Aviation Auscultation-Reply

In Reply.—  We agree wholeheartedly with Dr Bishop's observation that an "aircraft cabin makes for a crowded, noisy examining room." Indeed, we have never found a noisier one! The ambient noise levels on board a commercial aircraft generally are low frequency (<4000 Hz), range upward of 65 dB, and may approach 90 dB.¹ At these levels, any worthwhile auscultation may be impossible, regardless of stethoscope type.One of our reasons for studying inflight emergencies was to determine the utility of the stethoscope, a device whose ability in this unique environment was questionable. Many users were able to auscultate successfully; others were not. These differences may be related to aircraft type and location within the aircraft, as well as the hearing of the listener. We did receive several comments in our study that a higherquality stethoscope would be appreciated. Unfortunately, we have found that auscultating with our own "high-quality" stethoscopes