Precordial stethoscope

heartICU · Jan 24, 2005

OK, I hate to sound like an idiot, but what exactly is a precordial stethoscope? I've seen people on this board mention them, but I don't know what exactly you're talking about. Is this different from a regular stethoscope? I'm just a nursing student now, but wanting to go to CRNA school one day. I've observed a lot in the OR and never seen anyone use some like this. (They listen with a regular stethoscope to assess breath sounds after intubation, but that's it.) What is it and what is it used for? And why haven't I seen anyone using it? (I spent the entire summer observing anesthesia in the OR)
bryan

It's a stethoscope that is placed on the chest (just the bell part) that is attached to tubing with an ear piece on the other end, and you use it to continuously listen to breath sounds and heart tones throughout the case. You can quickly pick up on changes in patient condition (loss of breath sounds, loss of heart tones, etc). The other way to listen is through an esophageal stethoscope. When you were in the OR, your CRNA or MD may have placed a tube into the patient's mouth that also had a temperature probe on it. The end of that tube can also be attached to some tubing and the earpiece that sits in your ear, and you can listen to breath sounds & heart tones continuously that way.

I don't routinely use mine in adults, but always with kids. When kids start to crash, it is almost always do to repiratory causes (ETT migrated, disconnected from circuit, etc), and they go down quickly. Having the precordial stethoscope on during the entire case allows the anesthesia provider to quickly hear when breath sounds decrease/cease. That way, you can remedy the situation before the kid desats, etc.

cortrn · Jan 25, 2005

Hey, thanks for the detail of your response. I, too, was wondering about the precordial stethoscope. What an excellent explanation.

Cort

It's a stethoscope that is placed on the chest (just the bell part) that is attached to tubing with an ear piece on the other end, and you use it to continuously listen to breath sounds and heart tones throughout the case. You can quickly pick up on changes in patient condition (loss of breath sounds, loss of heart tones, etc). The other way to listen is through an esophageal stethoscope. When you were in the OR, your CRNA or MD may have placed a tube into the patient's mouth that also had a temperature probe on it. The end of that tube can also be attached to some tubing and the earpiece that sits in your ear, and you can listen to breath sounds & heart tones continuously that way.
I don't routinely use mine in adults, but always with kids. When kids start to crash, it is almost always do to repiratory causes (ETT migrated, disconnected from circuit, etc), and they go down quickly. Having the precordial stethoscope on during the entire case allows the anesthesia provider to quickly hear when breath sounds decrease/cease. That way, you can remedy the situation before the kid desats, etc.

cortrn · Jan 25, 2005

Hey, thanks for the detail of your response. I, too, was wondering about the precordial stethoscope. What an excellent explanation.

Cort

It's a stethoscope that is placed on the chest (just the bell part) that is attached to tubing with an ear piece on the other end, and you use it to continuously listen to breath sounds and heart tones throughout the case. You can quickly pick up on changes in patient condition (loss of breath sounds, loss of heart tones, etc). The other way to listen is through an esophageal stethoscope. When you were in the OR, your CRNA or MD may have placed a tube into the patient's mouth that also had a temperature probe on it. The end of that tube can also be attached to some tubing and the earpiece that sits in your ear, and you can listen to breath sounds & heart tones continuously that way.
I don't routinely use mine in adults, but always with kids. When kids start to crash, it is almost always do to repiratory causes (ETT migrated, disconnected from circuit, etc), and they go down quickly. Having the precordial stethoscope on during the entire case allows the anesthesia provider to quickly hear when breath sounds decrease/cease. That way, you can remedy the situation before the kid desats, etc.