing that than counting manually, although depending on environment you may not have monitoring to use so it's not a bad idea to practice.

 

The caveat to that is knowing how to interpret a monitor properly - eg for a sat probe, does the waveform look reliable? Does the extremity you're using have a good pulse and does it seem to link up with the waveforms? As for the ECG monitor are you getting a good signal with no artifact and is the monitor seem to be capturing all the R waves? Do the ECG + sat + your own measurement correlate? Hopefully that helps.

 

Thanks for the tips. I would really like to know this stuff in greater detail. I know how to look for ECG artifacts but am less sure about the SAT waveform... What exactly should it look like? I'm assuming it's a different waveform than the arterial one.... Is this assumption wrong? Sorry if this isn't clear...

Do you know of a really good resource that I can access on a student budget that explains SATs and provides diagrams of what the waveform should look like? Thanks :)

Link to comment
Share on other sites

as much as this may not be evidence based, trust your gut too.

 

Medicine almost always comes down to clinical acumen. Even if the test is negative, if you have a very high index of suspicion you will keep investigating or keep treating. Get a good feel of what "too fast" and "too slow" is. Obviously documenting accurate vitals is super important, but as you get further along in your training you'll find the really experienced guys look at the patients, not the numbers (treat the patient not the lab values). For example when I see a COPD exacerbation I'm often not counting reps rates, I'm looking at their overall work of breathing, their expiratory phase, accessory muscle work, cyanosis etc. I've stopped counting heart rate with a watch...mostly you can start to tell what too fast sounds like on auscultation or that their peripheral pulses are pounding and fast.

 

I used to find it so frustrating when a staff or resident would tell me "just look at the patient, they either look sick or not sick" - as a new learner, what the heck is that supposed to mean! I didn't have "sick" to compare with "not sick". With time I realized that was one of the most important lessons to figure out.

Link to comment
Share on other sites

I've stopped counting heart rate with a watch...mostly you can start to tell what too fast sounds like on auscultation or that their peripheral pulses are pounding and fast.

 

 

I absolutely agree with this. And it comes with experience, after having felt the pulse and listened to the hearts of many many sick and not sick patients.

 

Those med students who posted on here suggesting that listening to an infants heart rate is not useful, and who by extrapolation are not listening, will not develop this skill.

 

I did not finish med school THAT long ago. We were required to develop this skill with babies and infants. I would encourage everyone to develop this skill.

At least anyone who will be working with kids.

Link to comment
Share on other sites

Thanks for all of these suggestions... They have re-inforced the importance of considering the big picture in relation to single assessment findings. I don't think my "gut" is very reliable yet. I tend to worry about many different findings about my patients - even if there is nothing to worry about. Perhaps my gut will be a better guide with more experience! I need to remind myself to look at the bigger picture.

Link to comment
Share on other sites

Thanks for all of these suggestions... They have re-inforced the importance of considering the big picture in relation to single assessment findings. I don't think my "gut" is very reliable yet. I tend to worry about many different findings about my patients - even if there is nothing to worry about. Perhaps my gut will be a better guide with more experience! I need to remind myself to look at the bigger picture.

 

I'm very concerned at the novice HCP that relies on their gut to make decisions. It should almost entirely come from experience, because aside from some common sense stuff, you just don't have the wealth of experience of draw upon subconsciously to make the right "gut" decisions.

 

Gut decisions aren't wild guesses, they are just doing short hand division rather than long hand because you know the steps in between.

Link to comment
Share on other sites

I'm very concerned at the novice HCP that relies on their gut to make decisions. It should almost entirely come from experience, because aside from some common sense stuff, you just don't have the wealth of experience of draw upon subconsciously to make the right "gut" decisions.

 

Gut decisions aren't wild guesses, they are just doing short hand division rather than long hand because you know the steps in between.

 

I agree! This is why I mentioned that I need more experience before my gut will be useful at all.

Link to comment
Share on other sites

  • 5 weeks later...

I'm sorry to intrude on this part of the forum, but this caught my eye as I was reading and I thought I'd make a suggestion, though it may seem a bit odd.

 

Do you have a cat, or have a friend with a cat, or perhaps a small dog?

 

A small dog's heart rate and a cat's are around 160 beats per minute at rest. It's a bit easier to hear than an infant's (I have pets and kids as well as a stethoscope, curiousity, and occasionally too much time on my hands...) but it's around the same pace as a normal-to-high infant's heart rate.

 

Probably sounds a bit odd, but I thought I'd suggest it anyway. I'm not a med student yet, so feel free to take that with a grain of salt.

 

/reverting to lurker status in this part of the forum now...

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...