A simple technique for oesophageal stethoscopy.
We suggest using a lubricated endotracheal tube passed into the oesophagus as an oesophageal stethoscope. The proximal part of the tube is attached to the stethoscope (Figure 1). The oesophageal tube should be positioned while listening to the heart sounds and secured in position when the heart sounds are maximal. In children, we have used a range of sizes of tubes for this purpose and found that the tube size is not of much significance in auscultating heart and breath sounds. In adults we have used comparatively larger diameter endotracheal tubes to get a longer tube for appropriate depth of insertion (2). We have found that this technique can be used in the presence of a nasogastric tube or oesophageal temperature probe.
Other techniques of making an oesophageal stethoscope such as using a nasogastric tube and the finger of a rubber glove have been described1. We have found the more rigid endotracheal tubes are easier to introduce into the oesophagus than nasogastric tubes. Compared to other oesophageal stethoscopes, when using an endotracheal tube there is no danger of dislodgement of attachments such as a glove-finger (1) or puncture of the cuff used on other oesophageal stethoscopes.
[FIGURE 1 OMITTED]
We suggest that use of an oesophageal stethoscope still has a place and that the use of an endotracheal tube placed in the oesophagus is a simple, inexpensive, readily available method which requires minimal expertise to achieve.
(1.) Eckhardt K, Aseno S. The individually fitted earpiece. Letter to the editor. Update in Anaesthesia 2002; 14:33.
(2.) Manecke Jr GR, Poppers PJ.Esophageal stethoscope placement depth: its effect on heart and lung sound monitoring during general anesthesia. Anesth Analg 1998; 86:1276-1279.
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|Author:||Chakraborty, A.; Mathur, S.|
|Publication:||Anaesthesia and Intensive Care|
|Date:||Apr 1, 2007|
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