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Let's have a look at stethoscopes and auscultation. First of all, let's have a look at the stethoscope. Two important things before we even start, cleanliness. Whenever the stethoscope is used it is used on the skin surface, so it needs to be cleaned every time it's been used. Also, the earpieces go into your ear, so they need to be cleaned on a regular basis as well because we want to try and reduce cross­contamination and infection, so they need to be cleaned. You will notice on the stethoscope there are two earpieces.

The earpieces have to face forward. If they face backwards into your ears they won't work very clearly at all, so face them forward. So actually putting them into your ears it's important you get them the right way around. Once they're in the ears, be very very careful with the actual bellows on the end, because if you tap them it will make an awfully loud [chuckle] noise in your ears, so be careful. Once they're in your ears, be careful.

The end itself has two sides: One side has a little plastic bellows on, which we put onto the chest; the other side is a hard plastic area. But again remember, there are multiple different types of stethoscopes on the market. This is just a spirit stethoscope, just a basic one. So, we want to use the side that's got the nice plastic surface on it. So it will turn on the end of the pipe, and the way we decide which side it's on is once it's into the ears, we turn and tap, gently. If you bang on here too loud, or you drop it or banged it, it will affect your ears, so do it gently.

Once we have decided which side we've got working, we are now ready to go. So now we are gonna take a look at actually using the stethoscope on the patient's chest. There are four points on the front of the chest that we use. The first one is the top mid­clavicular line, just below the centre of the clavicle. That will listen to the top of the lung, and we compare left to right or right to left. The next position we're gonna use is just underneath the armpit, which is at the bottom of the lung. So basically comparing left again to right. Top, bottom. Fluid tends to fill up from the bottom of the lung.

Lungs collapsing tend to collapse from the top. So what we're listening for is normal air flow,  and again, this is one of these things that you will need to practice. Get family members, children, adults, anybody that smokes or has lung problems, ask them if you  can use their chest to have a little bit of a listen, and you'll soon start to pick up the different noises  that are created by damage to lungs, fluid to lungs, smoking, and all the rest of it. Another thing we can use is actually percussion. In here, we should have a hollow chamber full of air. If that chamber sounds as if it's full of fluid, whether that's blood or vomit or liquid or water, it will fill up and create a solid sound. So we can use a technique called percussion, which is placing the fingers of the hand flat on the chest and tapping.

When you tap, you should get a nice hollow sound. If it's full of fluids, to compare this, tap the stomach. The stomach is always full of fluids and food so you get a solid sound. It's a bit like tapping a hollow wall and a solid brick wall. What we're looking for here is a nice hollow sound, not a solid sound, and we compare left to right. We want two lungs that are working effectively and clearly. So another thing we have to take care of is we are exposing somebody's chest. And as we're here in a park, the last thing that I want to do is to expose this person's chest too much, for dignity purposes and also to keep the patient warm. We don't have to necessarily expose the chest completely to use the stethoscope.

One of the best techniques is once the stethoscope is fitted, is to undo the cloves slightly at the top. The next important thing is to get the patient to take a deep breath through their mouth on your command. So, please take a deep breath for me with your mouth open, and now breathe out" Compare left and use the same technique on the opposite side, take a deep breath in,  and breathe out, comparing both sides. We then use the bottom of the clothing to feed the stethoscope up, and again, keeping the patient warm and keeping the patient's dignity, we hold the stethoscope through the clothing and compare one side to the other. We have now completed all  four areas of the lung: Top left, top right, bottom left, bottom right