Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “STETHOSCOPE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed2003

Demise of the mercury sphygmomanometer and the dawning of a new era in blood pressure measurement.

After a little more than a century of use, the conventional Riva-Rocci/Korotkoff technique of measuring blood pressure with a mercury sphygmomanometer and stethoscope, is now being relegated to the museum shelves. Affectionately attached though we may be to this clinical measurement, we must acknowledge that the technique is fraught with inaccuracy and that the age of technology has brought more accurate alternative methodologies. However, we must ensure that the automated devices that are replacing the conventional technique are validated independently for accuracy. The Working Group on Blood Pressure Monitoring of the European Society of Hypertension has recently published an International Protocol to facilitate the validation of more automated devices than was possible with the earlier more complicated protocols.

Blood Pressure Determination↗
PubMed2005

Validation of semi-automatic device UA-704 for self-measurement of blood pressure.

OBJECTIVE: To perform a clinical validation for a semi-automatic arm-type device UA-704 (A&D Company, Ltd., Tokyo, Japan) according to the British Hypertension Society protocol. METHODS: Eighty-five study participants (37 men) were included. The mean age was 50.1+/-17.0 years, systolic blood pressure range was 79-212 mmHg and diastolic blood pressure range was 43-118 mmHg. For each participant, three readings of the UA-704 were compared with simultaneous auscultatory measurements by two trained independent observers. The observers used a mercury calibrated sphygmomanometer and a dual stethoscope. The results were graded according to the 1993 British Hypertension Society protocol. RESULTS: The average difference between mercury sphygmomanometer and UA-704 readings was -1.85+/-4.26 mmHg (mean+/-SD) for systolic blood pressure and -1.44+/-3.97 mmHg for diastolic blood pressure. The proportions of values agreeing to within 5, 10 and 15 mmHg were 79.2%, 96.5% and 99.6% for systolic blood pressure and 86.7%, 96.9% and 99.6% for diastolic blood pressure for the observers and device (A/A grade for British Hypertension Society). CONCLUSIONS: For an adult population, the UA-704 device for self-measurement of blood pressure achieved a British Hypertension Society grade A/A and therefore can be recommended for home blood pressure monitoring.

Adult↗
PubMed2006

Validation of TM-2655 oscillometric device for blood pressure measurement.

OBJECTIVE: To perform validation for an arm-type oscillometric TM-2655 device (A&D Company Ltd, Tokyo, Japan) for blood pressure measurement according to the British Hypertension Society protocol. METHODS: Eighty-five study participants (33 men and 52 women) were included in the study. Mean age was 52.9+/-15.0 years, systolic blood pressure range was 84-208 mmHg and diastolic blood pressure range was 48-120 mmHg. For each participant, three readings of TM-2655 were compared with sequential auscultatory measurements by two trained independent observers. The observers used a calibrated mercury sphygmomanometer and dual stethoscope. The results were graded according to the British Hypertension Society protocol 1993. RESULTS: The average difference between mercury sphygmomanometer and TM-2655 readings for systolic blood pressure was -1.0+5.2 mmHg (mean+/-SD) and for diastolic blood pressure -0.9+/-4.7 mmHg. The proportions of values agreeing to within 5, 10 and 15 mmHg were 72.5, 93.7 and 99.6% for systolic blood pressure and 78.8, 96.9 and 100% for diastolic blood pressure between the observers and the device (A/A British Hypertension Society grade). CONCLUSIONS: The TM-2655 device achieved British Hypertension Society grade A/A and therefore can be recommended for blood pressure measurement in an adult population.

Adult↗
PubMed2003

Patients' attitudes regarding physical characteristics of family practice physicians.

BACKGROUND: This study examined patient perceptions and attitudes toward various aspects of the male and female physician's professional appearance in the family practice setting. METHODS: Four hundred ninety-six patients from two family practice clinics in Knoxville, Tennessee, completed a valid and reliable questionnaire. Questionnaires were offered to all patients on registering at their respective clinic during a 2-week period. RESULTS: Most patients had no preference regarding the age or sex of their medical care provider. A nametag, white coat, and visible stethoscope were the most desirable characteristics, whereas sandals, clogs, and tennis shoes were the least desirable items. Younger patients were generally more accepting of casual attire than were older patients. Office clinic location was the most important predictor of preferences in six of the significant characteristics. CONCLUSION: Our findings support the results of both studies published two decades earlier and more recently. Patients prefer a traditionally dressed physician as opposed to one who is dressed more casually.

Adult↗
PubMed2006

Monte Carlo simulation of liquid bridge rupture: application to lung physiology.

In the course of certain lung diseases, the surface properties and the amount of fluids coating the airways changes and liquid bridges may form in the small airways blocking the flow of air, impairing gas exchange. During inhalation, these liquid bridges may rupture due to mechanical instability and emit a discrete sound event called pulmonary crackle, which can be heard using a simple stethoscope. We hypothesize that this sound is a result of the acoustical release of energy that had been stored in the surface of liquid bridges prior to its rupture. We develop a lattice gas model capable of describing these phenomena. As a step toward modeling this process, we address a simpler but related problem, that of a liquid bridge between two planar surfaces. This problem has been analytically solved and we use this solution as a validation of the lattice gas model of the liquid bridge rupture. Specifically, we determine the surface free energy and critical stability conditions in a system containing a liquid bridge of volume Omega formed between two parallel planes, separated by a distance 2h, with a contact angle Theta using both Monte Carlo simulation of a lattice gas model and variational calculus based on minimization of the surface area with the volume and the contact angle constraints. In order to simulate systems with different contact angles, we vary the parameters between the constitutive elements of the lattice gas. We numerically and analytically determine the phase diagram of the system as a function of the dimensionless parameters hOmega(-1/3) and Theta. The regions of this phase diagram correspond to the mechanical stability and thermodynamical stability of the liquid bridge. We also determine the conditions for the symmetrical versus asymmetrical rupture of the bridge. We numerically and analytically compute the release of free energy during rupture. The simulation results are in agreement with the analytical solution. Furthermore, we discuss the results in connection to the rupture of similar bridges that exist in diseased lungs.

Journal Article↗
PubMed2002

Narrowband auscultatory blood pressure measurement.

Auscultatory blood pressure measurement uses the presence and absence of acoustic pulses generated by an artery (i.e., Korotkoff sound), detected with a stethoscope or a sensitive microphone, to noninvasively estimate systolic and diastolic pressures. Unfortunately, in high noise situations, such as ambulatory environments or when the patient moves moderately, the current auscultatory blood pressure method is unreliable, if at all possible. Empirical evidence suggests that the pulse beneath an artery occlusion travels relatively slow compared with the speed of sound. By placing two microphones along the bicep muscle near the brachial artery under the occlusion cuff, a similar blood pressure pulse appears in the two microphones with a relative time delay. The acoustic noise, on the other hand, appears in both microphones simultaneously. The contribution of this paper is to utilize this phenomenon by filtering the microphone waveforms to create spatially narrowband information signals. With a narrowband signal, the microphone signal phasing information is adequate for distinguishing between acoustic noise and the blood pressure pulse. By choosing the microphone spacing correctly, subtraction of the two signals will enhance the information signal and cancel the noise signal. The general spacing problem is also presented.

Acoustics↗
PubMed1983

Oesophageal multipurpose monitoring probe.

An oesophageal probe which incorporates facilities for pressure, temperature, electrocardiographic and stethoscopic monitoring is described. Actual and potential uses are outlined.

Body Temperature↗
PubMed2004

Prehospital airway management in Ambulance Services in the United Kingdom.

A postal survey of the 38 Ambulance Services in the United Kingdom was undertaken to find out what equipment is provided for paramedic crews to aid tracheal intubation and to confirm tracheal placement. The response rate to our survey was 100%. Fourteen (37%) ambulance services provided neither stylet nor bougie to facilitate difficult intubation. The laryngeal mask airway was available to 15 (40%) ambulance services. Seventeen (45%) ambulance services had use of a needle cricothyroidotomy set. Twenty-nine (76%) ambulance services had no type of device other than a stethoscope to confirm tracheal tube placement. This survey showed wide variations in the equipment for airway management available to paramedic crews in the United Kingdom. We recommend provision of a standard set of airway management equipment to all paramedic crews in the United Kingdom together with introduction of appropriate training programmes.

Emergency Medical Services↗
PubMed1995

Method specificity of non-invasive blood pressure measurement: oscillometry and finger pulse pressure vs acoustic methods.

1. The agreement of blood pressure measurements by stethoscope auscultation (SBPa, DBPa-IV and DBPa-V), oscillometry (Dinamap; SBPo, and DBPo) and digital photoplethysmography (Finapres; SBPf, and DBPf) with the graphical analysis of the analogue microphone signals of vascular wall motion sound (SBPg and DBPg) was evaluated in eight healthy subjects in the presence of responses to the intravenous infusion of 1 microgram min-1 isoprenaline. 2. In general, there was good agreement between the SBP/DBP-measurements based on auscultatory Korotkoff-I- and IV-criteria and the reference method; the average method difference in estimating the isoprenaline responses for SBPa-SBPg was: -1.1, 95% CI: -5.4 to 3.1 mm Hg with a within-subject between-method repeatability coefficient (REP) of 11.6 mm Hg and for DBPa-IV-DBPg: 3.5, 95% CI: -0.5 to 6.5 mm Hg, REP: 11.5 mm Hg. The ausculatation of Korotkoff-V substantially overestimated the isoprenaline induced reduction of DBP: method difference DBPa-V-DBPg: -11.3, 95% CI: -17.8 to -4.7 mm Hg, REP: 31.8 mm Hg. 3. Oscillometry yielded good approximations for the SBP response to isoprenaline (average method difference SBPo-SBPg: -2.9, 95% CI: -9.0 to 3.3 mm Hg, REP: 17.6 mm Hg) but was poorly sensitive with regard to the DBP responses: method difference DBPo-DBPg: 6.5, 95% CI: -1.3 to 14.3 mm Hg, REP: 25.7 mm Hg. 4. Whilst the finger pulse pressure agreed well with regard to DBP (method difference for the DBP responses to isoprenaline: DBPf-DBPg: 1.8, 95% CI: -5.1 to 8.6 mm Hg, REP: 18.5 mm Hg) it was rather unsatisfactory with regard to SBP (method difference SBPf-SBPg: -14.1, 95% CI: -28.2 to -0.1 mm Hg, REP: 49.9 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1991

Medical informatics--an Australian perspective.

Computers, like the X-ray and stethoscope can be seen as clinical tools, that provide physicians with improved expertise in solving patient management problems. As tools they enable us to extend our clinical information base, and they also provide facilities that improve the delivery of the health care we provide. Automation (computerisation) in the health domain will cause the computer to become a more integral part of health care management and delivery before the start of the next century. To understand how the computer assists those who deliver and manage health care, it is important to be aware of its functional capabilities and how we can use them in medical practice. The rapid technological advances in computers over the last two decades has had both beneficial and counterproductive effects on the implementation of effective computer applications in the delivery of health care. For example, in the 1990s the computer hobbyist is able to make an investment of less than $10,000 on computer hardware that will match or exceed the technological capacities of machines of the 1960s. These rapid technological advances, which have produced a quantum leap in our ability to store and process information, have tended to make us overlook the need for effective computer programmes which will meet the needs of patient care. As the 1990s begin, those delivering health care (eg, physicians, nurses, pharmacists, administrators ...) need to become more involved in directing the effective implementation of computer applications that will provide the tools for improved information management, knowledge processing, and ultimately better patient care.

Australia↗
PubMed2006

Comparison of 'whoosh' and modified 'swoosh' test for identification of the caudal epidural space in children.

BACKGROUND: Caudal analgesia is widely used in pediatric anesthesia practice. The 'whoosh' test which uses air to identify the epidural space, has been recommended as a guide for successful needle placement. However, the use of air may be associated with an incidence of neurological complications. The 'swoosh' test avoids the injection of air and was originally performed using injection of a local anesthetic solution. A comparison was made between the 'whoosh' test and a modified 'swoosh' test using saline to identify the caudal epidural space in children. METHODS: We studied 60 children of either sex in the age group of 2-8 years undergoing inguinal herniotomy. During insertion of the caudal block, a stethoscope was placed over the lower lumbar spine to note the presence or absence of 'whoosh' or 'swoosh', by an independent observer who was blinded to the injection of 1 ml of air or saline which was given simultaneously by the operator into the caudal space. The operator's clinical impression of successful insertion of the needle was also recorded and correlated with the presence or absence of 'whoosh' or 'swoosh'. In addition, the need for supplemental intraoperative analgesia was noted. RESULTS: Overall success rate of caudal block using the 'whoosh' and modified 'swoosh' tests was found to be 96.6% and 93.3%, respectively as judged by the lack of supplementary perioperative analgesia. The sensitivity, specificity and positive predictive value of the 'whoosh' test and clinical predictors of caudal placement was found to be 100% whereas the modified 'swoosh' test had a sensitivity of 93%, specificity of 50% and a positive predictive value of 96%. However, statistically there was no significant difference between the clinical predictors, 'whoosh' and the modified 'swoosh' test for identification of the caudal epidural space. CONCLUSIONS: The modified 'swoosh' test is as reliable as the 'whoosh' test and we recommend it for identification of the caudal epidural space in children as it avoids injection of air into the caudal space.

Air↗
PubMed1995

Correlation of cervical auscultation with physiological recording during suckle-feeding in newborn infants.

Pharyngeal swallows during infant suckle-feeding are associated with a characteristic sequence of sounds audible by stethoscope or by an accelerometer or microphone held over the larynx. In rhythmically feeding term-born neonates, the delineating acoustic elements are discrete sounds which precede and succeed pharyngeal swallows. Digital signal processing shows similarities in morphological detail between the discrete sounds preceding swallows and between those succeeding swallows; those succeeding swallows are more variable in temporal relation to swallows, amplitude and morphological detail. Variations in the pattern of interswallow respiration, including apnea, are correlated with variations in the discrete sounds. Specification of physiological correlates of these internal feeding sounds increases the utility of cervical auscultation as a method of investigation and of clinical observation of feeding.

Auscultation↗
PubMed1994

Intermittent versus continuous electronic monitoring in labour: a randomised study.

OBJECTIVE: To compare the efficacy in detecting signs of fetal hypoxia in labour of intermittent (I-group) versus continuous (C-group) electronic fetal monitoring in women with low or moderate risk factors for fetal distress. DESIGN: A prospective, randomised study. SETTING: A tertiary referral centre. SUBJECTS: Four thousand and forty-four parturients at low risk for obstetric complications with a reactive fetal heart rate admission test at arrival in labour. During the study period (October 5 1989 to May 31 1991), 5647 women were delivered in the labour ward. Of these, 1178 women (20.9%) were excluded because of high risk factors in pregnancy or at admission for labour, including women undergoing elective caesarean section. Of the remaining 4469 women 4044 (90.5%) were randomised to either intermittent (n = 2015) or continuous monitoring (n = 2029) during the first stage of labour. METHODS: In the C-group the fetal heart rate was recorded continuously with electronic fetal monitoring during the first stage of labour. In the I-group the fetal heart rate was recorded with electronic fetal monitoring for 10 to 30 min every 2 to 2.5 h during the first stage of labour, and the fetal heart rate was auscultated every 15 to 30 min in between recording periods. If complications occurred, recording was changed to continuous. In the second stage of labour all the women were monitored continuously. Umbilical cord artery acid-base status was assessed at birth. MAIN OUTCOME MEASURES: Duration of electronic fetal monitoring, rates of abnormal fetal heart rate patterns, caesarean section for fetal distress, acidosis in umbilical cord arterial blood at birth, Apgar scores of less than 7 at 1 or 5 min, and referrals to the neonatal intensive care unit. RESULTS: There were no significant differences between the study groups in the incidence of ominous fetal heart rate recordings: 6.3% (I-group) versus 6.6% (C-group), or the interval from arrival to first detected abnormal fetal heart rate, although the number of suspicious fetal heart rate patterns was higher in the C-group (28.6%) than in the I-group (24.6%). In the I-group electronic fetal monitoring was performed for (median monitoring time) 38.8% of the first stage of labour as compared with 78.6% in the C-group. The incidence of caesarean section for fetal distress was similarly low in both groups: 1.2% versus 1.0%. There were no significant differences in the immediate neonatal outcome in terms of umbilical artery pH, Apgar scores, or admissions to the neonatal care unit. CONCLUSIONS: Intermittent use of electronic fetal monitoring at regular intervals (with stethoscopic auscultation in between) appears to be as safe as continuous electronic fetal monitoring in low risk labours.

Apgar Score↗
PubMed1987

Nuclear ejection fraction measurements with a small crystal detector: methodological investigations.

A series of studies were performed with a single crystal detector system, nuclear stethoscope (N.S.) (Bios) used for measuring left ventricular function (ejection fraction [EF]). Counting capacity, validity, reproducibility, effect of repositioning of the instrument and of different operators were investigated. Counting capacity was found to be approximately linear up to a count rate of 40.000 cps. Validity was studied by comparing measurements in the same subject using the N.S. with those obtained by a gamma-camera computer system with software using a background subtraction similar to that in the N.S. The mean difference in EF (0.01) was not significant. Maximum emptying and filling velocity measurements with the two instruments were also compared r = 0.86 and r = 0.89, respectively, and a coefficient of variation of 18.1% and 17.9%. Reproducibility was determined from duplicate determinations under identical conditions. The standard error of a single determination was 5%. Repositioning by the same operator increased the variation to 9.1% without any systematic difference. Comparison between two operators did not increase the coefficient of variation (8.8%). There was a systematic difference between measurements using the two acquisition modes, ventricular function mode and position monitor mode. Beat-to-beat variation of EF values during 12 s in 25 patients with coronary heart disease studied under standardized resting conditions was 11.9%.

Adult↗
PubMed2005

Esophageal temperature monitoring during radiofrequency ablation of atrial fibrillation.

INTRODUCTION: Ablative strategies for atrial fibrillation have centered on the left atrium, in particular the pulmonary veins. An emphasis on ablating outside the ostia of the pulmonary veins appears to have reduced the risk of pulmonary vein stenosis. Unfortunately, ablation in the posterior left atrium has been reported to result in fatal atrio-esophageal fistula. METHODS AND RESULTS: We monitored esophageal temperatures in 16 consecutive patients undergoing atrial fibrillation ablation. There were 14 men and 2 women; average age 54.7 +/- 10.6 years. Eight patients had a lasso-guided pulmonary isolation procedure, eight an electroanatomically guided left-atrial circumferential approach. A commercially available esophageal temperature probe (Mallinckrodt Mon-a-therm 12F Esophageal Stethoscope with Temperature Sensor, Thermistor 400 Series) was positioned under general anesthesia. Temperature changes were noted and related to the relative location of the ablation catheter and the temperature probe during the temperature change. The esophagus was midline in three, right sided in three, and left sided in the remaining patients. Temperature rises could be recorded at the posterior aspect of any pulmonary vein. Detailed analysis of six patient maps revealed heating occurred with lesions created within 1 cm of the esophagus. CONCLUSION: The location of the esophagus relative to the back of the left atrium displays considerable variability. It is rarely midline and most often lies in close proximity to the left-sided veins. Ablation in close radiographic proximity (approximately 1 cm) to the esophagus as defined by a radio-opaque temperature probe can result in heating at the esophageal lumen.

Adult↗
PubMed1993

The use of transesophageal echocardiography to evaluate the effectiveness of patent ductus arteriosus ligation.

The ligation of patent ductus arteriosus (PDA) is a comparatively easy operation, but some complications are possible. The most common complication is incomplete ligation of the PDA; others include inadvertent ligation of the descending aorta or left pulmonary artery, transient rise in systemic blood pressure and increased left ventricular afterload, and acute right heart failure due to pulmonary hypertension. The completeness of the PDA ligation is usually determined only by the operating physician's experience, including the use of an esophageal stethoscope or a finger on the lesion to feel for vibration. These methods sometimes fail to detect an incomplete ligation. With transesophageal echocardiography (TEE), we have monitored the entire course of the PDA ligation directly without interrupting the surgical procedure, and precisely determined the completeness of the ligation. We also expect that TEE will enable us to avoid other complications as well.

Adolescent↗
PubMed1991

Perceptions of nurses' uniforms.

Patients (N = 100), nurses (N = 30), and administrators (N = 15) in a regional medical center were surveyed about the professional image inherent in different styles of nurses' uniforms. The Nurse Image Scale (NIS) was used as the data-gathering tool with pictures of the same nurse in a variety of uniforms. Results showed that patients rated some uniforms significantly differently for professional image than did nurses and administrators. There was general agreement among all respondents on the nurse they would most like to have care for them (dress with stethoscope) and the nurse they would least like to have care for them (white pants with colored top).

Administrative Personnel↗
PubMed1998

Induction of abnormal respiratory sounds by capsaicin in rats previously infected with Bordetella pertussis.

Sprague Dawley rats, previously infected with Phase-I Bordetella pertussis, developed more severe abnormal respiratory sounds than normal animals, but not coughing, when exposed to aerosolized capsaicin, one of several cough-inducing agents tested. Stethoscope examination suggested that greater production of pulmonary mucus might be occurring after capsaicin challenge of the infected animals, compared to the uninfected controls. Rats of three other strains gave characteristically different responses from the Sprague Dawleys. The administration of capsaicin to B. pertussis-infected rats may provide useful insights into the pathophysiology of excess mucus secretion in human pertussis.

Aerosols↗