How to Differentiate Between Rales Vs. Crackles Vs. Wheezes

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Medical professionals can differentiate between rales and wheezing.
Medical professionals can differentiate between rales and wheezing. (Image: Jupiterimages/Comstock/Getty Images)

Rales -- also called crackles -- and wheezing are breath sounds produced by the lungs. These sounds can be distinguished with auscultation, the use of a stethoscope. Lung sounds can be heard in all parts of the chest from the collar bone to the bottom of the rib cage. Rales and wheezing are two of the four most common breath sounds.

Place the ear plugs in your ear canal and position the chest piece against the front peripheral area of the patient's chest. The peripheral area is the upper part of the chest towards the arms. Listen to the breath sounds during normal breathing.

Place the chest piece against the chest in the area near the front of the bottom of the rib cage. Listen to the breath sounds during normal breathing.

Place the chest piece against the chest in the back peripheral area of the chest and listen to the breath sounds during normal breathing.

Place the chest piece against the chest in the area near the back of the bottom of the rib cage. Listen to the breath sounds during normal breathing.

Repeat Steps 1 through 4 and listen to the sounds as the patient takes deep breaths as necessary.

Determine whether the sounds are heard continuously during inspiration or expiration or both. If so, the patient has wheezing sounds, which are caused by air moving through airways narrowed by constriction or swelling or an airway with a partial obstruction.

Determine whether the sounds are heard intermittently, briefly or are non-musical. This type of sound is characterized as crackles or rales, which are caused by air being forced through respiratory passages narrowed by fluid, mucus or pus.

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