best stethoscope?

[eunice]

Hi,
I'm a med student, and have found my Littmann 3M cardiology III steth to be full of background noise.
the doctor I was following had the HP Sprague Rappaport steth and said that it was the best one! And it was much clearer than the Littmann.

So, I was wondering, what do you think is the best stethoscope, that's not too fancy and expensive. under $100.

And does anyone know where I can buy a HP Sprague Rappaport Stethoscope? I've googled it to no avail.

Any help would be greatly appreciated!

Thanks!

Eunice

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[NateatUC]

I have both a Cardio III and an HP, and I tend to agree - the HP is MUCH better. AND it comes with interchangable sizes of bells and diaphragm - great for peds.

As for a good stethoscope under $100, some may disagree with me on this one, but if you found the Cardio III (~$125) to have lots of background noise, you really won't be able to do any better if you want to pay LESS money.

Finally, as for where to find the HP Sprague-Rappaport Stethoscope, its actually not made by HP anymore. Its made by Phillips Medical - same quality, just different manufacturer. I found this out the hard way when I had to order replacement parts. If you Google Phillips Medical, you should be able to find it. Also, check your local medical school bookstore. I know they sell it here.

 

[clkimmey]

we're getting ready to buy our equipment and i've heard many recommendations for the LYCOS. a psychiatrist swears that she could hear a heart murmur on one when she couldn't on the cardio III.

it's over $100, but might be worth a look.

 

[eunice]

Thanks!! Yeah.. I guess HP is much better.
And I guess I don't need to buy an expensive steth yet, since i'm only a 2nd year.
It's good to know that Phillips is the same quality as HP.

Thanks for that info! =)

eunice

I have both a Cardio III and an HP, and I tend to agree - the HP is MUCH better. AND it comes with interchangable sizes of bells and diaphragm - great for peds.

As for a good stethoscope under $100, some may disagree with me on this one, but if you found the Cardio III (~$125) to have lots of background noise, you really won't be able to do any better if you want to pay LESS money.

Finally, as for where to find the HP Sprague-Rappaport Stethoscope, its actually not made by HP anymore. Its made by Phillips Medical - same quality, just different manufacturer. I found this out the hard way when I had to order replacement parts. If you Google Phillips Medical, you should be able to find it. Also, check your local medical school bookstore. I know they sell it here.

 

[GATORade]

http://www.allheart.com/rappaport.html

 

[Diceman M.D.]

I'd actually recommend getting the best scope possible right now, since it will probably last you throughout your career if you take care of it. Acoustic stethoscope technology is unlikely to change within that timeframe, although electronic ones may get better than thay are now. Anyway, just to be different from the rest of the class, I got myself a Welch-Allyn Harvey DLX, and it frigging rocks! Sound quality and amplification beat the pants offa the Cardio 3's the rest of the class is getting.

Thanks!! Yeah.. I guess HP is much better.
And I guess I don't need to buy an expensive steth yet, since i'm only a 2nd year.
It's good to know that Phillips is the same quality as HP.

Thanks for that info! =)

eunice

 

[GATORade]

http://www.allheart.com/rappaport.html

Oh! I just realized that this is officially my first allopathic post. I've been savoring this moment for quite some time now. Ah, what a feeling.

 

[piu]

I'd actually recommend getting the best scope possible right now, since it will probably last you throughout your career if you take care of it. Acoustic stethoscope technology is unlikely to change within that timeframe, although electronic ones may get better than thay are now. Anyway, just to be different from the rest of the class, I got myself a Welch-Allyn Harvey DLX, and it frigging rocks! Sound quality and amplification beat the pants offa the Cardio 3's the rest of the class is getting.

don't you think the DLX looks butt ugly? why not the elite ?

 

[Diceman M.D.]

don't you think the DLX looks butt ugly? why not the elite ?

I like the DLX's look. To me, the Littmans and other brands look too much like toys, but the harvey looks all old-school (but not TOO old school like the Sprague).

 

[Jambi]

I like this one: Littmann Cardiology STC

I have a few friends with this one and they love it. Littmann also offers an engraving service for $25.

 

[subtle1epiphany]

I like this one: Littmann Cardiology STC

I have a few friends with this one and they love it. Littmann also offers an engraving service for $25.

Don't you need the bell for your peds rotation though?
It does look awesome though, the Littmann Cardio line just looks nice.

I was pretty set on getting a Cardio 3 for school in August because it's what I've been able to try at work, but now I'm wondering if that's the best idea. I mean, the Cardio 3 made my father's old school one sound like a toy tube, but as a student I know I'll have trouble distinguishing sounds, so I want to get the best I can afford. Many people claim that the Phillips Sprauge or Welch-Allyn are better, is there anyway to come to a conclusion which is best? Or should I just find a local reseller and try each out?

Also, what sort of care should be taken with stethoscopes? Should I treat it like a sensitive instrument, such as my computer or pda, or just as a tube with some metal at each end?
Okay, more realistically, should I worry about leaving it in the car all day or dropping it?

 

[Mike59]

There's no use stating that one stethoscope is superior to another when comparing anything between $30 and $200. The materials and technologies are similar enough across the board.

In the end, what accounts for our subjective preferences is the fitting of the ear pieces and tubes into our auditory canal which results in what we think are "clearer" sounds.

If you know what to listen for, auscultate someone in the ICU who's got crackles and a murmur with your fancy stethoscope- then later in the day, borrow a $20 nurses scope and have a listen. You'll be surprised how little difference there is how you can pick up anything with a "crappy" scope if you know what you're doing.

 

[Pyroclast]

Also, what about all the interchangeable pieces on some of the better stethoscopes, like the HP? Is it awkward to change them between patients/during exams? I haven't picked one out yet and I liked how the Littman Cardio III is just one piece, but I still haven't been able to decide. I really know nothing about these and would appreciate advice.

 

[Jambi]

Many people claim that the Phillips Sprauge or Welch-Allyn are better, is there anyway to come to a conclusion which is best? Or should I just find a local reseller and try each out?

The best thing you could do is just try them out. Find people with different steths and just use them on real live patients. Honestly, I would just get a sprague rappaport (generic) $10 steth. Use that until you have time to try all the different ones out there, then make a decision. Like Mike59 said, there is no use debating which one is better on the board, you just have to get what you like. After you learn what to listen for you can "do more with less." A cheap steth may work fine for you after you know what your doing.

It's like the age old truck debate, "which truck is better? Chevy, Ford, or Dodge?" No one can tell you that, you like which ever truck you like. Now all things aside, Chevy and Dodge are better that Ford.

 

[NateatUC]

Don't you need the bell for your peds rotation though?

Also, what sort of care should be taken with stethoscopes? Should I treat it like a sensitive instrument, such as my computer or pda, or just as a tube with some metal at each end?
Okay, more realistically, should I worry about leaving it in the car all day or dropping it?

Most stethoscopes are pretty durable. I don't generally worry about dropping mine, though the interchangable bells on the Phillps are plastic and can crack. Had this happen once - just ordered a new one for not too much $$$. I've also had mine in my hand when I hit a door running to a code, and it didn't hurt it.

I wouldn't leave it in the car in the sun all day though. Remember, the tubes are rubber, and the diaphragms are plastic, both of which can deform or melt if hot enough. This usually isn't a problem though, since my 'scope lives in the pocket of my white coat.

 

[NateatUC]

Also, what about all the interchangeable pieces on some of the better stethoscopes, like the HP? Is it awkward to change them between patients/during exams? I haven't picked one out yet and I liked how the Littman Cardio III is just one piece, but I still haven't been able to decide. I really know nothing about these and would appreciate advice.

Personally, I really like the interchangable parts on my HP. The different size bells and diaphragms just screw on and off. You can change them in ~10-15 SECONDS. Its also nice that you can have, say, a peds diaphragm on one side, and an adult size diaphragm on the other, which is really useful on peds or family medicine, where you may go from listening to teenagers and adults to listening to newborns. I actually very rarely use the bell, unless I'm REALLY trying to hear a murmur, and I don't think I've yet seen a resident use the bell for much of anything.

The Cardio III also has the ability to remove the peds diaphragm and put on a true bell, but I think this procedure is much more awkward - involves stretching rubber rings and things. Probably takes closer to 2-3 minutes to get everything positioned right. Also, I still haven't figured out the whole "tunable diaphragm" thing. If you need/want a bell, then get a scope with a real bell! Leave the gizmos for people that know what they're doing.

 

[eunice]

Many people claim that the Phillips Sprauge or Welch-Allyn are better, is there anyway to come to a conclusion which is best? Or should I just find a local reseller and try each out?

I was shadowing a doctor with my partner, and both of us got the 3M Cardio III. The doctor had a HP Sprague Rappaport from her med school days. She listened to my bowel sounds and heart sounds (we were doing a mutual exam and i was the patient) and told my partner to listen to them, and my partner couldn't hear them that well, so the doc tried listening w/ both of our cardio III and she frowned and said that she wouldn't be able to use ours b/c it had so much background noise. And my partner, when she used the HP heard the sounds much more clearly. Both of us are thinking of buying the Phillips (used to be HP) SPrague Rappaport.
Granted, this is an isolated case, but what are the chances that both our Cardio III is defective? Maybe they are just not that great overall.

Well, if you do go out and test out the different models, please do post your findings here~!! =)

So, a question for you guys... I am kinda broke right now... so I'm thinking of selling my Cardio III on ebay or something. I'll probably be able to get like $80-100, right? i've "used" it 1.5 years (although I've literally used it like 5 times...) Do you think it's reasonable? 3M lists it as $181 retail...

So, once I sell it, I have two options: I have a very simple steth at home. probably ~$30-40. I can use that...
or I can buy a Phillips Sprague Rappaport for $160.

should I just wait until I graduate? or Should I just invest in a good steth now? What if the electronic ones get much cheaper and better by the time i graduate? I don't know too much about the electronic ones... are they much better? will they take over the conventional steths??

Any feedback would be appreciated!

thanks!

 

[medicEZ]

Background noise with a Cardiology III?? Mine is a leap above my old (Littmann) Classic II SE, and with that one I could hear all kinds of lung sounds, your basic heart sounds, bruits, bowel sounds, etc. in the back of an ambulance. With my Cardiology III, I can even hear heart murmurs (except very soft ones -- the diesel engine is just too much for those).

Granted, everyone has different preferences, but in a lot of cases it's a matter of training your ear over time.

 

[DrMom]

in a lot of cases it's a matter of training your ear over time.

absolutely. practice & experience make a big difference regardless of the stethoscope.

 

[lotanna]

I'm sticking with the Classic II SE my cuz gave me as a gift, I figure if I can train myself to hear most everything with this, how much better can I get with anything more advanced? My clinical skills prof, an internist has the same as mine, and she was like it really doesnt matter, better for me cause I'll train my ear better

 

[drlexygoat]

A note on upkeep: don't leave your steth in a hot car in the summertime all kinked up. It will melt and bed into weird shapes and will never be exactly the same. Trust me - FL heat does awful things to scopes that are hanging over your seat. Lay it flat if you can.

 

[BUmmedic]

I have to say that for the first two years of medical school (I bought my Cardio III as an EMT senior year of undergrad) I was a little disheartened at the way things sounded with my Cardio III. I bought it for reputation, and there was just a lot of background noise and clicks and other annoying sounds that I had myself convinced that I was using it wrong or it just wasn't the right one for me. I used other students' Cardio III's and they always seemed to sound better than mine. I received a Master Cardio as a gift during my 3rd year, and it was so much clearer and didn't have all the annoying background noise that my Cardio III did. I could finally use the tuneable diaphragm technology and hear a difference! I decided to send my Cardio III to Littmann for a free refurb (they do this within warranty) and low and behold, when it came back to me, it was awesome!!! The chestpiece felt more solid with less give between the ped and adult sides, and there was almost no background noise. It was on par with my Master, and now I keep both. I take my Cardio III when I'm going to have pedi pts and my Master for everything else. To make a long story short, I think I got one from a bad batch with some manufacturing defects and a full refurb fixed it. I also have a sprague from my early EMT days, and this thing isn't a fluke either. I just don't like the extra noise created by the two tubes rubbing together and it's never as flexible (physically for comfort) as my Littmann's are.

 

[azzarah]

I used my preceptor's Tycos DLX and there was a huge difference...it looks like something out of the old star wars movies though....