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Could a Stethoscope be as Effective as a CT Scanner?

Could a Stethoscope be as Effective as a CT Scanner?
December 21, 2015 No comments

“Now I will never say again, I could not hear those crackles.”

by: Omeed Saghafi, MD

Chief medical editor,, GECC Volunteer

When provided his very own stethoscope, Baniga, one of the new ECP students smiled, his eyes lit up like he had just gotten the best present imaginable, and he said, “Now I will never say again, I could not hear those crackles.”

“Crackles” are the wet sound that lungs make when they are full of pus (pneumonia) or fluid (fluid overload from heart or liver or kidney failure).

In America, many providers have become overly reliant on x-rays and CT/CAT scans. The physical exam is never perfect, but the x-ray vision that results from shining beams of radiation through a human body is fantastic. So why take time to do a careful physical exam if you will know exactly what is going on within minutes using “the donut of truth” (what some providers playfully call the CT scan)?

At Nyakibale, getting an x-ray can take hours. The nearest CT scanner is in a city over four hours away and requires an expensive (in both time and money) transfer that most patients and their families cannot afford. A careful physical exam is the only way to learn the patient’s condition immediately. Further, the truth is, x-rays and CT scans are not perfect either and their accuracy is usually increased by “clinical correlation.” In short, there is no substitute for a solid clinical exam.

As a result, a quality stethoscope is infinitely more important in a low resource setting than a CT scanner. Listening carefully to the lungs can mean the difference between having to put in a chest tube to perform a life-saving maneuver to expand a collapsed lung, or giving antibiotics to treat pneumonia. Neither treatment can wait hours for an x-ray machine to be available, because in those hours the patient would likely decompensate and die.

Dr. Omeed Saghafi is one of dozens of doctors who has made it a commitment to serve on-the-ground to provide care and train health workers in resource poor regions. In the last month, he has corresponded and shared stories straight from the Emergency Room in Nyakibale Hospital as he serves with The Global Emergency Care Collaborative (GECC). A chief medical editor at and former biotech bioengineer, Dr. Saghafi is passionate about bringing awareness to sustainable International Medicine models. To learn about GECC and its efforts to sustainably provide quality emergency care in resource limited settings please visit their site here.

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Posted in: blog