A Simulator-Based Study of In-Flight Auscultation

Tourtier, Jean-Pierre MD; Libert, Nicolas MD; Clapson, Patrick MD; Dubourdieu, Stéphane MD; Jost, Daniel MD; Tazarourte, Karim MD; Astaud, Cécil-Emmanuel MD; Debien, Bruno MD; Auroy, Yves MD

Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare:
doi: 10.1097/SIH.0b013e3182a833e0
Empirical Investigations
Abstract

Introduction: The use of a stethoscope is essential to the delivery of continuous, supportive en route care during aeromedical evacuations. We compared the capability of 2 stethoscopes (electronic, Litmann 3000; conventional, Litmann Cardiology III) at detecting pathologic heart and lung sounds, aboard a C135, a medical transport aircraft.

Methods: Sounds were mimicked using a mannequin-based simulator SimMan. Five practitioners examined the mannequin during a fly, with a variety of abnormalities as follows: crackles, wheezing, right and left lung silence, as well as systolic, diastolic, and Austin-Flint murmur. The comparison for diagnosis assessed (correct or wrong) between using the electronic and conventional stethoscopes were performed as a McNemar test.

Results: A total of 70 evaluations were performed. For cardiac sounds, diagnosis was right in 0/15 and 4/15 auscultations, respectively, with conventional and electronic stethoscopes (McNemar test, P = 0.13). For lung sounds, right diagnosis was found with conventional stethoscope in 10/20 auscultations versus 18/20 with electronic stethoscope (P = 0.013).

Conclusions: Flight practitioners involved in aeromedical evacuation on C135 plane are more able to practice lung auscultation on a mannequin with this amplified stethoscope than with the traditional one. No benefit was found for heart sounds.

Author Information

From the Emergency Medical Service (J.P.T., D.J., C.E.A.), Fire Brigade of Paris, 1 Place Jules Renard; Department of Intensive Care (N.L., P.C., S.D., B.D., Y.A.), Military Hospital Val-de-Grâce, Paris; Department of Intensive Care, Military Hospital Val-de-Grâce, Paris; Emergency Medical Service, Fire Brigade of Paris, 1 Place Jules Renard; Emergency Medical Service (K.T.), Melun, 11 Rue Freteau De Peny, Melun, France.

Reprints:Jean-Pierre Tourtier, MD, Pr Tourtier, HIA Val-de-Grâce, secrétariat de réanimation, 74 boulevard port royal, 75005 Paris, France (e-mail: jeanpierre.tourtier@free.fr).

The authors declare no conflict of interest.

© 2014 by Lippincott Williams & Wilkins, Inc.