Global Health
By DONALD G. McNEIL Jr.
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.
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Also, Dr. Fowler of the W.H.O. noted, many Africans have had untreated infections, such as ear infections, that scar their heart valves. Leaky valves also cause fluid backup in the lungs, and stethoscopes can distinguish between the two causes.
Portable X-ray machines and ultrasound scanners could also do it, he said, but they are rare in Ebola wards and difficult to sterilize.
Clive Smith, the inventor of the Thinklab stethoscope, said that his device could be used even in crowded Ebola wards. Although chlorine spray would destroy its circuitry, he said, the bell could be wiped with alcohol or bleach pads.
Alternatively, he said, some American hospitals now put an “ultrasound condom” on the diaphragm between patients, and in a pinch, a clean surgical glove or a sandwich bag could serve the same purpose.
