Another stethoscope thread

[Megalofyia]

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Does anyone have any good recomendations for stethoscopes that magnify sound ALOT? I have pretty good hearing but I have NEVER been able to use a stethoscope succesfully. I have a difficult time differentiating sound and especially when usthing a stethoscope.

 

[JunkintheTrunk]

hmmm....i just got my littmann card III in the mail today!!! yay! it sounds good to me, but then again, i have no reference point 🙄

 

[carrigallen]

The Littman III is the loudest stethoscope in existence - it amplifies everything, which is good for noisy rooms. I purchased this microscope.

I used to use the cheap stethoscopes in clinics, and I was amazed at the difference. The downside is, the Littman III is expensive (~$120-150), so you need to be careful with it.

Another highly rated (but not as loud) stethoscope is the Master Cardiology - this is supposedly preferred by cardiologists because it does not amplify the sound as much, giving you better sound resolution. I have heard that only cardiologists will notice the resolution difference though. It is ~$150 I think.

If you are severe hearing loss, your school will probably let you get a digital stethoscope. These are designed for people with disabilities. Unfortunately they are extremely expensive, perhaps $300.

 

[shocker]

Littman III Cardiology....Look on www.allheart.com

 

[NateatUC]

I've got a Cardio III, and its OK, but as I said on another thread, I like the Phillips (formerly HP) Sprague-Rappaport stethoscope. I feel like I can hear MUCH better with it than the Cardio III, especially subtle sounds. I know a lot of attendings who feel the same way.

Also, and I'm not trying to be condecending or anything, but make sure you're using it right. Make sure the ear pieces are facing forward and angled correctly into your ears. (And I'm sure you know, make sure the side you're using is "turned on".)

One thing I don't like about the Cardio III is that its ear pieces are not too easy to adjust. I think they're actually angled too severely forward straight out of the box. Also, I think that "tunable diaphragm" thingy is overrated, and probably difficult to use correctly.

Another comparable model to think about is one of the Harvey/Tycos models. They run about the same price as the Cardio III and from what I've seen are probably easier to adjust and you don't have the confusing tunable diaphragm.

Outside of that, being able to use a stethoscope successfully takes practice, practice, practice.

If all else fails, Littman does make an electronically amplified 'scope, but like someone else said, it costs some serious $$$.

Good luck!

 

[Megalofyia]

Thanks! I'm not hard of hearing. I actually have pretty decent hearing. But I do have a really hard time differentating sound. Like when I go to crowded places with people I can't understand a word anyone is saying because there is too much noise and it's all the same. I've tried different, but cheap, stethoscopes and never could hear anything that was being described.

 

[velo]

The Littman III is the loudest stethoscope in existence - it amplifies everything, which is good for noisy rooms. I purchased this microscope.

I used to use the cheap stethoscopes in clinics, and I was amazed at the difference. The downside is, the Littman III is expensive (~$120-150), so you need to be careful with it.

Another highly rated (but not as loud) stethoscope is the Master Cardiology - this is supposedly preferred by cardiologists because it does not amplify the sound as much, giving you better sound resolution. I have heard that only cardiologists will notice the resolution difference though. It is ~$150 I think.

If you are severe hearing loss, your school will probably let you get a digital stethoscope. These are designed for people with disabilities. Unfortunately they are extremely expensive, perhaps $300.

They claim that the Master Cardio is actually 5db louder. I couldn't hear the difference, but maybe you can...Other option is a snazzy electronic one, but be prepared for some good-natured teasing 😉

 

[Mumpu]

Another vote for Phillips Sprague-Rappaport.

However, I think you have a different problem. Auscultation is a learned skill that takes work and time to master (just like everything else in medicine, for that matter). Old-school cardiologists who hear coronary artery bruits started off not hearing anything. But they kept listening and learning. You have to listen to a lot of hearts -- no other way to do it.

You can practice separating the sounds by listening to music. Rock/Pop is okay, classical is better. Focus your hearing on individual instruments in the orchestra. Pick out which part of the sound is violin and which is the French (ahem, "Freedom") horn.

Stay away from electronic stethoscopes -- they ALWAYS distort sounds, particularly the low-pitched vibrations like the S4 and the mid-diastolic rumble, simply because the tiny speakers cannot reproduce low tones. You will be able to hear but not diagnose because you will not hear the tell-tale characteristics of sounds.

 

[velo]

and which is the French (ahem, "Freedom") horn.

👍

 

[Firebird]

Don't worry about not being able to differentiate sounds yet. I have a Master Cardiology and there's no way I could pick out S3's or S4's consistently...or even a split S2 if it was tricky.

You learn what is "normal" by hundreds of repeats (hopefully during your 1st and 2nd years). You'll then figure out what is "not normal."

 

[Entol]

On allheart.com and some other places, there is one stethoscope called the Master Cardiology at
http://www.allheart.com/2163-65.html

and one called the Master Cardiology black edition, which is $20 or so more expensive at
http://www.allheart.com/littmann2159.html

What is the difference between these two? Which are people referring to when they say the littmann master cardiology?

 

[Megalofyia]

Don't worry about not being able to differentiate sounds yet. I have a Master Cardiology and there's no way I could pick out S3's or S4's consistently...or even a split S2 if it was tricky.

You learn what is "normal" by hundreds of repeats (hopefully during your 1st and 2nd years). You'll then figure out what is "not normal."

I'm really really lousy at it with regular stethescopes.. I have a difficult time just hearing a heart beat.. :-/

 

[unclej00]

If you are truly good, all you need is a plastic toy stethoscope. Plus they are much cheaper. Don't be fooled by the advertisements of the brand names. Just go with the toy. You will hear the sounds eventually. It just takes practice.
That's all medicine really is. Something seems so difficult until you actually do it yourself a few times and then it is fun. Unless you are doing heart surgery.

 

[ericdamiansean]

Thanks! I'm not hard of hearing. I actually have pretty decent hearing. But I do have a really hard time differentating sound. Like when I go to crowded places with people I can't understand a word anyone is saying because there is too much noise and it's all the same. I've tried different, but cheap, stethoscopes and never could hear anything that was being described.

Then it's not the stet's prob then, it's you.

Try concentrating, maybe some meditation may help 😳

 

[Megalofyia]

Then it's not the stet's prob then, it's you.

Try concentrating, maybe some meditation may help 😳

I realize the problem is me, but I also realize there are different stethoscopes with different capabilities. I'm hoping something that is louder might help.

 

[beanbean]

I have a similiar problem using stethoscopes. No matter how I angle the ear tips or which size ear tips I use they tend to plug up my ears and I hear nothing. What is paticularly annoying is that when I initially put the scope in my ears I can hear fine, but just as try to listen for the BP, heart, luings, etc the ear tips move slightly and all sound is blocked.

I have been using stethoscopes for 19 years and have still not found a great solution. I have tried many different scopes and ear tips. I now use a Littman Cardio III and love the sound quality when the ear tips are not blocking my ears.

If anyone has overcome this issue...what worked for you?

 

[Firebird]

I have been using stethoscopes for 19 years and have still not found a great solution.
QUOTE]

Are you sure you're not sticking it in your nose rather than your ear?

 

[beanbean]

I'm not stupid. I just happen to have external ear structure that make it difficult to use a stethoscope.

It can be annoying and I would love to find an easy solution to the issue, but so far the best I can do is to always try to use my stethoscope which is optimally fitted for me. However, this is difficult with patient's who have isolation precautions for infectious disease.