NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Monday, February 9, 2015

Doctors treating Ebola patients while wearing “the full spacesuit” — protective gear, including waterproof hoods — are struggling with a clinician’s dilemma: what to do if they can’t use one of the oldest, most basic tools in medicine — a stethoscope.

It’s not safe to cut holes in the hood, and nothing that might be contaminated should touch bare skin or the delicate ear canals.

Also, nothing that touches an infected patient should touch another or leave the ward.As a result, said Dr. Robert A. Fowler, a Canadian critical care specialist who helped write the World Health Organization treatment guidelines, “it’s quite uncommon that you see a stethoscope on an Ebolaward in Africa.”

Although cases are dropping rapidly in Africa, experts said stethoscopes could become more important as the remaining patients receive lifesaving intravenous hydration. A stethoscope can detect the “wet, crackling” sound of pneumonia — fluid in the lungs — that indicates a patient has been on the IV drip too long.

In American hospitals treating Ebola patients, doctors have used expensive electronic stethoscopes.

A $500 version from Thinklabs, a Colorado-based company, was used on Ebola patients at New York’s Bellevue Hospital Center and at University of Nebraska Medical Center. The hollow tubes are replaced by disposable earbuds that fit under the waterproof hood. The wire runs out the sleeve and plugs into a rechargeable, diaphragm-equipped microphone that acts as the bell. That microphone stays in the patient’s room, and the earbuds are thrown out. The microphone can also be plugged into speakers or into a cellphone for transmission.