Open Access Open Access  Restricted Access Subscription or Fee Access

Radiostethoscopes: An innovative solution for auscultation while wearing protective gear

Keith A. Candiotti, MD, Yiliam Rodriguez, MD, Luciana Curia, MD, Bruce Saltzman, MD, Ilya Shekhter, MS, Lisa Rosen, MA, David J. Birnbach, MD, MPH

Abstract


Objective: To demonstrate a radiostethoscope that could be modified and successfully used while wearing protective gear to solve the problem of auscultation in a hazardous material or infectious disease setting.
Design: This study was a randomized, prospective, and blinded investigation.
Setting: The study was conducted at the University of Miami-Jackson Memorial Hospital Center for Patient Safety.
Participants: Two blinded anesthesiologists using a radiostethoscope performed a total of 100 assessments (50 each) to evaluate endotracheal tube position on a human patient simulator (HPS).
Interventions: Each lung of the HPS was ventilated separately using a double lumen tube. Four ventilation patterns (ie, right lung ventilation only; left lung ventilation only; ventilation of both lungs; and an esophageal intubation or no breath sounds) were simulated. The ventilation pattern was determined randomly and participants were blinded. An Ambu-Bag was used for ventilation. An assistant moved the radiostethoscope to the right and left lung fields and then to the abdomen of the HPS while ventilating. Subjects had to identify the ventilation pattern after listening to all three locations. A third member of the research team collected responses. Each subject, who wore both types of respirator (positive and negative), performed a total of 25 trials. Participants later compared the two types of respirators and their ability to auscultate for breath sounds.
Results: Subjects were able to verify the correct ventilation pattern in all attempts (100 percent).
Conclusions: Radiostethoscopes appear to provide a viable solution for the problem of patient auscultation while wearing protective gear.


Keywords


auscultation, disaster training, emergency preparedness, medical education,HAZMAT gear

Full Text:

PDF

References


Buckingham PK, Cheney FW,Ward RJ: Esophageal intubation: A review of detection techniques. Anesth Analg. 1986; 65: 886-891.

Muir JD, Randalls Muir JD, Randalls PB, et al.: Correspondence, “End tidal carbon dioxide detector for monitoring cardiopulmonary resuscitation”. BMJ. 1990; 301: 41-42.

Varon AJ, Morrina J, Civetta JM: Clinical utility of a colorimetric end-tidal CO2 detector in cardiopulmonary resuscitation and emergency intubation. J Clin Monit. 1991; 7: 289-293.

Bhende MS: End-tidal carbon dioxide detectors—Are they useful in children? J Postgrad Med. 1994; 40: 78-82.

Candiotti KA, Saltzman BA, Curia LM, et al.: A comparison of different types of HAZMAT respirators by anesthesiologists. Anesthesiology. 2005; 103: A1194.

Mizutani AR, Ozaki G, Benumof JL: A low-cost, high-fidelity FM wireless precordial radiostethoscope for continuous monitoring of heart and breath sounds. J Clin Monit. 1990; 6: 61-64.

Hok B, Bythell V, Bengtsson M: Development of a wireless stethoscope for auscultatory monitoring during anaesthesia. Med Biol Eng Comput. 1988; 26: 317-320.

Sayah AJ, Peacock WF, Overton DT: End-tidal CO2 measurement in the detection of esophageal intubation during cardiac arrest. Ann Emerg Med. 1990; 19: 857-860.




DOI: https://doi.org/10.5055/ajdm.2011.0067

Refbacks

  • There are currently no refbacks.