Noise control challenges for auscultation on medical evacuation helicopters

Abstract

A stethoscope is the standard clinical tool used for auscultation. It amplifies chest sounds and enables diagnosis of both circulatory and respiratory systems. However, in many emergency transportation environments, ambient noise levels in excess of 90dB prevent successful auscultation. In this paper, data is collected in a U.S. Army Sikorsky UH-60 helicopter to analyze the inherent noise present during routine aeromedical transport. Data is gathered with a commercially available stethoscope retrofitted with an array of accelerometers and microphones. Peak acoustic noise levels are recorded in excess of 125dB and ambient vibration levels are measured to be near 0.5g RMS. The signal-to-noise ratio is much below 1 for the entire frequency range of interest in auscultation. It is shown using a combination of simulations and experimental data that existing active noise cancellation techniques using a reference microphone would be ineffective in this scenario. However, similar adaptive noise cancellation techniques using a reference accelerometer within the device would be significantly more effective at enabling auscultation.