In flight auscultation: comparison of electronic and conventional stethoscopes

The ability to auscultate during air medical transport is compromised by high ambient noise levels. The aim of this study was to assess the capabilities of a traditional and an amplified stethoscope (which is expected to reduce background and ambient noise) to assess heart and breath sounds during medical transport in a Falcon 50 plane.

A prospective, double-blind, randomized study was performed. We tested 1 model of traditional stethoscope (Littman cardiology III) and 1 model of amplified stethoscope (Littman 3100). We studied heart and lung auscultation during real medical evacuations aboard Falcon 50 (medically configured). For each, the quality of auscultation was described using a numeric rating scale (ranging from 0 to 10, with 0 corresponding to "I hear nothing" and 10 corresponding to "I hear perfectly"). Comparisons were accomplished using a t test for paired values.

A total of 32 comparative evaluations were performed. For cardiac auscultation, the value of the rating scale was 5.8 ± 1.5 and 6.4 ± 1.9, respectively, for the traditional and amplified stethoscope (P = .018). For lung sounds, quality of auscultation was estimated at 3.3 ± 2.4 for traditional stethoscope and at 3.7 ± 2.9 for amplified stethoscope (P = .15).

Practicians in Falcon 50 are more able to hear cardiac sounds with an amplified than with a traditional stethoscope, whereas there is no significant difference concerning breath sounds auscultation.