The usefullness of MONOSCOPES

  1. Does anyone regularily use monoscopes? If so where did you get fitted for one or where did you purchase this monitoring equipment and how much should they cost? Opinions differ with regards to their usefulness among my CRNA circle of friends. When shadowing Crnas at a major level 1 trauma center in a variety of settings (i.e. same day surgical suite versus OB/Gyn surgical suite versus main OR) and in numerous cases (100+) I rarely saw them in use. Please enlighten me on this subject. Thanks
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  2. 10 Comments

  3. by   TraumaNurse
    If you are refering to a precordial stethoscope, you get fitted at a hearing aid store. Costs are about $60-100. You are correct that opnions differ between providers, but then again so does a lot of aspects of anesthesia.
    We were required to purchase a precordial, not an option.
    Some schools include the cost in tuition. My school has cheap tuition, but I have to buy everything else myself...go figure!
  4. by   zrmorgan
    we were required to get fitted. I carry mine in my pocket. I found that most precordial steths, and esophageal steths can be auscultated with an old steth, with the bell taken off, and a female to female adapter. I think that would make it hard to listen continuously though. I could imagine the earpiece might come in handy for the longer cases, but have not had experience using it yet. Would be curious in other peoples thoughts.
  5. by   Passin' Gas
    Quote from zrmorgan
    we were required to get fitted. I carry mine in my pocket. .
    It's definitely not going to work if it's in your pocket! :chuckle Be adventurous, use it. On a non-paralyzed patient, spontaneously breathing, often they will take a deep breath or breath-hold when light. I can hear the change in breathing pattern before it shows up as a change in capnograph pattern, inc in HR/BP. Also useful in detecting changes in breath sounds during a case. It takes a while to get used to having it in your ear (and not to wrap yourself up in tubing :wink2: )

    PG
  6. by   skipaway
    A precordial/esophageal stethescope is extremely important in pediatric cases more than in adult cases IMO. When you're inducing an infant or a child, it's usually an inhalation induction not an IV induction (unless your child comes with an IV or lets you put one in). One sign of inhalational overdose in infants and children are muffled heart sounds. If you don't have a precordial steth on the child, you can't make that determination. I don't constantly use my stethescope on adults anymore but I do have it hooked up during the case so I can put it in my ear if I feel the need or I see a problem in my patients. For kids and for the adult patient who is a cardiac risk or asthmatic/bronchitis/ smoker, I use them routinely to assess for heart sounds and wheezing. I'm sure programs will require students to purchace these stethescopes and get used to what you can do with them. After you graduate, then you can make your own decision on whether you find them important enough to use.


    skipaway
    Last edit by skipaway on Jul 14, '04
  7. by   jwk
    OK, today's trivia question


    What is a Ploss valve?
  8. by   gaspassah
    What is a Ploss valve?
    is it a valve that switches a chest piece to the blood pressure cuff so you can then listen to koratkoff sounds?
  9. by   jbro
    we paid for our ear peices with tuition, and they came and fitted us a school
  10. by   ctbsurf
    my precordial collected dust until i did my pediatric rotation. it generally is more of a hassel to use b/c sometimes i won't hear the surgeon when they are asking me to do something. if they are playing music in the background, forget about it.
  11. by   jwk
    Quote from gaspassah
    is it a valve that switches a chest piece to the blood pressure cuff so you can then listen to koratkoff sounds?
    BINGO, you win the prize (whatever that is). At 37, you're not an old fart like me - did you actually use one, because I don't think I've seen one in close to 20 years. You can probably find them next to the copper kettles and side-arm vernitrol vaporizers.

    Oh, and as far as fitting earpieces - we recently had one of our drug reps come in and do them for our entire department, at least the ones who wanted them. I think she probably ended up doing about 60 of them at no charge to us. She brought the stuff to do the custom molds and everything - had them back to us in a couple of weeks.
    Last edit by jwk on Jul 14, '04
  12. by   Brenna's Dad
    Ya, Baxter does them free of charge for our school. Like everyone else has said, I think they are very helpful. For me anyway, it provides a link to the patient that I don't get by watching the monitor.

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