Lung sounds when on ventilator and/or when on a trach?

[ibarne242]

As far as I can tell, it seems that often when I hear gurgling or something that maybe sounds like rhonchi, it's the trach. Or maybe some other sounds I hear on patients is their ventilator. I just don't know
Like this morning, I felt like I was hearing something pretty gurgling or snoring-like. The patient was vented and trached. I said I heard rhonchi. The attending who's nice and not mean to us was just like "I don't hear anything but it's hard to tell since they're vented." or something. Like, so I guess what I'm asking is that if someones on vent or trach, what's up with their lung sounds. What do you hear just from those?
It's much easier to approach when people aren't like...on these crazy ventilators and trachs like they are all the time at this random old people home lol

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[throwaway1939]

no one gives a **** about ventilated breath sounds unless you hear nothing at all (eg pneumothorax), otherwise just get a xray or ct scan. the only things on physical exam that really matter in the ICU are mental status, edema, +/- abdominal, and skin.

 

[hallowmann]

You'll get used to differentiating upper airway sounds from lower airway sounds over time. For the vent, yeah it's hard to differentiate sounds, but this too will improve over time, but will always be tough.

 

[Angus Avagadro]

It's like anything else. The more patients you listen to, the better you will get. To the newly initiated , upper airway secretions can sound like rhonchi. Dont despair. With time you will be able to tell the difference