Hunt R C, Bryan D M, Brinkley V S, Whitley T W, Benson N H
Department of Emergency Medicine, East Carolina University School of Medicine, Greenville 27858-4354.
JAMA. 1991 Apr 17;265(15):1982-4.
This study assessed the capabilities of a traditional and an amplified stethoscope used by flight nurses to assess breath sound during air medical transport in an MBB BO-105 helicopter. We developed a normal breath sound model using a prerecorded tape of breath sounds interspersed with segments without breath sounds; the recorder had been placed in the chest wall of a resuscitation training manikin. Flight nurses completed control listening sessions in a quiet environment and experimental sessions during flight using a traditional stethoscope for half of the sessions and an amplified stethoscope for the remaining half. In the quiet environment, flight nurses accurately reported the presence or absence of breath sounds in 110 (92%) of 120 trials. During helicopter flight, none of the flight nurses heard breath sounds during any of the recorded segments with either the traditional stethoscope or the amplified stethoscope. We conclude that flight nurses are unable to hear normal breath sounds using a traditional or amplified stethoscope during flight in a medically configured MBB BO-105 helicopter. Improved stethoscopes, innovative methods of listening, and reduction of aircraft noise are potential solutions to the problems of breath sound assessment during air medical transport.
本研究评估了飞行护士在MBB BO - 105直升机进行空中医疗转运期间，使用传统听诊器和放大听诊器评估呼吸音的能力。我们使用一盘预先录制的呼吸音磁带（其中穿插有无呼吸音的片段）开发了一个正常呼吸音模型；该录音机放置在复苏训练人体模型的胸壁上。飞行护士在安静环境中完成对照聆听环节，并在飞行期间进行实验环节，其中一半环节使用传统听诊器，另一半使用放大听诊器。在安静环境中，飞行护士在120次试验中的110次（92%）准确报告了呼吸音的有无。在直升机飞行期间，无论是使用传统听诊器还是放大听诊器，没有一名飞行护士在任何录制片段中听到呼吸音。我们得出结论，在医疗配置的MBB BO - 105直升机飞行过程中，飞行护士使用传统或放大听诊器无法听到正常呼吸音。改进听诊器、创新聆听方法以及降低飞机噪音是解决空中医疗转运期间呼吸音评估问题的潜在解决方案。
