As an Amazon Associate we earn from qualifying purchases.
Information from Auscultation
The stethoscope is a device that allows doctors and nurses to listen for sounds made by the body. The word stethoscope means “look into thorax”. It has been over 200 years since Laennec first described his work on auscultation, and the stethoscope has gradually gained popularity in medical practices.
Few things make doctors seem more trustworthy than a stethoscope. It’s not uncommon to see physicians and nurses with one around their neck, ready for any situation where they might be needed.
All sorts of medical professionals also have found the device useful in assessing patients’ breathing patterns and lung conditions. Doctors often claim these devices help them better understand what is going on within a patient’s chest cavity due mostly to how well-resonated sounds come out of the instrument when pressed against skin or clothing
Auscultation with the stethoscope requires minimal cooperation on the part of a patient, it is cost-effective and can be repeated as often as necessary. Some common uses include: auscultate cardiac sounds, auscultate lung sounds, or bowel sounds which are all relatively inexpensive methods that offer an opportunity for future additional evaluation if needed.
However, these diagnostic accuracy rates remain limited in this day and age when so many new technologies exist (like an ultrasound).
Is the stethoscope a better tool than it used to be? COVID-19 has made that question now more pressing than ever. Over the past few years, many studies have been raising red flags about stethoscopes as possible vectors of infections.
The question often raised is “In the 21st century, does the benefit of this device still outweigh its risk?” With all these debates and pandemic outbreaks coming up in recent times due to the COVID-19 virus; one can’t help but wonder if we should start using other tools for examination or not use them at all because they may carry viruses from person to person which endangers lives on both sides
What are the risks of contaminating a stethoscope during patient examination?
Using a stethoscope for just one physical exam can spread bacteria to the device.
In a hospital, the most common area at risk of contamination is the diaphragm on stethoscopes. In one study, a large percentage of one hospital’s stethoscopes were found to have harmful bacteria on them.
The most common bacterial organisms isolated in that study were benevolent, found to have come from the patient’s skin flora.
Though limited studies exist on the viral contamination of stethoscopes, it has been proven that viruses can survive and thrive when they are inoculated onto a surface.
One study found that the respiratory syncytial virus (RSV) was able to live for an indefinite period of time in contact with surfaces such as cell phone screens or door handles; however, more data is needed before we know how long RSVs can remain viable after being infected by human fluids like saliva droplets.
Every doctor knows that the stethoscope is a device with many parts, but it’s not only bacteria you need to be worried about. A recent study found that viruses are just as likely to contaminate one of these devices and pass on disease!
How often do doctors and nurses clean their stethoscopes?
When medical students were interviewed about their stethoscope cleaning practices, many of them reported never doing so.
The majority admitted to only cleaning theirs after every patient visit and few even confessed when they did a quick wipe before the next examination.
One study showed similar findings, with less than 4% reporting thorough cleans between each patient interaction.
This was concerning enough for researchers to implement an educational curriculum on proper instrument hygiene, which may be able to improve these numbers as well as overall quality health practice habits among future doctors-in-training.
How likely is it for a potentially contaminated stethoscope to transmit infections to patients?
Despite multiple studies showing the risk of stethoscope contamination with microorganisms, no conclusion has been found that it contributes to the transmission of infection.
However, it has been shown that microorganisms on stethoscope surfaces can transfer to other surfaces they touch.
When it comes to health care, safeguards should be in place for any potentially infectious material.
Though never studied rigorously, a contaminated surface like the stethoscope likely carries microorganisms and transmits infections.
What are the best ways to clean a stethoscope?
Cleaning your stethoscope is a must. However, much like all other aspects of life, there isn’t just “one way”
Many disinfectant methods for cleaning stethoscopes have been discussed in the medical literature. Napolitani et al completed a study and categorized studies into two types of methods; chemical and physical.
Chemical disinfectants include 90% ethanol, chlorhexidine liquid gel foam formulations of alcohol-based disinfectants, as well as wipes soaked with an alcoholic solution. These all proved to be effective at killing bacteria.
The physical means included UVC-LED devices, and antibacterial copper surfaces (such as on a stethoscope’s components). Both methods can kill bacteria by exposure.
To keep stethoscopes clean, hydrogen peroxide wipes are commonly used. Recently a study was conducted to determine the efficacy of these types of wipes at reducing bacteria on stethoscope surfaces. They employed a standardized 1-minute cleaning procedure and then verified the resulting levels of contamination.
The results found that half the contaminated instruments had their contamination eliminated, returning to a state as clean as new. However, the remaining 50% still had contamination on their surfaces. Very concerning, indeed.
One major stethoscope manufacturer advises cleaning their products with a 70% Isopropyl Alcohol wipe, or 2% Bleach solution. Unfortunately, the bleach comes with a risk of tube discoloration.
They also advise against the use of hand sanitizer, but they also do not recommend dipping into any liquid solutions, as this can damage both metal and rubber components which could reduce earpiece volume control sensitivity.
With advances in technology, there are many new ways to clean a stethoscope. Alcohol-based wipes or hydrogen peroxide wipes might be the most practical of them all for today’s healthcare environment.
Why is the stethoscope important during COVID-19?
In 2019, a new coronavirus disease pandemic emerged that is caused by the SARS-CoV-2 virus.
By 2021 this has affected over 195 million people across the entire world. Many have argued the danger of doctors continuing the use of stethoscopes, as they may pose more dangers than benefits during this time.
It is scientifically uncertain whether a stethoscope can potentially spreading diseases due to how long it can stay on steel or plastic surfaces for 72 hours or longer without being destroyed.
In a world where COVID-19 is still spreading rapidly, the need for respiratory rate and lung sounds has increased. However, it’s hard to argue in favor of routine chest examination because most often there isn’t any change in patient management as a result of such assessment.
Contamination risk from stethoscopes should be considered with caution during this pandemic; however removing them altogether would seem impractical – especially since we don’t know what will happen next in these uncertain times.
It is difficult to determine whether the stethoscope is a necessary tool or an unnecessary evil during this COVID-19 pandemic, but going without it in caring for patients with COVID-19 does not seem practical.
Principles for Stethoscope Safety
The following are basic principles for using a stethoscope during the COVID 19 outbreak:
1. Limit auscultation to those who may truly benefit.
2. Encourage providers to avoid auscultation if they feel that other means may achieve a similar result.
3. Discourage the use of personal stethoscopes.
4. Utilize disposable stethoscope components.
5. Institute a standard stethoscope cleaning process, to be undertaken after each patient’s auscultation. Hydrogen peroxide wipes or alcohol wipes for no less than 1 minute.
6. When expertise and technology are available, use ultrasound for pulmonary evaluation.
Point of care ultrasound may be a helpful technology, but it is not immune to contamination with infectious agents.
Author Copetti discussed the advantages and disadvantages of lung sonography in comparison with stethoscopes in his article “Is Lung Ultrasound The Stethoscope Of The New Millennium? Definitely Yes.”
Bedside ultrasonography could be a valuable tool for physicians to use in the ER. The availability of equipment and trained clinicians, however, limits its potential as a standard practice.
We have looked at the challenges posed by COVID-19 during this pandemic and proposed recommendations for dealing with them. For the duration of this outbreak, routine auscultation using personal stethoscopes is simply not recommended.
We hope that you learned something interesting from this article. If you are interested in learning more about the best stethoscopes on the market, and which ones will be useful to you, check out our definitive guide to buying stethoscopes!
Amazon and the Amazon logo are trademarks of Amazon.com, Inc, or its affiliates.