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: (1) traditional stethoscope, (2) electrocardiogram and traditional stethoscope, and (3) 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 (three 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 (six teams of three 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.

Key Points

• Amplified heartbeats during neonatal resuscitation improved documentation.

• Amplified infant heartbeats resulted in earlier recognition of HR changes (increase or decrease).

• Providers using this method had greater satisfaction.

Keywords

digital stethoscope - heart rate amplification - neonatal resuscitation

Authors' Contributions

A.D. conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. K.A., S.K., and S.S. set up the experiment, collected data, and reviewed the manuscript. A.M. was involved in data review, reliability testing, and manuscript review. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Publication History

Received: 18 November 2022

Accepted: 28 June 2023

Accepted Manuscript online:
03 July 2023

Article published online:
29 July 2023

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