Re: How To Crack An Old Safe With A Stethoscope
Mazie Wingeier
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Objectives: Stethoscopes carry a significant risk for pathogen transmission. Here, the safe use and performance of a new, non-sterile, single-use stethoscope cover (SC), that is impermeable for pathogens, was investigated by different healthcare professionals (HCPs) in the postoperative care setting of an intensive care unit (ICU).
Methods: Fifty-four patients underwent routine auscultations with the use of the SC (Stethoglove, Stethoglove GmbH, Hamburg, Germany). The participating HCPs (n = 34) rated each auscultation with the SC on a 5-point Likert scale. The mean ratings of acoustic quality and the SC handling were defined as primary and secondary performance endpoint.
Conclusion: Using a real-world setting, this study demonstrates that the SC can be safely and effectively used as cover for stethoscopes during auscultation. The SC may therefore represent a useful and easy-to-implement tool for preventing stethoscope-mediated infections.Study Registration: EUDAMED no. CIV-21-09-037762.
Quick question for anyone who has already had some clinical experience. I was just accepted to my ADN program for Fall 2015 (yay!) and as a congrats gift my family bought me a stethoscope along with a really cute charm chain that hangs from it. I'm just wondering, are these charms allowed in nursing school/clinicals/hospitals? Being where it is located on the scope, I don't see how it would ever really come in direct contact with a patient but I could see why maybe some facilities would be worried about it not being sterile? Anyone have one of these and does your school/facility allow it?
It is up to your facility. I know my steth is wrapped in braided paracord and I've never had an issue. But I also demonstrated to my charge nurse that it gets soaked in cavicide to no ill effect. Then again half my ER had scopes like that, and cleanliness in an ambulance tends to be a constant job.
Then there's that famous TV psychologist that says most people would be amazed at how little others think about them at all. Why do you need to be a "cute" nurse? Do you think any sick person is going to see your little charm bracelet-equivalent (how middle school!) and think that you must be a better nurse because of it?
Besides, once you really start learning how to use that thing for higher-level assessments than BPs in the learning lab and the grossest of lung sounds, you're going to realize that something like that rattling around is going to make it harder to hear well enough to do a good assessment. Yes, it will.
GrnTea, I think you're taking my post completely the wrong way. Like I said, the charm was a gift from my family and includes charms that have great meaning to me...therefore it is special to me personally, I am definitely not using it in hopes that my patients think I am better, that's just silly. I am a mature adult and I don't appreciate being told that I am acting like a middle schooler. I am taking nursing and my education completely seriously, wanting to use a simple charm on my stethoscope should not make anyone think otherwise. I suppose scrubs with patterns and brightly colored stethoscopes would bother you too, because they're too "cute"? I understand you must have quite a bit more experience in the nursing profession than I do, but I don't think that gives you any right to put me down for asking a simple question.
I can appreciate the practicality of the charms making it harder to do an assessment. I do think they are cute though, is that really wrong? Would I want them so that others could think I'm cute? No! It would be because I like them, whether anyone else would think they are cute is irrelevant to me.
Hmm...I'm confused, because NO WHERE in the OP's post did she state that she thought she was a better nurse for wanting to add a charm to her stethoscope. You have taken a simple question and have completely blown in out of proportion in a failed attempt to put someone down. Why does she feel the need to be a "cute" nurse? Why do you feel the need to ask asinine questions? Please have a sip of tea and sit your ratchet self down! #byeFelicia
OP, bottle line, you gotta ask your program director for the ok and save yourself any trouble. How any one chooses to spend their money is absolutely their business, and if you feel the need to "look cute" and it does not break any of the hospital's rule and regulations then by all means do so because that is your prerogative!
Since you mention the scrubs, I have often said that so many young nurses come here to complain that nobody takes them seriously, but then they dress as if they were going to a middle school sleepover. Pedi is the only place you get to wear unicorns, rainbows, and panda bears.
If your charm from a family member is so meaningful to you, put it on a chain and wear it around your neck. Stethoscopes are not "bling" holders. My opinion on that (and its interference with hearing subtle sounds) stands.
Overcome the challenges of conventional ECG-gating by developing an acoustic cardiac gating approach, which offers (i) no risk of high voltage induction and patient burns, (ii) immunity to electromagnetic interferences, (iii) suitability for all magnetic field strengths and ease of use for the pursuit of robust and safe clinical CVMR. For this purpose, this study examines and demonstrates the suitability, efficacy and robustness of acoustic cardiac triggering (ACT) in CVMR applications at 1.5 T, 3.0 T and 7.0 T including prospective gating and retrospective triggering regimes.
The acoustic gating device consists of three main components: (i) an acoustic sensor, (ii) a signal processing unit and (iii) a coupler unit to the MRI system. An acoustic wave guide was used for signal transmission while accomplishing galvanic decoupling. Signal conditioning and conversion were conducted outside of the scanner room using dedicated electronic circuits. All scanner and gradient coil noise contributions to the acoustic signal were cancelled using a 3rd order inverse Chebychev filter. The final waveform was delivered to the internal physiological signal controller circuitry of a clinical MR scanner. The current implementation connects the trigger signal with the MR-scanner's standard ECG-signal input. Hence, no changes to the MR system's hardware and software are required. Volunteer studies (n = 10) were performed on 1.5 T, 3.0 T and 7.0 T whole body MR systems (Achieva, Philips, Best, The Netherlands). The acoustic sensor was positioned at the anterior left side of the torso to obtain acoustic cardiograms. For comparison, ECG was recorded for all subjects. A retrospectively triggered 2D CINE SSFP technique was used to examine acoustic gating for reliable tracking of myocardial contractions over entire R-R intervals. Black blood prepared gradient echo imaging, 3D phase contrast MRA and free breathing 3D coronary MRA were employed to evaluate acoustic triggering in a prospective gating regime.
The acoustic MR-stethoscope provided cardiograms at 1.5 T, 3.0 T and 7.0 T free of interferences from electromagnetic fields or magneto-hydraulic effects and hence is suitable for synchronization (Fig 1). In comparison, ECG waveforms were susceptible to T-wave elevation and other distortions which were pronounced at (ultra)high fields (Fig 1). Acoustically triggered 3D SSFP coronary MRA imaging produced images free of motion artifacts (Fig. 2a). Conversely, R-wave mis-registration occurred in ECG-triggered acquisitions due to T-wave elevation, which made 3D coronary MRA prone to motion artefacts (Fig. 2a). Motion artifacts were not present in full R-R interval coverage, acoustically triggered CINE imaging (Fig. 2b). The merits of acoustic triggering were further explored in prospectively gated, blood suppressed anatomic imaging, which provided image quality competitive or even superior to that obtained from the ECG-gated approach as indicated by Fig. 2c. Acoustically triggered 3D PC MRA acquisitions resulted in MR angiographies of superb quality free of motion artifacts even at (ultra)high magnetic field strengths, as shown in Fig. 2d.
The proposed acoustic approach was found to fully meet the demands of cardiac gated/triggered MRI. Its superior robustness has been demonstrated by eliminating the frequently-encountered difficulty of mis-triggering due to ECG-waveform distortions. ACT-MR substantially reduces the complexity of patient preparation by obviating the need to set up ECG-electrodes and position ECG-leads, and hence serves to streamline clinical CVMR.
Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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