Anesthesia Provider's Use of the Precordial or Esophageal Stethoscope: Is Anyone Still Listening to the Patient

The purpose of this study was to ascertain the utilization rate of the precordial or esophageal stethoscope among anesthesia providers. Stethoscope utilization rates were determined through the collection and analysis of both quantitative and qualitative data. Quantitative data were collected through random observations of anesthesia providers while they provided uninterrupted anesthesia care. Anesthesiologists, Certified Registered Nurse Anesthetists CRNA, and Student Registered Nurse Anesthetists SRNA comprised the group of anesthesia providers observed. Fifty observations N50 were conducted that not only focused on the use of a precordial or esophageal stethoscope, but also on the use of electronic monitoring equipment. Of these 50 observations an average overall stethoscope utilization rate of 68 was observed. Specifically, 0 of the anesthesiologists n4, 9. 1 of the CRNAs n 11, and 94.3 of the SRNAs n35 who were observed used a precordial or esophageal stethoscope. Qualitative data were analyzed from five interviews conducted with randomly selected anesthesia providers. Two anesthesiologists and three CRNAs were permitted to participate in these interviews. The interview questions were designed to elicit theanesthesia providers thoughts and feelings as they pertained to the precordial or esophageal stethoscope and to elicit responses that could be related to clinical practice. From those anesthesia providers interviewed, 40 stated they utilized one of these specialized stethoscopes to assess a patients respiratory and circulatory status during the administration of an anesthetic. Eighty percent of those interviewed felt it was unacceptable to discontinue the routine use of these specialized stethoscopes and 40 of those interviewed stated that they would rely on one of these stethoscopes to monitor a patients status in the absence of electronic monitoring equipment.