The Value of the Stethoscope in the Era of Ultrasound

I read with interest the editorial by Isono et al.¹  I appreciate their assessment of the value of ultrasound detecting endobronchial intubation but disagree when they state that “perhaps the stethoscope is closer to a costume piece than ever before” or that “the findings of Ramsingh et al. further undermine the perioperative role of the stethoscope (except perhaps as a fomite).” It is unfortunate that many anesthesiologists fail to carry a stethoscope or neglect to use a stethoscope preoperatively where it provides a wealth of information about the circulatory system, the heart, and the lungs. Auscultation of the carotids provides a window into the state of the arterial system. It is rare to have atherosclerosis limited just to the carotids. Cardiac murmurs, especially aortic stenosis, are easily detected by auscultating the heart. Preoperative auscultation of the lungs prevents one from wondering if that wheeze or rhonchi started intraoperatively. While the ultrasound appears to be more diagnostic of endobronchial intubation, it is premature to dismiss the use of the stethoscope.

The author declares no competing interests.