Do we need expensive stethoscopes?

[zeppelinpage4]

So I've sort of been putting off the stethoscope order, but they require them starting next semester and I wanted to know what level or quality of stethoscope I'd need at this stage as a med student.

Almost everyone in my class has ordered the Littmann Cardiology III
http://www.allheart.com/3m-littmann-stethoscope/p/31273134/

I was pretty much set on getting the Littmann Cardiology III since most my classmates got it.

BUT, one of my classmates told me it was way too much for what we would be doing as med students. He's been using a $50 stethoscope from his EMT days and it has worked well for him, and he plans to use that.

So, I have no problem buying a good stethoscope if I need it, but I don't want to unnecessarily spend money on a super nice stethoscope if I'm not going to be using it to it's full potential and a cheaper one could do the trick for me now. Any opinions?

Would it be worthwhile getting the Littmann Cardiology III now? Also, is it something I could hopefully use in residency? I can see the benefit of getting a Cardiology III now, if it doesn't need to be replaced by a better stethoscope later.

If the Cardiology III isn't necessary and there are cheaper stethoscopes that do the trick, any suggestions?
I was looking at the Littmann Classic II SE as a more budget friendly option.
http://www.allheart.com/3m-littmann-stethoscope/p/2200-16/

Sorry for the all the questions, I literally know nothing about stethoscopes. Just learned to take blood pressures a couple weeks back haha.

Thanks!

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[BadHorse]

At the beginning of med school I got the littmann classic II as a gift, it's all I've ever needed. I tend to doubt if there's any real difference honestly, but if you end up in cardiology (or neonatology) and need slightly different stethoscope you can worry about it then, but it's likely that something "basic" is all you'll ever need.

 

[deleted564496]

From my understanding a Littmann cardiology 3 will last throughout your career (or at least for a long time)… why buy a pos if you're going to end up buying a nice one anyway.. Yeah right now it probably won't make a huge difference, but once you know what you're doing it definitely will…

Edit--I'm sure the 2 would suffice throughout your career as well unless you will rely on it heavily in your specialty.

 

[N. Marin]

It really depends-- some keep theirs until residency, some get a cheap one for the first few years then buy a proper one later on. Honestly, the Littmann Classic II will be more than adequate and last you as well (I know nurses who use them regularly). Both Littmanns have the quality and warranty to last you until residency and beyond.

 

[zeppelinpage4]

Fantastic, thanks for the reply guys. If either is fine, I'll probably go with the Classic II SE. I want to get a really nice one now, but I'm afraid it might get lost or stolen over the years, so the more budget friendly one is probably the best for me.

Also, I did some searches in past threads and happened across this ADC ADSCOPE 603. There's only a few left in stock, would this be comparable or better than the Littmanns?
http://www.amazon.com/gp/product/B001IDZLA2/ref=ox_sc_act_title_1?ie=UTF8&psc=1&smid=ATVPDKIKX0DER

 

[Frazier]

Everyone in my class appears to have a Littman Cardiology III. Pick a color that you like.

Very happy with the purchase. Awesome stethoscope.

 

[FionaTang]

go to book store, honestly as long as they r legally for sale, they can all last for 10 years or more. i have littmann classic II and all of my teachers have it, it can last for 2o years.

 

[FunnyCurrent]

I have owned: WA Double Head, WA Elite, Litm Master Cardiology, Litm Cardio 3, Litm Cardio 2 (the original predecessor of the cardio 3 not the new cheapy one), and Sprague Rappaport.

GET THE CARDIO 3 - LESS CLARITY BUT AT LEAST ALL ABNORMALITIES ARE LOUD A ****!!! Litm Cardio 3 + Clinical reasoning = the right answer 99% of the time = more than you can ask for as a 3rd year medical student.

I would routinely miss **** with the WA double head - it just isn't as loud and you have to auscultate more carefully - not easy when you have 4-5 patients to round on and youre still a slow medical student

 

[MerickManual]

Try listening through different stethoscopes if you get a chance. I was about to buy a standard Lit Cardio 3, but I have a history of some hearing problems and realized I didn't hear sounds as well. That's why I invested in a Li 3M Cardio. Don't regret it, hear all the sounds I need. It comes with an attachable rubber piece you put on the bell to hear on infants. Included was free engraving, so I was less worried someone might swipe it.

Someone mentioned neonates. Don't worry about neonate size- when you're in the NICU each baby has a neonatal stethoscope attached to the incubator or crib. This prevents spreading of germs to one infant to the next.

 

[ksmi117]

At the beginning of med school I got the littmann classic II as a gift, it's all I've ever needed. I tend to doubt if there's any real difference honestly, but if you end up in cardiology (or neonatology) and need slightly different stethoscope you can worry about it then, but it's likely that something "basic" is all you'll ever need.

I agree. The Cardio III is definitely a better stethoscope, but I have a Classic II and it still works, it's just not as loud so it's a bit harder to detect murmurs, but if murmurs are obviously, you'll be able to hear them with either. If you end up going into cardiology, I think you'll need a better stethoscope, but for most specialties the Classic II is just fine. Most surgeons don't even have a stethoscope with them when seeing patients.

 

[SLC]

Our school gave us a littman cardio3 along with some Welch-Allyn oto/ophthalmoscopes when we matriculated. I like the cardio3, but like MerickManual above me, I have some mild hearing loss and I wonder if the Master or an electronic stethoscope would suit me better?

The class above me was given electronic littmans as an experiment (along with all preceptors affiliated with the school), but I guess they weren't happy enough with the results to get them for us?

 

[Nymphicus]

How often do you lose, misplace, or have things walk away?

 

[Kahreek]

No you dont need a expensive stethoscope.
From my experience dual head littmans have great clarity but arent great amplifying sounds like subtle murmurs.
I've heard good things about littman master classic. I have a litmann classic II (dual head) and a no name brand sprague, i dont know about sound quality, but sprague is much easier to pick sounds.

 

[obgyny]

No you dont need a expensive stethoscope.
From my experience dual head littmans have great clarity but arent great amplifying sounds like subtle murmurs.
I've heard good things about littman master classic. I have a litmann classic II (dual head) and a no name brand sprague, i dont know about sound quality, but sprague is much easier to pick sounds.

Wow, really? Someone bought me a sprague before med school and I couldn't even hear my own heartbeat with it . Tried out the Littman cardio 3 at my school's bookstore and the first thing I thought was "wow, my heart is loud." So I bought the cardio 3. Now of course I know how to use a stethoscope and know what to look for, I can hear with the sprague (have to jam it in my ears), but it sounds much quieter to me.

As for hearing murmurs, most people are terrible with it in the beginning regardless of the stethoscope they use. I got much better at auscultating in 3rd year.

OP, I'd also recommend trying out the stethoscopes before buying if possible. And don't let your school trick you into buying an otoscope/ophthalmoscope. No matter what they say, you won't need it.

 

[notbobtrustme]

I got the Littmann 3 as a gift. It's probably worth it to get as a med student since you can use this as a resident.

If you are going for a cheapo, be aware you might not be able to hear important things with it and as a student, you definitely don't want to miss out. It's one thing for someone with 20 years experience to be a bit non-chalant about hearing everything, but at our stage in our careers, hearing correctly is a huge deal.

 

[KnuxNole]

They should know med students are all poor as hell, and should donate expensive steths 😛

 

[JGimpel]

You have a very high chance of loosing one or more pieces of your medical gear at one time or another in your training and you're just going through the motions for most of the first few years anyways, so save the fear of having to find/grade complicated murmurs and the equipment needed to hear them properly for the time when you'll actually use them. You will also be cleaning it with some sort of mildly abrasive chemical between patients and this will degrade any manufacturers' equipment over time. After finding out that you just examined a patient with TB/MRSA/Tiny insects/Acinetobacter, don't be ashamed to want to soak this in peroxide for a few hours or throw it away, either.

Buy the higher-end ADC or MDF steths, such as their cardiology-oriented ones and you'll be more than fine. Amazon has great reviews to guide you along in this case.

Great ADC that is appropriate from the first day of training until you loose it:
http://www.allheart.com/adc-stethoscope/p/adc601/

Same for this MDF:
http://www.allheart.com/mdf-stethoscope/p/mdf797dd/

If you absolutely have to buy an expensive high-end steth, get the one that records heart sounds so you can go home and study them and look like a star on rounds the next day when you've got the murmur/grading nailed. They have mixed reviews over whether they really make your life easier and/or if they're worth the money.

ADC: around $250
http://www.allheart.com/adc-advanced-electronic-stethoscope/p/adc657/

Thinklabs for around $250, $300 with the iPhone software
http://www.thinklabsdirect.com/id2

If you must have a Littman: around $350
http://www.allheart.com/3m-littmann-stethoscope/p/litt3100/

Low-tech, Baller-status steth that will get you brutally pimped on rounds:
Welch Allen Triple Head model 5079-321: around $300
http://www.allheart.com/product.aspx?p=ty507932xth

The Welch-Allyn optho is just a very expensive crutch that you'll hardly ever carry around with you on rounds and may have a $400 window in your car broken if you keep it there while parked in the wrong place at the wrong time. Use the school ones mounted in the exam rooms to learn what to look for, an online optho slide set to know what you should see, then use the basic one as soon as you're proficient. Tell you're attending that you're not good at auscultation or ophthalmic exams without your Ferrari-level of equipment that you may or may not have on you or in your car and see how well that goes over.

 

[zeppelinpage4]

Awesome advice guys! It seems like there's a fair share of Cardiology III and Classic II SE users who are happy with their steths. Guess this means I'm okay either way. All the positive Cardiology III posts are making me lean towards that now though. Assuming I don't break or lose it, it's nice to know it'll serve all purposes regardless of how far I am in training.

One thing about Littmann's I am concerned about is the tunable diaphragm. Another thread discussed how this made it difficult to learn auscultations with. Is that true? If so, I found an ADC brand "copy" of the Littmann Cardiology III, it's much cheaper and I am assuming it does not have the tuneable diaphragm.
http://www.reddingmedical.com/steth...convertible-cardiology-stethoscope-601-series

Also, JGimpel, yeah I think I'd rather get a cheap ADC than get a $300 steth right now. I found this ADC though, i'm assuming this would be one of their higher end models?

Would this be a good option? I figured it's a nice middle ground between the Littman Cardiology III and the cheaper Classic II.

 

[Kaustikos]

I had a nice one...and then lost it this year. I almost wish I had a cheap one to carry around until I actually needed that expensive one. The cheapest ones can deduce a murmor/rales/wheezes. You're not expected to diagnose a grade 1 systolic murmor with compounded pericarditis/cardiac tamponade. That's the doctor. I'd say get a decent one and don't fall for the "YOU NEED THE CARDIOLOGY III Ultra-Deluxe Gold Plated Carbon Fiber". Just like you don't need an opthalmoscope. They might trick you into the belief that it's needed for practice...but it's not.

 

[Kahreek]

No you dont need a expensive stethoscope.

Wow, really? Someone bought me a sprague before med school and I couldn't even hear my own heartbeat...

maybe this is why

 

[JGimpel]

Awesome advice guys! It seems like there's a fair share of Cardiology III and Classic II SE users who are happy with their steths. Guess this means I'm okay either way. All the positive Cardiology III posts are making me lean towards that now though. Assuming I don't break or lose it, it's nice to know it'll serve all purposes regardless of how far I am in training.

One thing about Littmann's I am concerned about is the tunable diaphragm. Another thread discussed how this made it difficult to learn auscultations with. Is that true? If so, I found an ADC brand "copy" of the Littmann Cardiology III, it's much cheaper and I am assuming it does not have the tuneable diaphragm.
http://www.reddingmedical.com/steth...convertible-cardiology-stethoscope-601-series

Also, JGimpel, yeah I think I'd rather get a cheap ADC than get a $300 steth right now. I found this ADC though, i'm assuming this would be one of their higher end models?

Would this be a good option? I figured it's a nice middle ground between the Littman Cardiology III and the cheaper Classic II.

I appreciate your input and have updated my original post as a result.

 

[obgyny]

One thing about Littmann's I am concerned about is the tunable diaphragm. Another thread discussed how this made it difficult to learn auscultations with. Is that true?

I've never heard that. How would it make it difficult? I really don't think you'll have any trouble with the littman cardio III.

maybe this is why

Which was explained in the rest of my post...

 

[Charles_Carmichael]

Personally, I prefer the WA Harvey Elite and think it's better than the Littman III that everyone else seems to have, but I don't think you can go wrong with either. I've occasionally used the "cheaper" stethoscopes that are hanging around in patient rooms and there's a noticeable difference in the sound quality between them and my WA Harvey Elite.

 

[goft20]

Maybe it is because I am naive but 150 dollars for a stethoscope? It must cost them 10 dollars to manufacture it... http://www.youtube.com/watch?v=QK8m...Z8RPfIZ-gnuMJV1uw&sig2=1njtBj30eiACiIGQ8fsbvw

Sent from my GT-I9505 using Tapatalk

 

[SouthernSurgeon]

On the one hand...a littmann cardio iii costs what...$150 bucks? So the savings we are talking about here are $50-70 if you buy a cheaper model? That's a drop in the bucket in the scheme of your medical education.

On the other hand...I no longer carry a stethoscope as of a year ago. I know friends who celebratorily threw theirs in the trash after intern year. So in retrospect I certainly didn't need a high end stethoscope.

 

[zeppelinpage4]

On the one hand...a littmann cardio iii costs what...$150 bucks? So the savings we are talking about here are $50-70 if you buy a cheaper model? That's a drop in the bucket in the scheme of your medical education.

On the other hand...I no longer carry a stethoscope as of a year ago. I know friends who celebratorily threw theirs in the trash after intern year. So in retrospect I certainly didn't need a high end stethoscope.

Haha quite true, I really don't mind spending $150 to $200 on a good stethoscope. I just want to make sure it's a worthwhile expenditure and not unnecessary. I like look and simplicity of the cheaper stethoscopes, and it's nice to know that if I lose it, or end up not needing it much, I didn't spend too much money on it. BUT, I want to get something that is good enough for me to learn on. Maybe I could get away with a cheap stethoscope as a better trained doctor, but right now, I think a good quality stethoscope might help the learning process.

I appreciate your input and have updated my original post as a result.

Awesome, thanks so much for the links! Both the ADC and MDF look amazing, and the ADC seems to be at a very reasonable price. The MDF is priced close enough to the Cardiology III though, so I wouldn't mind getting either of these three. I'm thinking I'll choose from among these three, unless I decide I want a basic Classic II design or something simpler.

I've never heard that. How would it make it difficult? I really don't think you'll have any trouble with the littman cardio III.

Which was explained in the rest of my post...

Thanks for the reassurance, my classmates also seem to fine with the Cardiology III. I just wanted to bring it up because this post was suggesting that the tunable diaphragms on the Littmann's weren't a good feature for those just learning.
http://forums.studentdoctor.net/threads/stethoscope.253778/#post-3289972


Edit:
Yeah I was looking at the Welch Allyn steths, specifically the Elite, but it's $170 or so online and it looks a bit bulky to me.

At the moment (unless I change my mind which I probably will haha) I think I've narrowed it down to the Littmann Cardiology III ($160) (the safe choice/seemingly standard), the ADC Convertible Cardiology ($90) (at just $90 it's much cheaper, but seems to be almost as good), and the MDF ER Premier Stethoscope ($130) (slightly cheaper than the Littmann, but not by much, if it's as good or better I may get this).

http://www.allheart.com/product.aspx?p=31273134

http://www.reddingmedical.com/steth...convertible-cardiology-stethoscope-601-series

http://www.allheart.com/mdf-stethoscope/p/mdf797dd/

 

[RangerBob]

I also have the Welch Allyn Elite and have been very happy with it. I've used the WA DLX (doubles as a flail as it's rather heavy...) and the Cardiology III. All were great. I thought the Littmann was louder and the WA's were clearer.

Most other residents/medical students I run into seem to all get the Cardiology III. On the other hand, most attendings I've worked with seem to have one of the cheaper Littmanns, or other brands I don't immediately recognize. The cardiologists I worked with generally seemed to prefer the Littmanns without the bell or second (peds) diaphragm--I'm not sure which model.

Honestly I think everyone seems to buy/prefer the Cardiology III over the cheaper models because everyone else seems to be buying the III's. I agree with SouthernIM that it's not a whole lot more expensive than a cheaper stethoscope when you really look at it, so if money isn't that much of an issue go for the better stethoscope--if you're lucky you'll never need to buy another one again, just replacement tubing and ear-pieces. But otherwise I think a cheaper stethoscope will be more than adequate, and may be preferable if you have a tendency to misplace things.

It does feel cool to have a nice and expensive stethoscope though, so I wouldn't fault anyone for buying one. But on the topic of medical equipment, I do fault people for buying the Taylor reflex hammers--spend the extra $10-$20 to get a real reflex hammer. The Taylor's are hardly any better than your fingers or stethoscope. (Easy way to make a better first impression with your neurology attending is to have a Tromner, Babinski, or Queen Square reflex hammer in your white coat pocket).

 

[e30ftw]

I bought a welch harvey allen elite at the beginning of med school and used it through the end of intern year.

good steth, attatchments (bell/peds), good sound. something like $150 new

However it was heavy and cumbersome to carry daily at an ER pace.

so I bought a littmann master classic ($100) and now prefer it for both sound and portability. YMMV. I'm sure a well put together $50-$100 steth would suit you fine for medical school. In the end you need to recognize certain lung/heart patterns but it is much more important to develop recognition of pathological patterns using your optical photon scanners (eyes), ability to apply your knowledge of medicine, and experience.

 

[MerickManual]

It does feel cool to have a nice and expensive stethoscope though, so I wouldn't fault anyone for buying one. But on the topic of medical equipment, I do fault people for buying the Taylor reflex hammers--spend the extra $10-$20 to get a real reflex hammer. The Taylor's are hardly any better than your fingers or stethoscope. (Easy way to make a better first impression with your neurology attending is to have a Tromner, Babinski, or Queen Square reflex hammer in your white coat pocket).

Or a dejerine hammer, these are good.

 

[Law2Doc]

How often do you lose, misplace, or have things walk away?

I've had two wander off over the years since residency started. You really don't want an expensive one during the training stage. You want one you can jam into your white coat or leave wherever and not really worry about it. Having a spare isn't a bad idea either. Go on eBay and see what you can get really cheap that isn't a toy. They all more or less work.

 

[GopherMD]

Not that it matters at this point, but I just wanted to say I received a cardiology III as a gift from my school and I like it. Can't go wrong with stethoscopes from Littman in general.

 

[Instatewaiter]

BUT, one of my classmates told me it was way too much for what we would be doing as med students. He's been using a $50 stethoscope from his EMT days and it has worked well for him, and he plans to use that.

A doctor should have a doctor scope. You can't hear crap with a crap scope.

 

[BurberryDoc]

A doctor should have a doctor scope. You can't hear crap with a crap scope.

Or, will you just hear crap with a crap scope?

#bellysounds lol

 

[Wordead]

It's a 50-100 dollar one time expense for a tool that you'll use for at least the next 3 years. I don't understand how some medical students are just completely unable to see the forest for the trees. It's like the people studying for step 1 who don't want to shell money out for Uworld or NBMEs or whatever. Too stupid to live.

 

[Charles_Carmichael]

Or, will you just hear crap with a crap scope?

#bellysounds lol

Not sure if you're joking or not, but we actually do listen for bowel sounds using our stethoscopes.

I personally do notice a difference between my WA and the cheap scopes hanging in patients' rooms, so I'd agree with Instatewaiter. In the grand scheme of things, like Wordead mentions, spending $100-150 is a drop in the bucket compared to the costs of attending med school. I wouldn't spend money on certain other things the school requires however (ex. otoscope, ophthalmoscope, etc).

 

[BurberryDoc]

Not sure if you're joking or not, but we actually do listen for bowel sounds using our stethoscopes.

I personally do notice a difference between my WA and the cheap scopes hanging in patients' rooms, so I'd agree with Instatewaiter. In the grand scheme of things, like Wordead mentions, spending $100-150 is a drop in the bucket compared to the costs of attending med school. I wouldn't spend money on certain other things the school requires however (ex. otoscope, ophthalmoscope, etc).

It was a joke, and yeah, I know you auscultate bowel sounds with a Steth. Sheesh.

 

[zeppelinpage4]

It's a 50-100 dollar one time expense for a tool that you'll use for at least the next 3 years. I don't understand how some medical students are just completely unable to see the forest for the trees. It's like the people studying for step 1 who don't want to shell money out for Uworld or NBMEs or whatever. Too stupid to live.

You make a good point, but I really hope you weren't directing that too stupid to live comment at me. Nowhere did I say I wasn't willing to spend the cash on something good, I just wanted to get more info. on whether or not getting a good one now would be worthwhile or if I could get away with a cheaper one. Why spend a ton on a stethoscope I might lose or damage? If I can learn just fine on a cheaper one, it won't feel as bad if it walks away on me.
Please don't be so quick to criticize. If I can use a $70 stethoscope just fine, then why spend more? Of course, if that $70 scope is crap and I won't be able to hear properly or learn from it, then I'm more than willing to spend more on a nice stethoscope. Hence I started this thread to find out what level of stethoscope I would need.

 

[zeppelinpage4]

A doctor should have a doctor scope. You can't hear crap with a crap scope.

True, I don't want a $20 scope. I'm looking more at the intermediate priced ones, like the Littmann Classics or the Adscope Cardiology stethoscopes. They're not top of the line, but from what other posters have been saying, they don't seem like crap scopes either.

 

[Wordead]

You make a good point, but I really hope you weren't directing that too stupid to live comment at me. Nowhere did I say I wasn't willing to spend the cash on something good, I just wanted to get more info. on whether or not getting a good one now would be worthwhile or if I could get away with a cheaper one. Why spend a ton on a stethoscope I might lose or damage? If I can learn just fine on a cheaper one, it won't feel as bad if it walks away on me.
Please don't be so quick to criticize. If I can use a $70 stethoscope just fine, then why spend more? Of course, if that $70 scope is crap and I won't be able to hear properly or learn from it, then I'm more than willing to spend more on a nice stethoscope. Hence I started this thread to find out what level of stethoscope I would need.

I was just addressing the general attitude. Maybe a little harsher than intended.

 

[obgyny]

Even a $70 steth I wouldn't let out of my sight. Don't set your steth down on a table (why would you anyways?). You should always just immediately put it back in your white coat pocket (or around your neck or wherever you carry it) after you use it. If someone borrows it from you (which really doesn't happen to me very often), watch it like a hawk!

My steth never leaves my white coat unless I'm using it on a patient or about to wash my coat at home.

And there's nothing wrong with trying to be frugal in med school, all these things add up unfortunately.

 

[Mad Jack]

You have a very high chance of loosing one or more pieces of your medical gear at one time or another in your training and you're just going through the motions for most of the first few years anyways, so save the fear of having to find/grade complicated murmurs and the equipment needed to hear them properly for the time when you'll actually use them. You will also be cleaning it with some sort of mildly abrasive chemical between patients and this will degrade any manufacturers' equipment over time. After finding out that you just examined a patient with TB/MRSA/Tiny insects/Acinetobacter, don't be ashamed to want to soak this in peroxide for a few hours or throw it away, either.

Buy the higher-end ADC or MDF steths, such as their cardiology-oriented ones and you'll be more than fine. Amazon has great reviews to guide you along in this case.

Great ADC that is appropriate from the first day of training until you loose it:
http://www.allheart.com/adc-stethoscope/p/adc601/

Same for this MDF:
http://www.allheart.com/mdf-stethoscope/p/mdf797dd/

If you absolutely have to buy an expensive high-end steth, get the one that records heart sounds so you can go home and study them and look like a star on rounds the next day when you've got the murmur/grading nailed. They have mixed reviews over whether they really make your life easier and/or if they're worth the money.

ADC: around $250
http://www.allheart.com/adc-advanced-electronic-stethoscope/p/adc657/

Thinklabs for around $250, $300 with the iPhone software
http://www.thinklabsdirect.com/id2

If you must have a Littman: around $350
http://www.allheart.com/3m-littmann-stethoscope/p/litt3100/

Low-tech, Baller-status steth that will get you brutally pimped on rounds:
Welch Allen Triple Head model 5079-321: around $300
http://www.allheart.com/product.aspx?p=ty507932xth

The Welch-Allyn optho is just a very expensive crutch that you'll hardly ever carry around with you on rounds and may have a $400 window in your car broken if you keep it there while parked in the wrong place at the wrong time. Use the school ones mounted in the exam rooms to learn what to look for, an online optho slide set to know what you should see, then use the basic one as soon as you're proficient. Tell you're attending that you're not good at auscultation or ophthalmic exams without your Ferrari-level of equipment that you may or may not have on you or in your car and see how well that goes over.

I've had a Classic II SE for about 6 years and the abuse it takes from cleaning is minimal. I had to replace the diaphragm once, but that was about it. We use a mix of cavi wipes and bleach wipes at my hospital, and I clean it perhaps 10 times per hour with them. If you really want to make it last, keep it out of the cold. If you leave it in your car and it's freezing out, it totally wrecks the rubber, even once or twice at sub zero temps has lead to tearing for some of my coworkers. The tubing is the second most expensive piece, so take care of it.

Great thing about Littman stethoscopes is all of the parts you need for repair are cheaply and easily available. I'm not in a field where I listen to heart sounds at the moment, so I can't comment on the Cards III vs the Classic II SE, but I literally just got a cards III for Christmas (when I got it my first thought was awesome, I hope I don't lose it!) so I'm curious if it makes any difference for breath sounds. The Classic II has been my standby stethoscope as a respiratory therapist for years, lung sounds are clear as crystal. Even the cheap disposables can get you by with breath sounds if you know what you're listening for (might take you a few breaths, but you'll make it out eventually), but for heart sounds I'd wager it makes a difference to have something half decent.

 

[zeppelinpage4]

I was just addressing the general attitude. Maybe a little harsher than intended.

All good, we're on the same page.

Even a $70 steth I wouldn't let out of my sight. Don't set your steth down on a table (why would you anyways?). You should always just immediately put it back in your white coat pocket (or around your neck or wherever you carry it) after you use it. If someone borrows it from you (which really doesn't happen to me very often), watch it like a hawk!

My steth never leaves my white coat unless I'm using it on a patient or about to wash my coat at home.

And there's nothing wrong with trying to be frugal in med school, all these things add up unfortunately.

I'll have to keep this in mind, hopefully I can keep mine in sight.

I've had a Classic II SE for about 6 years and the abuse it takes from cleaning is minimal. I had to replace the diaphragm once, but that was about it. We use a mix of cavi wipes and bleach wipes at my hospital, and I clean it perhaps 10 times per hour with them. If you really want to make it last, keep it out of the cold. If you leave it in your car and it's freezing out, it totally wrecks the rubber, even once or twice at sub zero temps has lead to tearing for some of my coworkers. The tubing is the second most expensive piece, so take care of it.

Great thing about Littman stethoscopes is all of the parts you need for repair are cheaply and easily available. I'm not in a field where I listen to heart sounds at the moment, so I can't comment on the Cards III vs the Classic II SE, but I literally just got a cards III for Christmas (when I got it my first thought was awesome, I hope I don't lose it!) so I'm curious if it makes any difference for breath sounds. The Classic II has been my standby stethoscope as a respiratory therapist for years, lung sounds are clear as crystal. Even the cheap disposables can get you by with breath sounds if you know what you're listening for (might take you a few breaths, but you'll make it out eventually), but for heart sounds I'd wager it makes a difference to have something half decent.

Awesome advice, more reason for me to look into the Littmanns. Good to know the Classic II SE can do a good job also.

I guess it really comes down to whether or not I should get one of the Littmann stethoscopes, or the ADC or MDF cardiology stethoscopes.



My only concern with the Littmann is the tunable diaphragm which a few users in past threads have said was bad. If anyone can weigh in on their experience with that, I'd appreciate it. If the tunable diaphragms isn't a big deal, I'll probably just spring for the Littmann now, but if it's a bad feature, I'll look into the ADC or MDF equivalents.

I'm torn between this MDF ER Premier
http://www.amazon.com/MDF-Premier-Stethoscope-MDF797DDBO-Pediatric/dp/B000IF6ZO2

And the Littmann Cardiology III

Are these two equivalent or is one better?

 

[Law2Doc]

It's a 50-100 dollar one time expense for a tool that you'll use for at least the next 3 years. I don't understand how some medical students are just completely unable to see the forest for the trees. It's like the people studying for step 1 who don't want to shell money out for Uworld or NBMEs or whatever. Too stupid to live.

First, as mentioned, these things have been know to walk off frequently, so it may very well be an annual (not one time) expense. Certainly has been for me. You'll even want a back up. Second, at least in most urban hospital settings where MRSA, VRE, and c diff., etc are common, you are going to have to leave your scope at the door in over half the patient rooms in favor of disposable stethoscopes anyhow, so the value of a good scope is limited. Like owning a Ferrari you rarely get to take out of the garage and when you do you often have to risk street parking. Bad idea-- Too stupid to live. 😉

 

[Law2Doc]

...
My steth never leaves my white coat unless I'm using it on a patient or about to wash my coat at home....

Yes but does your white coat go with you into MRSA patient rooms, the OR, etc.? It shouldn't. And if it doesn't you aren't watching it. You can be careful, but bottom line is that if you have something worth hundreds of dollars hanging on a coat hook outside a patients room, there's a risk.

 

[JGimpel]

It looks like things may be getting a bit personal here...about what type of stethoscope to wear in your first few years of training. If you look at the post history of some of the people posting the more curt comments, you'll get a feel for how often they throw this attitude around, so place them on your ignore list now while you're just getting started.

I bought a decent starter scope for a really good price when I began medical school, then went around to the former RN/EMT/Paramedic classmates that had been using all kinds of them and asked them to compare ours and tell me if I needed to 'upgrade' mine to a Littman ASAP. To this day, not one person has ever told me to, be they a colleague/trainer/supervisor, and I still compare notes with others often just to be sure. Those that get handed a $1600 WA gift bag by your family as just that, a gift, should be thankful and know that most people aren't that lucky. They also are often the same ones that complain that the nearest BMW, Mercedes or Land Rover dealership to get their car (that their parents bought them at 23 years old) serviced at is so far away. I continue to laugh at the life lessons they've been taught and urge you to stay away from them. Too spoiled to live.

Anyways, if you get a stethoscope that is fancier than the people that actually have medical licenses around you have, you may just be asked to prove you really know how to use it; at least with me. Be prepared to explain why you chose the Littman Cardiology Master 3 or other stethoscope that is well beyond your level of training and costs way more than mine to use when rounding. If you can hear the difference in heart and lung sounds between your patients by listening in the proper areas and defend what you think you heard, that's all that is expected of you for quite a while. Being able to quickly and correctly interpret an EKG, an ABG and a PFT will impress me more. Calling out a nitro patch/paste during a code will get you an A on your eval and submission for student of the year, if you really want to know what will impress me the most when it really counts. Very observant and lived.

Start here:
http://www.wilkes.med.ucla.edu/

The "drop in the bucket" argument gets really old fast as you use it to approach everything while in your training and end up spending way more money in the short and long run on every laptop, textbook and tablet, expensive scrubs on every school or amazon list that you see and then have problems flying out for med school/residency interviews, away rotations and paying first and last month's rent when you move somewhere. Too broke to live.

I'll put it out there; if anyone on SDN has ever tuned a diaphragm for any reason in practice on a regular basis, please post why and how often. I've yet to ever hear of someone having the need to do this or seen it done in the many, many medical environments across the country I've had the pleasure of stumbling into at 4:45AM on a regular basis. I've had my equipment hold up pretty well to Cavicide, Avaguard and even those purple or gold topped mystery buckets seen often in different settings and it's also doing just fine, but the stuff you have to use to get their residue off can be a bit more abrasive.

If I see the PPE cart outside of a room, then see MRSA/C-diff/VRE/ACB/Droplet/Penem somewhere on the chart, I'm leaving everything at the nurses' desk and will do my best to separate the sounds from the ventilator from the heart sounds with the yellow disposable hanging outside the door (which also get's swabbed with a Cavi wipe for 30 seconds.) You're most valuable piece of equipment will be the N95 mask, in addition to the rest of the stuff in that box outside the door. It ALL must go in the trash BEFORE you leave the room, by the way.

Hands down, the MDF ER Premier wins by far if you want to spend over $100 and you can get it gold plated and monogrammed for less than some of the stethoscopes others have mentioned if you're really trying to make an impression with your teachers and patients.

Congratulations on Stony Brook; invest in a good flashlight for those late nights getting home from school. It's pitch black very early at night and no need to run into one of those trees walking to your dorm. Enjoy your time off while you can before you're too tired to read!

All good, we're on the same page.

I'll have to keep this in mind, hopefully I can keep mine in sight.

Awesome advice, more reason for me to look into the Littmanns. Good to know the Classic II SE can do a good job also.

I guess it really comes down to whether or not I should get one of the Littmann stethoscopes, or the ADC or MDF cardiology stethoscopes.



My only concern with the Littmann is the tunable diaphragm which a few users in past threads have said was bad. If anyone can weigh in on their experience with that, I'd appreciate it. If the tunable diaphragms isn't a big deal, I'll probably just spring for the Littmann now, but if it's a bad feature, I'll look into the ADC or MDF equivalents.

I'm torn between this MDF ER Premier
http://www.amazon.com/MDF-Premier-Stethoscope-MDF797DDBO-Pediatric/dp/B000IF6ZO2

And the Littmann Cardiology III

Are these two equivalent or is one better?

 

[Petypet]

Get a cheaper one, ($80 ish). Learn to hear the sounds on a dummy or a simulator. I have heard more stories about nurses/docs/residents/etc "picking up" the wrong stethoscope and then the $200 "investment" is gone. Abuse the heck out of a cheap one, and then invent in a better one once your skills are sufficient and you have a need to hear every little sound. Heck, I don't know how many times I have gone in a room with an attending to see a patient and they don't even use their stethoscope.

The same goes for the expensive otoscope and other expensive toys. A lot of my classmates probably dropped several hundred dollars to make a dr bag and now they use none of those pieces equipment.

 

[Mad Jack]

All good, we're on the same page.

I'll have to keep this in mind, hopefully I can keep mine in sight.

Awesome advice, more reason for me to look into the Littmanns. Good to know the Classic II SE can do a good job also.

I guess it really comes down to whether or not I should get one of the Littmann stethoscopes, or the ADC or MDF cardiology stethoscopes.



My only concern with the Littmann is the tunable diaphragm which a few users in past threads have said was bad. If anyone can weigh in on their experience with that, I'd appreciate it. If the tunable diaphragms isn't a big deal, I'll probably just spring for the Littmann now, but if it's a bad feature, I'll look into the ADC or MDF equivalents.

I'm torn between this MDF ER Premier
http://www.amazon.com/MDF-Premier-Stethoscope-MDF797DDBO-Pediatric/dp/B000IF6ZO2

And the Littmann Cardiology III

Are these two equivalent or is one better?

Can't say about the MDF. We've got one ED attending that swears by his, other than that I've never seen one. And I'm not knocking any other scopes out there by any means. Just saying that I like my Littmann, it's never done me wrong, and the acoustic quality is far better than the Sprague-Rappaport I started off with in school. I've been playing around with the Cardiology III today, so I could compare it to the Classic II. The tunable diaphragm isn't difficult to use at all. Just place it lightly on a patient's chest and press until the sound quality changes, and you can easily get a feel for the pressure to apply for low versus high frequency sounds. It is heavier than the classic, with thicker tubing and a weightier bell, but it still isn't all that noticeable on hour shoulders. The nice thing about Littmann tubing is that it is quite flexible compared to some of the cheaper scopes I have used, leaving it less prone to flexing off of your neck when you lean over. A big bonus for me is the pedi side of the scope, as I work in neo, pedi, and adult units. Sound quality is marginally better than the classic, likely thanks to the thicker tubing. It's a solid scope, I like it so far.

I own ADC pedi and neo stethoscopes (no way in hell was I paying for a Littmann for every patient size!), but I'm not working peds today so I can't compare the sound quality between the pedi side of the cardiology III and the ADCs at the moment. The ADCs have always worked fine for day to day assessments but have always been quieter than I would like.

You can definitely get by in school without a Littmann, but buying one is a purchase you'll likely never regret so long as you don't lose it. It'll last you a lifetime, after all. I'm not saying by one or don't, but I've never really known someone that was disappointed by their performance, durability, or quality. Probably 98% of our attendings use Littmanns, with an odd Sprague thrown in every now and then. Make of that what you will.

 

[Wordead]

First, as mentioned, these things have been know to walk off frequently, so it may very well be an annual (not one time) expense. Certainly has been for me. You'll even want a back up. Second, at least in most urban hospital settings where MRSA, VRE, and c diff., etc are common, you are going to have to leave your scope at the door in over half the patient rooms in favor of disposable stethoscopes anyhow, so the value of a good scope is limited. Like owning a Ferrari you rarely get to take out of the garage and when you do you often have to risk street parking. Bad idea-- Too stupid to live. 😉

If your hospital has rules about leaving your steth outside isolation rooms, it's different from the ones I've been in. You gown/glove up and use the disposable stethoscope. Keep your steth in your pocket.

If you lose them constantly, well, that sucks. Put a tracker on it I guess. Not much else you can do.

 

[zeppelinpage4]

It looks like things may be getting a bit personal here...about what type of stethoscope to wear in your first few years of training. If you look at the post history of some of the people posting the more curt comments, you'll get a feel for how often they throw this attitude around, so place them on your ignore list now while you're just getting started.

I bought a decent starter scope for a really good price when I began medical school, then went around to the former RN/EMT/Paramedic classmates that had been using all kinds of them and asked them to compare ours and tell me if I needed to 'upgrade' mine to a Littman ASAP. To this day, not one person has ever told me to, be they a colleague/trainer/supervisor, and I still compare notes with others often just to be sure. Those that get handed a $1600 WA gift bag by your family as just that, a gift, should be thankful and know that most people aren't that lucky. They also are often the same ones that complain that the nearest BMW, Mercedes or Land Rover dealership to get their car (that their parents bought them at 23 years old) serviced at is so far away. I continue to laugh at the life lessons they've been taught and urge you to stay away from them. Too spoiled to live.

Anyways, if you get a stethoscope that is fancier than the people that actually have medical licenses around you have, you may just be asked to prove you really know how to use it; at least with me. Be prepared to explain why you chose the Littman Cardiology Master 3 or other stethoscope that is well beyond your level of training and costs way more than mine to use when rounding. If you can hear the difference in heart and lung sounds between your patients by listening in the proper areas and defend what you think you heard, that's all that is expected of you for quite a while. Being able to quickly and correctly interpret an EKG, an ABG and a PFT will impress me more. Calling out a nitro patch/paste during a code will get you an A on your eval and submission for student of the year, if you really want to know what will impress me the most when it really counts. Very observant and lived.

Start here:
http://www.wilkes.med.ucla.edu/

The "drop in the bucket" argument gets really old fast as you use it to approach everything while in your training and end up spending way more money in the short and long run on every laptop, textbook and tablet, expensive scrubs on every school or amazon list that you see and then have problems flying out for med school/residency interviews, away rotations and paying first and last month's rent when you move somewhere. Too broke to live.

I'll put it out there; if anyone on SDN has ever tuned a diaphragm for any reason in practice on a regular basis, please post why and how often. I've yet to ever hear of someone having the need to do this or seen it done in the many, many medical environments across the country I've had the pleasure of stumbling into at 4:45AM on a regular basis. I've had my equipment hold up pretty well to Cavicide, Avaguard and even those purple or gold topped mystery buckets seen often in different settings and it's also doing just fine, but the stuff you have to use to get their residue off can be a bit more abrasive.

If I see the PPE cart outside of a room, then see MRSA/C-diff/VRE/ACB/Droplet/Penem somewhere on the chart, I'm leaving everything at the nurses' desk and will do my best to separate the sounds from the ventilator from the heart sounds with the yellow disposable hanging outside the door (which also get's swabbed with a Cavi wipe for 30 seconds.) You're most valuable piece of equipment will be the N95 mask, in addition to the rest of the stuff in that box outside the door. It ALL must go in the trash BEFORE you leave the room, by the way.

Hands down, the MDF ER Premier wins by far if you want to spend over $100 and you can get it gold plated and monogrammed for less than some of the stethoscopes others have mentioned if you're really trying to make an impression with your teachers and patients.

Congratulations on Stony Brook; invest in a good flashlight for those late nights getting home from school. It's pitch black very early at night and no need to run into one of those trees walking to your dorm. Enjoy your time off while you can before you're too tired to read!

Wow, fantastic advice, thanks JGimpel. I appreciate the link to that sire and the insight. It's nice to hear some sound logic behind wanting to get a budget friendly stethoscope.

Get a cheaper one, ($80 ish). Learn to hear the sounds on a dummy or a simulator. I have heard more stories about nurses/docs/residents/etc "picking up" the wrong stethoscope and then the $200 "investment" is gone. Abuse the heck out of a cheap one, and then invent in a better one once your skills are sufficient and you have a need to hear every little sound. Heck, I don't know how many times I have gone in a room with an attending to see a patient and they don't even use their stethoscope.

The same goes for the expensive otoscope and other expensive toys. A lot of my classmates probably dropped several hundred dollars to make a dr bag and now they use none of those pieces equipment.

I agree, going with JGimpel's post and reading yours, I feel more comfortable getting a more budget firendly but hopefully decent stethoscope for now. Do you think it would be hard to transition to using a nice stethoscope if I were to get something better down the road though? I just don't want to be in a situation where the stethoscope I get now makes it difficult to hear even basic things and I end up not learning to use it properly as a result.

Can't say about the MDF. We've got one ED attending that swears by his, other than that I've never seen one. And I'm not knocking any other scopes out there by any means. Just saying that I like my Littmann, it's never done me wrong, and the acoustic quality is far better than the Sprague-Rappaport I started off with in school. I've been playing around with the Cardiology III today, so I could compare it to the Classic II. The tunable diaphragm isn't difficult to use at all. Just place it lightly on a patient's chest and press until the sound quality changes, and you can easily get a feel for the pressure to apply for low versus high frequency sounds. It is heavier than the classic, with thicker tubing and a weightier bell, but it still isn't all that noticeable on hour shoulders. The nice thing about Littmann tubing is that it is quite flexible compared to some of the cheaper scopes I have used, leaving it less prone to flexing off of your neck when you lean over. A big bonus for me is the pedi side of the scope, as I work in neo, pedi, and adult units. Sound quality is marginally better than the classic, likely thanks to the thicker tubing. It's a solid scope, I like it so far.

I own ADC pedi and neo stethoscopes (no way in hell was I paying for a Littmann for every patient size!), but I'm not working peds today so I can't compare the sound quality between the pedi side of the cardiology III and the ADCs at the moment. The ADCs have always worked fine for day to day assessments but have always been quieter than I would like.

You can definitely get by in school without a Littmann, but buying one is a purchase you'll likely never regret so long as you don't lose it. It'll last you a lifetime, after all. I'm not saying by one or don't, but I've never really known someone that was disappointed by their performance, durability, or quality. Probably 98% of our attendings use Littmanns, with an odd Sprague thrown in every now and then. Make of that what you will.

Thanks Mad Jack, that's a very fair assessment. I think I'll be looking at a good Littmann down the road, it's good to know the tunable diaphragm isn't difficult to use, it was the only thing about the Littmann's that had concerned me. I really liked the look of the Littmann's otherwise, and there's something reassuring about seeing other med students or residents carrying them around too.

 

[zeppelinpage4]

Welp! I got tired of doing all this stethoscope research and realized I'd be better served using my remaining precious winter break days for less school related things, so I caved in an ordered a stethoscope.

I went through various sites and decided to get the ADC Adscope Convertible Cardiology 🙂
http://www.amazon.com/ADSCOPE-Convertible-Cardiology-Stethoscope-Black/dp/B000NIB6IY/ref=sr_1_1?ie=UTF8&qid=1388380308&sr=8-1&keywords=ADC convertible cardiology

It seems to be a Cardiology III copy, but the reviews were quite good and from advice in this thread, it seems like this should be more than enough for my needs. The price was too good to pass up also.
Thanks so much again for all of your input guys. I learned a lot from this thread, and feel much better about my choice. Hopefully the ADC works out okay. I haven't tried it, so it was a bit of a risk buying it, but at this price I thought it would be worth a try.

Hopefully somewhere down the road if I really want or need, I can get a Cardiology III or something even nicer.