The stethoscope

Stetho·scope. Function: noun : an instrument used to detect and study sounds produced in the body that are conveyed to the ears of the listener through rubber tubing connected with a usually cupshaped piece placed upon the area to be examined.peer-reviewe

DEVELOPMENT OF IOT STETHOSCOPE WHICH SUPPORTS THE TELEMEDICINE PROCESS

Modern stethoscopes can be divided to three main categories: acoustic, electronic, and stethoscopes for hearing impaired. The acoustic stethoscopes can be divided into several classes depending on their purpose. For hearing impaired medical professionals, special adaptors called stethomate tips, allows medical professionals who wear hearing aids to use the stethoscope with their hearing aids. Other electronic stethoscopes, like Thinklabs one digital stethoscope, have headphone jack which allow hearing impaired professionals to use a comfortable headphone with the stethoscope However, stethoscopes intended for remote diagnosis of patients have not existed until the beginning of this research. The purpose of the IoT stethoscope is to upgrade the telemedicine process by enabling the patient to plug the stethoscope into his device and let the doctor remotely listen to his body’s internal sounds. The steps to construct of the IoT stethoscope have been described and the detailed levels of the components and the technology options that can be used on each layer is presented. The technologies that can be used on each layer of the developed stethoscope have been researched. Based on the technology researches the developed IoT stethoscope has been implemented and realized. The implemented device demonstrated perfect results in the preliminary tests.The implemented stethoscope can be used in providing online medical care to patients who leave in villages where no doctors are available, hikers in emergency situations, and patients during epidemic situations.Modern stethoscopes can be divided to three main categories: acoustic, electronic, and stethoscopes for hearing impaired. The acoustic stethoscopes can be divided into several classes depending on their purpose. For hearing impaired medical professionals, special adaptors called stethomate tips, allows medical professionals who wear hearing aids to use the stethoscope with their hearing aids. Other electronic stethoscopes, like Thinklabs one digital stethoscope, have headphone jack which allow hearing impaired professionals to use a comfortable headphone with the stethoscope However, stethoscopes intended for remote diagnosis of patients have not existed until the beginning of this research. The purpose of the IoT stethoscope is to upgrade the telemedicine process by enabling the patient to plug the stethoscope into his device and let the doctor remotely listen to his body’s internal sounds. The steps to construct of the IoT stethoscope have been described and the detailed levels of the components and the technology options that can be used on each layer is presented. The technologies that can be used on each layer of the developed stethoscope have been researched. Based on the technology researches the developed IoT stethoscope has been implemented and realized. The implemented device demonstrated perfect results in the preliminary tests.The implemented stethoscope can be used in providing online medical care to patients who leave in villages where no doctors are available, hikers in emergency situations, and patients during epidemic situations

Direct Signal-to-Noise Quality Comparison between an Electronic and Conventional Stethoscope aboard the International Space Station

Introduction: Evaluation of heart, lung, and bowel sounds is routinely performed with the use of a stethoscope to help detect a broad range of medical conditions. Stethoscope acquired information is even more valuable in a resource limited environments such as the International Space Station (ISS) where additional testing is not available. The high ambient noise level aboard the ISS poses a specific challenge to auscultation by stethoscope. An electronic stethoscope's ambient noisereduction, greater sound amplification, recording capabilities, and sound visualization software may be an advantage to a conventional stethoscope in this environment. Methods: A single operator rated signaltonoise quality from a conventional stethoscope (Littman 2218BE) and an electronic stethoscope (Litmann 3200). Borborygmi, pulmonic, and cardiac sound quality was ranked with both stethoscopes. Signaltonoise rankings were preformed on a 1 to 10 subjective scale with 1 being inaudible, 6 the expected quality in an emergency department, 8 the expected quality in a clinic, and 10 the clearest possible quality. Testing took place in the Japanese Pressurized Module (JPM), Unity (Node 2), Destiny (US Lab), Tranquility (Node 3), and the Cupola of the International Space Station. All examinations were conducted at a single point in time. Results: The electronic stethoscope's performance ranked higher than the conventional stethoscope for each body sound in all modules tested. The electronic stethoscope's sound quality was rated between 7 and 10 in all modules tested. In comparison, the traditional stethoscope's sound quality was rated between 4 and 7. The signal to noise ratio of borborygmi showed the biggest difference between stethoscopes. In the modules tested, the auscultation of borborygmi was rated between 5 and 7 by the conventional stethoscope and consistently 10 by the electronic stethoscope. Discussion: This stethoscope comparison was limited to a single operator. However, we believe the results are noteworthy. The electronic stethoscope out preformed the traditional stethoscope in each direct comparison. Consideration should be made to incorporate an electronic stethoscope into current and future space vehicle medical kits

Scrutinizing and De-Biasing Intuitive Physics with Neural Stethoscopes

Visually predicting the stability of block towers is a popular task in the domain of intuitive physics. While previous work focusses on prediction accuracy, a one-dimensional performance measure, we provide a broader analysis of the learned physical understanding of the final model and how the learning process can be guided. To this end, we introduce neural stethoscopes as a general purpose framework for quantifying the degree of importance of specific factors of influence in deep neural networks as well as for actively promoting and suppressing information as appropriate. In doing so, we unify concepts from multitask learning as well as training with auxiliary and adversarial losses. We apply neural stethoscopes to analyse the state-of-the-art neural network for stability prediction. We show that the baseline model is susceptible to being misled by incorrect visual cues. This leads to a performance breakdown to the level of random guessing when training on scenarios where visual cues are inversely correlated with stability. Using stethoscopes to promote meaningful feature extraction increases performance from 51% to 90% prediction accuracy. Conversely, training on an easy dataset where visual cues are positively correlated with stability, the baseline model learns a bias leading to poor performance on a harder dataset. Using an adversarial stethoscope, the network is successfully de-biased, leading to a performance increase from 66% to 88%

Bacterial contamination of stethoscopes of anaesthetists in the department of anaesthesiology

A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, in fulfilment of the requirements for the degree of Masters of Medicine. Johannesburg, 2016Background South Africa has a huge burden of infectious diseases as many patients are immunocompromised and are at an increased risk for infection. An almost unnoticed piece of equipment possibly harbouring pathogens is the stethoscope. Alcohol swabs are readily available and have been shown to effectively reduce the growth of micro-organisms on stethoscopes. Methods Data was collected from 26 anaesthetists and their stethoscopes in the Department of Anaesthesiology at two academic hospitals in Johannesburg. Two samples were taken from each stethoscope. Group A was assigned to the stethoscope samples that were taken prior to disinfecting the stethoscope with a 70% isopropyl alcohol swab and Group B was assigned to the stethoscope samples that were taken after disinfecting of the stethoscope. Anaesthetists were then asked about their frequency of cleaning the stethoscopes. Results In Group A 19 (73%) stethoscopes grew micro-organisms. Micro-organisms were identified on three stethoscopes in Group A. Two stethoscopes grew coagulase-negative staphylococcus (CNS) and one stethoscope grew Staphylococcus aureus. In Group B, 5 (19.2%) cultured micro-organisms. The only micro-organism identified in this group was CNS. The results showed that most anaesthetists even if infrequently disinfected their stethoscopes. Conclusion This study demonstrated the contamination of stethoscope diaphragms in the Department of Anaesthesiology and the effectiveness of disinfecting the stethoscope with a 70% isopropyl alcohol swab. Most of the anaesthetists reported disinfecting their stethoscopes.MT201

Aseptic Barriers Allow a Clean Contact for Contaminated Stethoscope Diaphragms.

Objective:To determine whether a single-use stethoscope diaphragm barrier surface remains aseptic when placed on pathogen-contaminated stethoscopes. Methods:From May 31 to August 5, 2019, we tested 2 separate barriers using 3 different strains of 7 human pathogens, including extended-spectrum β-lactamase-producing Escherichia coli, methicillin-resistant Staphylococcus aureus, and vancomycin resistant Enterococcus faecium. Results:For all diaphragms with either of the 2 barriers tested, no growth was recorded for any of the pathogens. Stethoscopes with aseptic barriers remained sterile for up to 24 hours. These single-use barriers also provided aseptic surfaces when stethoscope diaphragms were inoculated with human specimens, including saliva, stool, urine, and sputum. Conclusion:Disposable aseptic diaphragm barriers may provide robust and efficient solutions to reduce transmission of pathogens via stethoscopes

The Improvement of Phonocardiograph Signal (PCG) Representation Through the Electronic Stethoscope

A conventional stethoscope (an acoustic stethoscope) is an acoustic medical device that is always used for preliminary examination of patients with any heart abnormalities. The main disadvantage of acoustic stethoscope is its dependence on how to use it and the experience of the examining physician. This paper presents a simple electronic stethoscope design in Phonocardiograph system that is free from subjectivity of doctors or other medical personnel. This electronic stethoscope is made sensitive in order to capture as many acoustic signal as possible from the activities of the human body, especially the heart and lungs. The design of this electronic stethoscope consists of chest piece, a pipe with proper acoustic impedance, mic condenser, mic preamp, and battery. The output of the mic preamp is connected to the mic channel on the laptop. The recording signal then processed separately. The repeatability of output signal was investigated in this paper. The signal was analyzed by using the Fast Fourier Transform (FFT). The result showed that the frequency responsea of the output signals are consistent, hence the instrument is reliable. Furthermore, the frequency response of the system with filter that connecting chest piece and mic condensor were also investigated

Auscultating heart and breath sounds through patients’ gowns: who does this and does it matter?

Background Doctors are taught to auscultate with the stethoscope applied to the skin, but in practice may be seen applying the stethoscope to the gown. Objectives To determine how often doctors auscultate heart and breath sounds through patients’ gowns, and to assess the impact of this approach on the quality of the sounds heard. Methods A sample of doctors in the west of Scotland were sent an email in 2014 inviting them to answer an anonymous questionnaire about how they auscultated heart and breath sounds. Normal heart sounds from two subjects were recorded through skin, through skin and gown, and through skin, gown and dressing gown. These were played to doctors, unaware of the origin of each recording, who completed a questionnaire about the method and quality of the sounds they heard. Results 206 of 445 (46%) doctors completed the questionnaire. 124 (60%) stated that they listened to patients’ heart sounds, and 156 (76%) to patients’ breath sounds, through patients’ gowns. Trainees were more likely to do this compared with consultants (OR 3.39, 95% CI 1.74 to 6.65). Doctors of all grades considered this practice affected the quality of the sounds heard. 32 doctors listened to the recorded heart sounds. 23 of the 64 (36%) skin and 23 of the 64 (36%) gown recordings were identified. The majority of doctors (74%) could not differentiate between skin or gown recordings, but could tell them apart from the double layer recordings (p=0.02). Trainees were more likely to hear artefactual added sounds (p=0.04). Conclusions Many doctors listen to patients’ heart and breath sounds through hospital gowns, at least occasionally. In a short test, most doctors could not distinguish between sounds heard through a gown or skin. Further work is needed to determine the impact of this approach to auscultation on the identification of murmurs and added sounds