Given the increased proliferation of multidrug resistant (MDR) microorganisms, it is considered standard of care to use patient-dedicated, disposable, or “crappy” stethoscopes to prevent transmission from patients in contact isolation to other nearby patients or workstations. Though there are some studies comparing stethoscopes of different quality, none have dared ask the simple question: can a stupid, white Styrofoam cup outperform these ridiculously crappy disposable stethoscopes? I hypothesize, OMG yes, without a freaking doubt.
This highly biased, poorly thought-out study used a simulation center at a local medical school, healthcare professionals of my choosing who knew what my goal endpoint would be, a really ugly and fragile yellow disposable stethoscope (pseudostethoscope), and a used white Styrofoam cup from the nearly coffee area. My friends and colleagues listened to four basic sounds (screaming, crying, cursing, and explosions) using the two items, and I tested their proficiency using a protocol I made up as we went along. The study was sufficiently powered to achieve something.
Five healthcare providers participated in the study: one attending, one nurse, one intern, one secretary, and one janitor. The enrollment period for patients lasted no time whatsoever since we were using a simulation center. As expected, the stained white Styrofoam cup outperformed the sad yellow children’s toy in nearly every category.
Whereas healthcare providers were able to identify screaming, crying, cursing, and bone-jarring explosions with tremendous clarity 100% of the time with the used white Styrofoam cup, those same healthcare providers struggled with the yellow piece of crap we somehow call a stethoscope. Screaming and crying were often mistaken for dead silence while cursing was often missed completely since participants were too busy re-assembling the stupid darned thing. The stained, coffee-smelling Styrofoam cup also proved to be of a sturdier design, lasting longer than the silly jaundiced device in such conditions as a gentle breeze or someone coughing downstairs. Not surprisingly, the attending physician performed the best in auscultatory findings. Everyone else outperformed the intern.
This study proves beyond a shadow of a doubt that patients in contact isolation might suffer in two different ways while in the hospital: one, from multidrug resistant disease and two, from providers using inadequate tools to identify loud blatant noises. Patient-dedicated stethoscopes are faulty in their design (they fall apart with exposure to air) and functionality (they diminish sound rather than amplify it). All healthcare providers and patients would benefit if cost-saving useless pieces of plastic were replaced with better auscultatory devices such as Styrofoam cups, cupped hands, or two cans on opposite ends of a long piece of string. Finally, we can all improve our physical exam skills but wow, we really need to help out our poor, poor interns with their exam findings.
I have no conflicts of interest. I just really hate those crappy disposable stethoscopes with a passion. Can I get a hell yeah?!
Keywords: crap, pieces of crap, garbage, crying, Styrofoam, explosions