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Most cardio iii's I've seen come in 27 inches, but I have seen 22 inches as well. Is the shorter one better?
bigger is better. always.
This is not true. Shorter stethoscopes, at least in my experience, give better sound. I don't know of any quantitative data, but it makes sense -- how perfect of a conduit do you think that rubber hose really is?
Granted, it means you have to get closer to patients, and that creeps out some providers...
This is not true. Shorter stethoscopes, at least in my experience, give better sound. I don't know of any quantitative data, but it makes sense -- how perfect of a conduit do you think that rubber hose really is?
Granted, it means you have to get closer to patients, and that creeps out some providers...
Most cardio iii's I've seen come in 27 inches, but I have seen 22 inches as well. Is the shorter one better?
Ew don't wear stethoscopes around your neck. Didn't you ever hear of the dude with the MRSA abscess on the back of his neck from his stethoscope? Put it in your pocket.
Go with the 27 inch-- you want to be as far away from your patient as possible. If the sound is better, then you probably won't even notice it at this stage.
Right. The 22 inch scope is undeniably better sound. Really no comparison.
Is this from two different crappy steths? Littman says that there's no humanly detectable difference between the shorter and longer, and that longer might enhance low frequency sounds.
I wouldnt go with data on the Littmann website that you can crosscheck elsewhere. Theres other data out there to support a detectable difference... including expert testimony. I was actually pimped on rounds about this stethoscope tubing length issue.
Another thing...
There was a paper published around July of this year which showed that, in vivo in order to get a low frequency response from a Littmann tunable diaphragm, one must press so lightly that coupling to the skin becomes the problem. Meaning, you need to press so lightly that your stethoscope isnt even on the skin, and you dont hear anything. So, if youre interested in low frequency sounds like diastolic murmurs, dont even get a Littmann.
Really? a 3/6 is booming. I just learned from a cardiologist that it's a 3/6 if the murmur is as loud or louder than S2. If you can't hear any murmurs quieter than S2, you're not hearing much at all.Have an 18" Welch Allyn Elite (was a gift) and a 27" Litmann Cardio III (gift to myself). Comparable stethoscopes quality wise and hear absolutely no difference in sound quality. Still can't hear a II/VI murmur with either, still can hear a III/VI just fine.
Um, just wear it outside your collar. My scope is laying on my coat, on top of my dress shirt, on top of my undershirt. It's nowhere near my skin. I also use bleach wipes on it pretty often (1-2x a day). And I like the low blow jab that it's because we're trying to look like McDreamy.Get the longer one. I agree with everyone here. I have already treated many patients with whom the extra distance is greatly appreciated. Seriously, you would regret having to get that close no matter how touchy-feely you are.
And I also agree with pocketing your scope when not in use. Unless you are going to use it within the next 10 seconds, put it in your coat pocket or get yourself one of those hip clips for the scope if you are only wearing scrubs and no coat w/ pockets. This is not grey's anatomy or some other glorified medical soap opera. Keep it off your neck. The oils in your skin also degrade the rubber with time, especially the oils from your sweaty nape of the neck in the hot ICU.
Oh, and thanks for the cheap shot, calling me 'doctor'.
Im a medical student, says so on the left side of my post. You're a resident, says so on the left side of yours. I try and do what residents tell me, as much as I can. You asked if I was finding citations, and so I did. I call residents 'doctor'. I think they earned it.
Is this from two different crappy steths? Littman says that there's no humanly detectable difference between the shorter and longer, and that longer might enhance low frequency sounds.
Go with the 22", you'll get better sound. In vet med (where we can get bitten or stomped on by our patients), we don't even get 27".
27" sounds ridiculously long and unwieldy. My 22" has served me well thus far.
I find 22" to be a more comfortable length as far as lugging it around. Then again, I haven't had to use one as a medical student, just as an MA to do BPs (and HRs on infants and such), so the quality of the scope has mattered little. But having a 28" scope swinging from your neck is uncomfortable. I guess it could be stashed in a pocket, but then again a 22" would fit better . . .
I might change my tune on the wards . . .
Funny, you've got a picture of the 25" Welch Allyn DLX as your avatar.
why the hell does everybody think im being sarcastic?
Funny because we wouldn't be having this argument between 22" and 27" if everyone could just agree on 25"
According to allheart.com, new ones come with 25" tubing now. I just got my tubing replaced about 2 weeks ago (25" for me, thanks).
The above mentioned review actually deducted points for stethoscopes with too short of a tube. It was part of their rating system.
http://www.forusdocs.com/reviews/Acoustic_Stethoscope_Review_page3.htm
Personally I consider a 27 inch length optimal. Definitely nothing less than 25 inch. Those few inches make a big difference. Allow me to elaborate, with some clinical vignettes
1. The Southeast Asian patient on the teaching service with unexplained hemoptysis, weight loss, shortness of breath, and cough. TB is on the differential. Initially the patient is in respiratory isolation until a biopsy is positive for nonsmall cell lung cancer. The masks come off and the medical students spend hours examing him. Six weeks after their discharge from the hospital, the routine culture comes back as multidrug resistant TB. The student with the short tube stethoscope is the only one who PPD converts.
2. The patient who has a tracheostomy which is colonized by MRSA and Pseudomonas. Each time he coughs a purulent green stream hits the face of anyone with a short tube stethoscope examining him.
3. The patient who smells like they havent bathed in the past year. You hold your breath while you examine them.
4. The lady with the pendulous breasts which totally obscure heart sounds. You lift her left breast to listen to her heart. Your stethoscope is shorter than her breasts. A personal touch in medicine is nice, but it shouldnt be quite that personal.
5. The guy with a history of diabetes and vascular problems, and you are listening to his femoral artery for bruits. He is attracted to you. The only saving grace is that his vascular problems have also rendered him impotent.
6. You hurt your back using a rowing machine at the gym before coming to work. You are having to bend low to check the blood pressure of a bedridden patient. You scream louder than the ob patients as your partially herniated disc herniates more completely.
7. The male infant on the peds service who isnt wearing a diaper. The thing they dont teach you in medical school is that a male infant will reflexly pee in your left nostril when you examine them. And their reach is longer than the 22 inch stethoscope you are using.
Need I say more?
27" sounds ridiculously long and unwieldy. My 22" has served me well thus far.
How about girth?!!????
I thought that is what we were talking about....
It's not the size of the stethoscope that matters, its the location of auscultation baby
Good grief! 22" girth?! That's the size of one of my thighs... crazy talk.
there was a rep @ our school recently selling the Cardio II for about $140. I know absolutely nothing about stethoscopes...but I've heard the Cardio II is the most popular at my school. Do you think those reps that come to the school are ripping us off? Have any of you ordered online and if so, what website did you use? What do you all think about the Cardio II?