USE OF ESOPHAGEAL OR PRECORDIAL STETHOSCOPES BY ANESTHESIA PROVIDERS - ARE WE LISTENING TO OUR PATIENTS

Study Objective: To ascertain current anesthesia utilization of esopha geal and precordial stethoscopes in U.S. anesthesia training programs. Design: Prospective, single-blind, incidence study. Setting: Operatin g rooms of three tertiary care hospitals with major academic anesthesi ology departments. Subjects: Anesthesia faculty [MD and certified regi stered nurse-anesthetist (CRNA) staff] and anesthesia trainees (anesth esiology residents and student nurse-anesthetists). Interventions: Obs erve and record the placement (stethoscope device appropriately positi oned) and utilization (stethoscope in place and connected to the ear p iece of the anesthesia provider) of the esophageal or precordial steth oscope during general, regional, and monitored anesthesia care. Measur ements and Main Results: During 520 anesthetics, an esophageal stethos cope was inserted in 68% of subjects, a precordial stethoscope was pos itioned in 16%, and an anesthetic stethoscope was absent in 16% of cas es. Utilization (stethoscope connected to earpiece) ranged from a low of 11% of cases to a high of 45%, depending on the institution Overall , providers were listening via an, anesthetic stethoscope in only 28% of anesthetics. Conclusions: Our data suggest infrequent utilization, of esophageal and precordial stethoscopes in anesthesia training insti tutions. Thus, current anesthesia training may be fostering an environ ment where providers overlook a valuable minimally invasive, and cost- effective continuous monitor of patients' dynamic vital organ function .