Amplification of Heart Sounds Using Digital Stethoscope in Simulation-Based Neonatal Resuscitation

Abstract

Objective: The accuracy, timeliness, and reliability of the current methods of Heart rate (HR) determination in neonatal resuscitation are debatable, each having its own limitations. We aim to compare three methods of HR assessment: a) Traditional stethoscope, b) Electrocardiogram and traditional stethoscope, and c) digital stethoscope with loudspeaker amplification of heart sounds. Study Design: This was a simulated crossover experiment using a high-fidelity manikin. Each team with a physician, a nurse and a respiratory therapist performed the resuscitations using the three methods (3 different scenarios) in different order. The person controlling the HR via manikin controller was blinded but the single recorder and the providers were not. Results: Eighteen resuscitations were completed (6 teams of 3 methods each). The time to first HR recording (p<0.001), total number of HR recorded (p<0.001) and time to recognize dips in HR was significantly improved in the digital stethoscope group (p=0.009). Conclusion: Use of digital stethoscope with amplification improved documentation of HR and earlier recognition of HR changes.