Читать книгу Management of Complications in Oral and Maxillofacial Surgery - Группа авторов - Страница 22

The precordial or esophageal stethoscope is a bell‐type stethoscope that is placed on the pretracheal region near the sternal notch. By listening through one or two earpieces, or using a Bluetooth system, a practitioner can auscultate a patient's respirations and will be immediately alerted to any change in respiratory rate, depth, or quality. While this method of intraoperative monitoring is sensitive, it does not appear to be particularly popular among OMSs. The study by D'Eramo reported only 36% of practitioners used a precordial stethoscope, compared to a 93% utilization rate for blood pressure and pulse oximetry monitoring [1]. The stethoscopes become less reliable in situations of increased ambient noise or excessive patient movement that can displace the bell of the stethoscope. Nevertheless, the esophageal stethoscope can provide additional clinical information regarding a patient's respiratory status. It may be most useful when treating small children (or others at increased risk of rapid respiratory compromise) and obese patients, in whom it can sometimes be difficult to observe chest rise and other signs of ventilatory effort.