The effectiveness of esophageal stethoscopy in a simulated in-flight setting.
OBJECTIVE
Previous research has confirmed the inability of flight nurses in an airborne BO-105 helicopter to hear breath sounds using normal or amplified transthoracic stethoscopy. The purpose of this study was to determine whether esophageal stethoscopy enabled effective auscultation of breath sounds in a simulated in-flight environment.


METHODS
The cabin-sound environment of an in-flight BO-105 was recorded and recreated in an audiology laboratory, where five flight nurses were evaluated listening to taped breath sounds via an esophageal stethoscope. This audiotape model, validated in a previously published study, used a tape consisting of 24 20-second segments. Each segment, the beginning of which was marked with a beep signal, consisted of 20 seconds of silence or breath sounds. The distal (esophageal) end of the esophageal stethoscope was attached to the tape recorder; the intensity level of breath sounds heard at the stethoscope earpiece was calibrated to equate the sound level of actual esophageal breath sounds recorded on a volunteer.


RESULTS
All nurses correctly identified the 24 taped segments as silent or including breath sounds 100% of the time.


CONCLUSIONS
In the simulated environment tested, esophageal stethoscopy enabled 100% accuracy in identification of breath sounds, as compared with previously reported 0% efficacy for standard transthoracic auscultation. Study in the actual patient-care environment is indicated to confirm the usefulness of esophageal stethoscopy in the in-flight setting.
Stone
C K
CK
University of Kentucky Medical Center, Lexington, KY 40517, USA.
Stimson
A
A
Thomas
S H
SH
Hume
W G
WG
Hunt
R
R
Cassell
H
H
Brinkley
S
S
Bryan-Berge
D
D
D017732:Air Ambulances / Q000592:standards*; D001314:Auscultation / Q000379:methods / Q000592:standards*; D016529:Emergency Nursing / Q000592:standards*; D004947:Esophagus / Q000503:physiopathology*; D006309:Hearing; D009623:Noise, Occupational / Q000009:adverse effects; D009657:North Carolina; D012119:Respiration; D019023:Stethoscopes