Menu Icon Search
Close Search

About the ads

  1. If you prefer the SDN Blue style, go to the bottom left of the page and select "SDN Blue"

Stethoscope

Discussion in 'Allopathic' started by FERDOC, 01.20.06.

  1. FERDOC

    FERDOC Junior Member

    Joined:
    10.28.02
    Messages:
    12
    Location:
    Florida
    SDN 7+ Year Member

    SDN Members don't see this ad. (About Ads)
    We have a co-worker who is going to be leaving us soon to try her hand at Medicine. We were thinking that a Stethoscope would be a good going away gift. Does anybody have any reccomendations for a good Stethoscope that could be used in school and practice? Thanks.
  2. DoctorFunk

    DoctorFunk Get down with the boogie

    Joined:
    05.17.04
    Messages:
    2,815
    Location:
    The Good Land
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    I like my Littman Cardio III, and it seems as if a great number of students own this scope. Not sure how many people are going in on the gift, but I'm pretty sure it can be found for about $150.
  3. eripearson

    eripearson Junior Member

    Joined:
    07.05.04
    Messages:
    24
    SDN 5+ Year Member
    I use the Master Cardiology by Littman...it may be over the top but it's a gorgeous stethoscope and every consultant that has had to borrow it seems to point it out! www.stethoscope.com is a great place to shop!
  4. emack

    emack Senior Member

    Joined:
    10.30.05
    Messages:
    122
    Location:
    Canada
    Status:
    Medical Student
    SDN 5+ Year Member
    I second the nomination for the Littman Cardiology III. This is the standard (good) student stethescope that almost everyone in my class has, and from what I've heard is more than adequate, beyond med school years, for most people. And it comes in various pretty colours.

    PS-- The Littmans (and probably others) come with engravable nameplates. Essential not only so it doesn't get stolen/lost, but also a nice touch to add before you give it to her as a gift.
  5. DW3843

    DW3843 Senior Member

    Joined:
    03.29.04
    Messages:
    183
    SDN 5+ Year Member
    one more vote here for the Littman Cardio III

    a great all around stethoscope for beginners and beyond

    I got mine and some BP gear from www.steeles.com
    good prices (basically the same as the reps that came to school)

    . . . and the engraving is indeed a nice touch
  6. SLUser11

    SLUser11 CRS

    Joined:
    02.22.05
    Messages:
    2,672
    Status:
    Attending Physician
    SDN 7+ Year Member
    Honestly, it probably doesn't matter too much, and you can auscultate effectively even with the $10 lightweight scopes that the LPNs use.

    That being said, I'm not starting trouble, but the Littman Cardio III is just the most readily available scope at equipment fairs, etc, and people are trying to defend their personal purchase. I've never felt there was an advantage to this particular scope. In fact, it's mostly impractical since it has a pediatric diaphragm (which you mostly won't need) instead of a bell (which you mostly won't use but is better for certain low-pitch murmurs).

    I would decide how much money you want to spend and then shop accordingly. www.egeneralmedical.com has always had good prices. The most important aspect to good acoustics is the Double Lumen...look for that.

    Littman is kind of the Nike of stethoscopes, and some students need the name brand to feel like real doctors. My fiancee is a drug rep, so I've been stealing different name-brand scopes from her for a while, and as far as affordable scopes go, I like the acoustics on some of ADC's scopes. My personal favorite is a welsch/allen (sp?) Harvey something-or-other scope I got as a present from my brother, but I think it's like $200.
  7. Gimlet

    Gimlet Cardiac Anesthesiologist

    Joined:
    11.29.04
    Messages:
    4,710
    Status:
    Attending Physician
    SDN 7+ Year Member
    The pediatric diaphragm on a Littman Cardio III can easily be converted to a bell. I bought mine at allheart.com. From what I hear, they generally have the best prices on medical equipment such as this.
  8. UCLAstudent

    UCLAstudent I'm a luck dragon!

    Joined:
    09.06.02
    Messages:
    5,048
    Location:
    CA
    Status:
    Resident [Any Field]
    SDN 10+ Year Member
    I also suggest the Littman Cardio III.
  9. logos

    logos 100% Organic

    Joined:
    11.15.02
    Messages:
    1,231
    Location:
    Out there.
    Status:
    Resident [Any Field]
    SDN 10+ Year Member
    Cardio III is as close as there is to a standard at my school...although pretty much anything of decent quality is acceptable.

    Just make sure you shop around on the internet. Check out ebay etc...because i payed about 2x as much for mine in person as i would have had i shopped around on the 'net.
  10. Ezekiel20

    Ezekiel20 Resident

    Joined:
    08.18.05
    Messages:
    272
    Location:
    Sydney, NSW Australia
    Status:
    Resident [Any Field]
    SDN 5+ Year Member
    Ok so everyone recommends the Littman Cardiology III.

    Funny thing I've noticed in my hospital is that the average medical student's stethoscope tend to be more expensive than the average attending's.

    Seriously, the haemotologist who teaches my patient communication tutorials uses an allied health stethoscope that probably costs $10, and it doesn't seem to bother him.

    I bought a 'Prestige Medical' cardiology stethoscope for half the price of a Littman Cardio, and I can see myself using it for the next 10 years or so, until the rubber tubing cracks or something..

    [​IMG]
  11. rockdoc

    rockdoc MSIV

    Joined:
    11.12.05
    Messages:
    46
    Status:
    Medical Student
    SDN 5+ Year Member
    As much as I agree with the other folks about the Littmann Cardiology III (our school gave the students this type), I also recommend the Littmann S.T.C. It's a different looking stethoscope, and works really well, too (got this one as a gift from cowokers when I left, and loved it). Almost the same tech as the Master Cardiology.
  12. deuist

    deuist Stealthfully Sarcastic Lifetime Donor

    Joined:
    06.14.04
    Messages:
    4,053
    Location:
    Florida
    Status:
    Attending Physician
    Physician Air Force SDN 10+ Year Member
    Unfortunately, my school requires expensive cardiology grade stethoscopes. I bought a Welch Allen for $130. It's heavier than the Littman, but I like the sound better.
  13. emack

    emack Senior Member

    Joined:
    10.30.05
    Messages:
    122
    Location:
    Canada
    Status:
    Medical Student
    SDN 5+ Year Member
    Yeah. My Cardio III was free as well (thank you, provincial government).

    I recommended it because it seems like a good but safe choice. Whoever gets it as a gift from co-workers isn't going to think "WTF, these people know nothing about stethoscopes. Now I have to go out & buy my own anyway."
  14. oudoc08

    oudoc08 Please pass the gas...

    Joined:
    03.12.04
    Messages:
    1,054
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    I've had a Littman Cardio III for about 8 years and love it. Master cardiology is also nice, but not quite as versatile.

    One nice feature of the pediatric head (besides its namesake) is for the little old emaciated individual whose ribs are showing, and who has arms like pencils.

    Much clear sounds can be had when the entire head of the stethoscope fits completely over the auscultated area, and the smaller head works great in these people when taking vital signs as well as cardiorespiratory ausc.

    As most people know, Littman scopes (at least the mid to more expensive models) function as both a bell and a diaphragm (bell when barely held on the skin, and diaphragm when pressure is applied).

    As well, Littman will refurbish your stethoscope (new diaphragms, tubing, ear pieces) for about 75.00, this includes new tubing, diaphragms, ear pieces, and a thorough cleaning of the head, and also comes with a new two year warranty. It's about half the cost of a new one, and should the need ever arise is a pretty good deal, IMO

    5 stars for this scope.
  15. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

    Joined:
    01.21.06
    Messages:
    9,218
    Location:
    South of disorder.
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
    OK, here's my opinion regarding stethoscopes.

    If all you're doing is checking blood pressures and making sure somebody's got blood going 'round and 'round and air going in and out, any old stethoscope will do. However, if you're truly interested in hearing subtle cardiac murmurs and other elusive biological sounds, you should only consider stethoscopes that have a floating (not "tunable") diaphragm, a traditional bell, and dual-lumen tubing.

    Interestingly, this excludes all stethoscopes currently manufactured by 3M Littmann, the market leader. 3M has gradually incorporated the tunable diaphragm (originally offered only on the Master Cardiology) into all of its stethoscopes except the single-lumen pediatric and infant models, resulting in one of the most uniformly mediocre and overrated product lines in the industry.

    Why do I dislike tunable diaphragms so much? In short, because they muffle sounds, and because most people don't know how to use them properly. In order to use a tunable diaphragm as a diaphragm (which is what you'll want to do most of the time), you have to press firmly and evenly on the chestpiece. Uneven pressure will result in muffled sounds. Firm, even pressure is the only way to clearly hear higher-pitched sounds. This is best accomplished on a flat surface. However, most patients' bodies are not flat, making it virtually impossible to maintain firm, even pressure as you move your stethoscope around. Unfortunately, if you only apply light pressure (which is what most people do most of the time), all you'll hear are boomy, muffled sounds. Contrary to 3M's advertising, it's nothing like what you'll hear using a traditional bell, where the low-pitched sounds are crisp and distinct. To further confuse things, correct use of a traditional bell demands light pressure, as firm pressure essentially turns the skin into a diaphragm. In short, tunable diaphragms are a recipe for disaster when you're trying to learn how to listen, and (IMHO) are partly to blame for the poor auscultation skills of modern doctors.

    If you can find an older (pre-tunable diaphragm) Littmann Cardiology or Cardiology II (not SE) model, grab it...they're among the best stethoscopes ever made (Abella M, Formolo J, Penney DG. Comparison of the acoustic properties of six popular stethoscopes. J Acoust Soc Am 1992 Apr;91(4 Pt 1):2224-8). 3M discontinued the Cardiology II in 1994. However, with a little patience, you should be able to find one on eBay. If it's worn, you can send it to 3M for refurbishing, and it'll come back looking like new.

    The original Hewlett-Packard (later Philips) Rappaport-Sprague is an old favorite with excellent acoustics. It's a little bulky, but the sound quality is superb. Unfortunately, it's been discontinued as well. These occasionally turn up on eBay, and replacement parts are still available. The cheap Spragues offered by other vendors simply don't compare, and are to be avoided at all costs.

    Here's a list of currently-manufactured stethoscopes that are worth checking out. If you can, try them out before you buy. Everyone's ears are different, and what sounds good to me might not sound good to you.

    ADC 602 Cardiology (www.adctoday.com)
    Allen Series 5 (www.allenstethoscopes.com)
    DRG PureTone Cardiology (www.doctorsresearchgroup.com)
    GRx CD-25 Advanced Cardiology (www.grxmedical.com)
    Heine Gamma C (www.heine.com)
    Magna Fortis Metacardia LT (www.magnafortis.com)
    MDF 797 Classic Cardiology (www.mdfdirect.com)
    W.A. Baum Cardiology (www.wabaum.com)
    Welch-Allyn Harvey Elite (www.welchallyn.com)
    Welch-Allyn Harvey Double Head (www.welchallyn.com)

    The old saying, "The most important part of the stethoscope is what's between your ears" is certainly true. Unless you know what you're listening to, the best stethoscope in the world isn't going to help you. However, if the sounds don't make it to your brain in the first place, your knowledge is wasted. So, if you really want to master cardiology, ditch the Master Cardiology and get yourself a proper stethoscope. You'll be glad you did.
  16. SLUser11

    SLUser11 CRS

    Joined:
    02.22.05
    Messages:
    2,672
    Status:
    Attending Physician
    SDN 7+ Year Member
    That is the best statement I've ever read on this website...kudos, KentW. Not only does he back up his opinion with extensive knowledge, he then provides a peer-reviewed journal article to seal the deal. :thumbup:

    Most stethoscopes on the market will work fine...this man has given a list of several good scopes in different price ranges with links to where they're sold. If you still want the Littmann Cardio III or master cardiology, fine, but I think you're paying for the name.
  17. lil jon

    lil jon New Member

    Joined:
    01.09.06
    Messages:
    9
    Status:
    Medical Student
    Everyone in my class has a Cardiology III but I went with the DRG Puretone Cardiology. I'm very happy with my purchase, though I haven't had the chance to compare it to the III. I did compare it to my ex's Cardiology II SE and I like mine better. In any case, it's safe to say that Bose knows a thing or two about acoustics. In addition, it comes with a normal diaphragm and a bunch of the disposal the optional Safe Seal antimicrobial diaphragms which actually do improve the sound of the scope.

    Got if for $99 USD on ebay from an authorized dealer, which also has the titanium model for a bit more.

    Oh yeah, the earbuds are really comfy!
  18. mackability729

    mackability729 Junior Member

    Joined:
    05.01.05
    Messages:
    13
    SDN 5+ Year Member
    I have a Littman Cardio III, also. Everyone seems to use them; and, I felt like a black sheep when I did not have one.

    I got mine from a study carrel in the library.
  19. blue_feiyan

    blue_feiyan Junior Member

    Joined:
    09.29.05
    Messages:
    26
    Status:
    Medical Student
    SDN 5+ Year Member
    Littmann Cardiology III. That's the one most people in our class got
  20. cHocoBo 118

    cHocoBo 118 Senior Member

    Joined:
    07.27.02
    Messages:
    369
    Location:
    Irvine, CA
    Status:
    Medical Student
    SDN 7+ Year Member
    KentW: May I ask which stethoscope you personally recommend?
  21. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

    Joined:
    01.21.06
    Messages:
    9,218
    Location:
    South of disorder.
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
    I don't really recommend any particular make/model. As I mentioned, what sounds good to me might not sound good to you. My workhorse stethoscope is a Littmann Cardiology II that I bought on eBay.

    Over the years, I've accumulated several stethoscopes as I tried to figure out which one I preferred. I've since sold the Littmann Cardiology II SE and Master Cardiology that I used in medical school, but along the way I picked up a Welch-Allyn Harvey Elite, HP Rappaport Sprague, an original Littmann Cardiology, a couple of Littmann Classics (including one of the original Cardiosonics-branded Littmanns) and a Littmann Pediatric. I tried the DRG PureTone Cardiology, but sold it because the earpieces didn't fit me very well, and the tubing was very stiff because of the inner coil spring (it kept "jumping" off my neck when I'd bend over). Most of these were purchased secondhand from eBay.

    If I had to recommend a new stethoscope, it would probably be the Welch-Allyn Harvey Elite. It sounds great, and is very versatile (it easily converts to a peds scope if needed).

    Hope this helps!
    Kent
  22. cHocoBo 118

    cHocoBo 118 Senior Member

    Joined:
    07.27.02
    Messages:
    369
    Location:
    Irvine, CA
    Status:
    Medical Student
    SDN 7+ Year Member
    so i've been doing some research and i'm having a bit of a problem figuring out what exactly the difference is between the welch allyn harvey elite and DLX doublehead. they both seem to be "double headed", have peds, bell, diaphragm. i'm clueless about stethoscopes as i'm only about to START med school so i would appreciate it if someone can explain it to me. thanks in advance.
  23. dpill

    dpill Senior Member

    Joined:
    04.18.04
    Messages:
    127
    SDN 7+ Year Member
    Would you recommend the Elite over the DLX? I have been looking at both for a while- is the Elite a better option because it is more versatile (better for peds)? Thanks for your input. Also, for anyone considering Welch-Allyn the student prices offered at http://www.ewelchallyn.com/ seem very good.
  24. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

    Joined:
    01.21.06
    Messages:
    9,218
    Location:
    South of disorder.
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
    The Harvey DLX is based on Dr. Proctor Harvey's original stethoscope, updated with a beadblasted finish and Elite-style tubing and binaurals. The original Harvey stethoscope used a two-tube design similar to an HP Rappaport-Sprague. It's a very good stethoscope. The headpiece is a little bulky, and doesn't have the non-chill bell and diaphragm rings found on most modern stethoscopes. The Harvey Elite addresses these issues. You really can't go wrong with either model.
  25. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

    Joined:
    01.21.06
    Messages:
    9,218
    Location:
    South of disorder.
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
    Personally, I prefer the Elite, as it's more compact and modern. Both the Elite and the DLX have peds adapter kits. They're both excellent stethoscopes.
  26. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

    Joined:
    01.21.06
    Messages:
    9,218
    Location:
    South of disorder.
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
  27. MaloCCOM

    MaloCCOM Senior Member

    Joined:
    10.31.02
    Messages:
    215
    SDN 7+ Year Member
    I have the Welch Allyn orignal Harvey triple head scope. I used to have the typical Littman Cardio III when I first started, cuz everyone has that. After deciding to go into cardiology and seeing all our cardiologists use the triple head, and listening to patients with both... i was beyond convinced that I need a new set of ears.

    Plus Clinical Cardioogy Made Ridiculously Simple also recommends it!

    Here is the link to it:
    http://www.welchallyn.com/medical/products/catalog/detail.asp?ID=25336

    You can get it on Steeles.com for like 130 instead of 230.

    You can read my story and why I decided to change at:
    http://www.thealo.com/maloblog/blog_comment.asp?bi=209

    I love what KentW said, right on man!
  28. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

    Joined:
    01.21.06
    Messages:
    9,218
    Location:
    South of disorder.
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
    As you have already figured out, the diagnostic utility of bedside cardiac auscultation cannot be overstated, even with modern adjuncts such as echocardiography at our disposal.

    If you haven't read Classic Teachings in Clinical Cardiology, I'd definitely recommend it. Dr. Harvey discusses the value of a corrugated diaphragm (as found on the Harvey Triple-Head) for "surveying" the precordium, as it picks up midrange sounds better than a flat diaphragm.

    The Harvey Triple-Head is indeed a great set of ears. The only downside is that you can knock yourself unconscious with it if you're not careful. ;)
  29. MikeyLu2010

    MikeyLu2010 UT Longhorns Alumni

    Joined:
    04.19.05
    Messages:
    1,070
    Location:
    New York, NY
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    awesome..looks like the triple head harvey is something i will invest in...thx alot malo and kentw..btw i found it at allheart for less than 150..dont know about shipping ..i will wait till my school starts in august to see when we need to actually buy a stethoscope
  30. MaloCCOM

    MaloCCOM Senior Member

    Joined:
    10.31.02
    Messages:
    215
    SDN 7+ Year Member
    I'd love to read that, but it looks like its $145 dollars. And it says that it is a boxed set of some sort. Does that sound right? Then you have used ones that are on sale for like 4-50 dollars. Does that sound right?
  31. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

    Joined:
    01.21.06
    Messages:
    9,218
    Location:
    South of disorder.
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
    It's a two-volume set. You can read a review of it here . I think some of the cheaper ones for sale only include one volume, so if you buy secondhand, make sure you're getting the whole set. My copy was paid for by a pharmaceutical company, but even if you have to buy it yourself, it's worth having.
  32. Bigmom

    Bigmom New Member

    Joined:
    02.12.06
    Messages:
    2
    Status:
    Non-Student
    Hello,
    My husband bought his Hewlett Packard Rappaport Sprague stethoscope in 1969 or '70 in Halifax and now that our daughter is entering medical school, he wants to get it refurbished for her. You seem to know a great deal about them and the fact that replacement parts are available - can you (or anyone out there) refer us to some places which would offer decent replacement parts for this lovely old stethoscope please? None of the metal parts need replacing - just the plastics and the tubing. Thank you for any information you can give us.

  33. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

    Joined:
    01.21.06
    Messages:
    9,218
    Location:
    South of disorder.
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
    Parts are available from several online sources, including Elitemedical.com and Philips themselves. I recommend the 18" Reconditioning Kit at a minimum (this includes the rubber hoses), plus any eartips or chestpieces that you need.

    Those are great old stethoscopes, and I'm sure it will continue to serve your daughter for years to come.

    Hope this helps,
    Kent
  34. AStudent

    AStudent Senior Member

    Joined:
    01.24.05
    Messages:
    877
    SDN 5+ Year Member
    Cardio III
  35. Bigmom

    Bigmom New Member

    Joined:
    02.12.06
    Messages:
    2
    Status:
    Non-Student
    Thanks so much for your help! We'll give them a call tomorrow! It is surprising that they don't make them anymore - my husband considers his an "old friend of his".
  36. osin83

    osin83 Strung Out

    Joined:
    03.13.06
    Messages:
    186
    Location:
    Northern New Jersey
    Status:
    Medical Student
    SDN 5+ Year Member
    an oldie but a goodie!!
  37. Wizard of Oz

    Wizard of Oz Guest

    Joined:
    09.08.06
    Messages:
    1,296
    Location:
    enraged
    Status:
    Medical Student
    Try steeles or allheart. I think they're a little cheaper.

    Our school actually gives us one, a Classic II S.E. Really that's all you need. That's all most of the attendings I've worked with use.

    Ding Ding. That's either because students think that they need a more expensive one to hear better or they view it as a status symbol worthy of dropping the cash on.

    or because of this I spose...

    What I've seen is that when students go out and buy them, they want the Cardio III. It's not really necessary, but med students also have the loan cash lying around.

    Do a search for stethoscopes or some of the brands. In the past I've read that a bunch of us said it doesn't matter much as a med student. You'll barely use it for the first two years.

  38. MartianOddity

    MartianOddity The sexy thing from Mars

    Joined:
    01.05.07
    Messages:
    219
    Location:
    Mars, Milky Way
    Status:
    Medical Student
    SDN 2+ Year Member
    I've got a basic stethoscope from Umedico...haven't used it yet, I'm a MS 1. But giving away a stethoscope is a good idea. It gives the recipient a great boost in his/her ego. At least that's how it worked for me.
  39. vtucci

    vtucci EM PGY-1 Moderator Emeritus

    Joined:
    08.06.03
    Messages:
    1,663
    Location:
    tampa
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    Just about everyone in my class has a Littmann III.
  40. crazy_cavalier

    crazy_cavalier T3-Weighted

    Joined:
    04.03.05
    Messages:
    4,993
    Location:
    Far away from my pillow -_-
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    WA harvey elite
  41. Caboose

    Caboose

    Joined:
    06.28.05
    Messages:
    367
    Status:
    Medical Student
    SDN 5+ Year Member
    This would have been so peachy to read on Monday. Just thought someone else, (tis the season), might benefit.

    Caboose.
  42. howelljolly

    howelljolly

    Joined:
    08.30.07
    Messages:
    2,088
    Status:
    Resident [Any Field]
    SDN 2+ Year Member
    Seeing as you've resuscitated this thread, I'll add what I had posted on another forum a few weeks ago (edited for clarity, and with additions), Hope it helps:

    Do NOT jump on the Littmann bandwagon at this point in your training. The "tunable diaphragm" is old technology that was pulled out of the trash, and marketed successfully to first year med students. Just look at the timeline of the R&D of Littmann scopes

    Master Cardio > Cardio2 (had a non-tunable diaphragm) > discontinued Cardio2 and released Cardio3 (added the Patented tunable technology) > Added tunable technology to all Littmann scopes besides Lightweight.

    I'd argue that it's only a matter of utilizing the patent, and ranking the product line to follow the manufacturing costs. Littmann's website ranks the Master Cardio as #1. Does this mean that every Littmann Cardiology model developed in the 20 years since 1987 has been a step down? Why did they disown the CardioII, their child prodigy?

    So anyway, whats was wrong with a tunable diaphragm that the separate bell/diaphragm improvement had fixed, before it was abandoned?

    The tunable diaphragm will miss sounds at the extremes of the frequency, ie. very low, and very high, and will not filter out unwanted frequencies.

    Based on the research by Rappaport and Sprague in the '50s A tight diaphragm is needed to detect high frequencies, and a deep bell with a sharp edge is needed to detect low ones. Other findings included dual lumen tubing at specific lengths of 14", 18", or 25" (if memory serves)
    The purpose of each chestpiece is not only to pick up those frequencies, but to attenuate part of the spectrum, making the rest of the spectrum more easily audible . The tunable diaphragm seems to pick up everything besides the extremes, because it is not tight, or sharp edged, or deep. Ergo, you don't get the extreme frequencies or the attenuation. You hear everything, and nothing at the same time.

    I think this may be why sounds are not sharply distinct from each other with a tunable diaphragm. Its harder to detect S2 splitting, for example. If you have not been able to detect the normal physiological S2 splitting in all your patients (or your roommate) with the Littmann, this may be why!

    Once you know what a diastolic murmur or a midsystolic click sounds like, you can "tune in" to it. Otherwise you need a stethoscope thats sensitive and specific and pre-set to those frequencies. Also keep in mind that Amplitude and Frequency are different things. Louder does not mean better.

    Note that for learning purposes, many schools require a separate Bell and Diaphragm, and all the textbooks suggest it. Some schools require a Welch Allyn stethoscope so that you have a separate non-tunable diaphragm and bell.

    In the spirit of Evidence Based medicine, here are some articles about various stethoscopes:

    http://cardinal.com/mps/focus/respiratory/abstracts/abstracts/ab2004/OF-04-250 Waugh corrected.asp

    http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

    Since the Allen, Littmann Cardiology II and HP Rappaport-Sprague are no longer available, based on the articles, the ideal scope is the Welch Allyn, which has the best bell, and a good diaphragm. Note, from the first article, that "least negative", or closer to zero, is good. Meaning, the Welch Allyn bell has the least difference between input (heart) and output (ears). And from the second article, significant differences in frequency response between bell and diaphragm, (which we want), was present in the Welch Allyn. And though clinical significance can not be determined by these studies, that is where the most important part of the stethoscope comes in -- the part between the ear pieces.

    So, go for the Welch Allyn -- Elite, or DLX. There are pros and cons to each (PM me if you want details, Ive got both of them, and a Littmann Master Cardio). The summary is: While the DLX has slightly better acoustics, the Elite is slightly more user and patient friendly.

    If you have a stethoscope that is sensitive and specific to physiologic sounds, and a have physical diagnosis text chapter or two in your brain, you can more easily and reliably make a clinical diagnosis
  43. The Janitor

    The Janitor I hate Scooter Pies.

    Joined:
    09.05.06
    Messages:
    134
    Status:
    Non-Student
    SDN 5+ Year Member
    Exactly. I can't believe that more people haven't recognized this.
  44. Sessi

    Sessi

    Joined:
    03.15.08
    Messages:
    2
    Hi everyone!!

    I wonder if you can tell me where i can buy a littmann stethoscope in san fransisco???:confused:

    Thanks!!!
  45. deuist

    deuist Stealthfully Sarcastic Lifetime Donor

    Joined:
    06.14.04
    Messages:
    4,053
    Location:
    Florida
    Status:
    Attending Physician
    Physician Air Force SDN 10+ Year Member
    I don't know about San Fran in particular, but All Heart will ship it to you. Also, your medical school's bookstore should sell them.
  46. TMP-SMX

    TMP-SMX Senior Member Moderator Emeritus

    Joined:
    06.12.06
    Messages:
    3,474
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    I'll make it easy for you: Redding Medical Littman Card III for 126.99. It's a great price. You also have to order the free student accessory kit with the CD and extra accessories. You also get free engraving on the metal.
  47. nlax30

    nlax30 Now with pumped up kicks

    Joined:
    10.04.06
    Messages:
    3,436
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    Old thread but I'll chime in...

    So far very happy with my Welch Allyn Harvey DLX. Some in our class went with the Littman Cardio III, some with the Harvey. I haven't compared them but I'm more than happy with mine. Especially while learning I wanted the separate bell and diaphragm. The idea of tunable diaphragm and not having rotate the head is nice in theory, but common sense was telling me that usually when you try and combine to separate functions into one then some compromises may be made.

    Only thing about the DLX is it doesn't have any rubber on the metal edges of the bell or diaphragm, so warm up the end before sticking cold metal on patient's skin.
  48. ChimpanzeeMinky

    ChimpanzeeMinky Nanterhead

    Joined:
    10.01.07
    Messages:
    786
    Location:
    Richmond, VA
    Status:
    Medical Student
    SDN 5+ Year Member
    Do you have the double-head or the triple-head? I was looking at the welch-allyn site and they only appear to list the double. Yet, on allheart, the triple-head is available. I am wondering if they have discontinued the triple-head, or if I just happen to not be finding it.

    Thanks!
  49. ChimpanzeeMinky

    ChimpanzeeMinky Nanterhead

    Joined:
    10.01.07
    Messages:
    786
    Location:
    Richmond, VA
    Status:
    Medical Student
    SDN 5+ Year Member
    Belay my last. Appears that the triple-head isn't listed under the student section on the welch-allyn site, but is listed under the main product listing. Seems suggestive that it's not appropriate for students, but I wouldn't know why.

    In any case, my question still stands as far as which folks would recommend.
  50. nlax30

    nlax30 Now with pumped up kicks

    Joined:
    10.04.06
    Messages:
    3,436
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    I just have the double head. Haven't seen the triple head one personally, though I've heard good things about it.

// Share //

Style: SDN Universal