Six weeks into the SIBOL-COVID-19 projects, a resident in Pediatrics called me excitedly describing a bright idea she had to address the problem of stethoscope use while wearing thick PPEs. She had obviously been trying to find a solution because she was familiar with different products available in the market that could convert acoustic sound waves into electrical signals. A few days later, PGH Director Gap Legaspi texted to ask if SIBOL could make electronic stethoscopes. The E-Steth is an exciting project initiated by Dr. Mikki Miranda, a 3rd year Pediatric Resident with her team of classmates and consultant friends who were linked with UP Diliman engineers Charleston Ambatali and Jason Pechardo by SIBOL.
– Dr. E. Wang, SIBOL Lead
In the COVID-19 wards of the Philippine General Hospital, healthcare workers (HCWs) wear hazmat suits as part of their Physical Protective Equipment (PPE) for maximum protection against the viral infection. However, because
of these bodily coverings, doctors have to forgo the use of the usual stethoscope as their “go-to” diagnostic tool to listen to their patients’ lung or heart sounds.
Auscultation using a stethoscope is an essential component of the physical examination especially of a very sick patient. Listening to the lungs to diagnose pneumonia is critical among COVID-19 patients. If not diagnosed appropriately, this may lead to significant morbidity and mortality. Usually, when using an acoustic stethoscope, the diaphragm or bell end of the device should be in direct contact with the patient’s skin while the earpiece is inserted in the HCWs’ ears. In this process, the HCWs must compromise the integrity of their hazmat suit in order to use the acoustic stethoscope. To strictly adhere to the recommendations of the PGH Hospital Infection Control Unit for the safety of the HCWs, viable alternative auscultation approaches must be utilized. However, a single, high-end electronic stethoscope unit currently available in the market costs at least PhP40 to 50 thousand. Their proprietary designs also prevent local mass production.
To solve this problem, our group is working on the “E-Steth”, a home-grown low-cost acoustic-electronic hybrid stethoscope that costs less while maintaining the same effectiveness of an on-the-market electronic stethoscope. This would address the performance of auscultation without compromising the protection provided by the PPEs of the HCWs. Using proper validation methods, the device may be generalized to other disease targets and clinical diagnostic tasks that rely on auscultation. Our goal is to provide our medical front-liners with a low-cost, alternative tool that can adapt to these changing times.
Dr. Michelle Cristine B. Miranda | Published in Healthscape Special COVID-19 Issue No. 10
