Harvey Elite vs Cardiology III - n" versions

[bluegene]

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Heya!

The reason for posting a new thread regarding the ancient battle of stethoscopes is that I've been researching my choices for a while and I've narrowed my choices down to the Welch-Allyn Harvey Elite and the Littman Cardiology III. The problem is that I haven't got access to the Harvey Elite where I am, and I've been relying much on peoples' experiences with both stethoscopes for my choice, and many of the posters do not specify which lengths they've had experience with (and there are several accounts on size actually mattering).

Perhaps I'm being a little bit too Type A, but I'd really like hear the experience of those who've used these stethoscopes, which length, which one they prefer over the other (and why), and (if available), which speciality you're mainly using it for.

 

[FIREitUP]

Heya!

The reason for posting a new thread regarding the ancient battle of stethoscopes is that I've been researching my choices for a while and I've narrowed my choices down to the Welch-Allyn Harvey Elite and the Littman Cardiology III. The problem is that I haven't got access to the Harvey Elite where I am, and I've been relying much on peoples' experiences with both stethoscopes for my choice, and many of the posters do not specify which lengths they've had experience with (and there are several accounts on size actually mattering).

Perhaps I'm being a little bit too Type A, but I'd really like hear the experience of those who've used these stethoscopes, which length, which one they prefer over the other (and why), and (if available), which speciality you're mainly using it for.

you're really reading into this a bit too much. you could probably make do with a $15 sprague if you wanted to. personally i like my welch allyn harvey elite because it's comfortable and I don't get as many artifacts as with my cheap steth. plus, every person at my school has a cardio 3, which makes it really lame.

 

[OveractiveBrain]

you're really reading into this a bit too much. you could probably make do with a $15 sprague if you wanted to. personally i like my welch allyn harvey elite because it's comfortable and I don't get as many artifacts as with my cheap steth. plus, every person at my school has a cardio 3, which makes it really lame.

Its the Farmer, not the tools, right?
But a Diesel Tractor sure is better than a pair of oxen​

I've said this many times before. I'd like to think that it is the FARMER and not the TRACTOR that causes the bad crops. And, for sure, you give a novice a Cardio III and they are no better than the novice with the yellow one they keep in isolation rooms. But here's my argument.

If you are a novice, and you "can't here" what other people hear, you are likely to make up excuses. Really, you're likely to say "oh I heard it" (forcefully nodding your head as if by agreeing you make yourself more believable). BUt in your head, you'll say things like "oh that was too subtle" or "oh, he's got a better scope." And I know this sounds hokey, but if you give a novice a great scope (and a great teacher) the only burden is on the novice, not the equipment.

My girlfriend has a murmur. I'm pretty into the physical exam. No master, but pretty damn good. I couldn't hear her murmur without making her do 25 jumping jacks (which is pretty awesome in and of itself) to get her heart rate and contractility up. At rest, no way. I was using a Master Classic II. Ok, then I got a CArdio III. At rest, all the way. No jumping jacks required.

Bottom line, a better scope gives the learner more confidence and shifts the responsibility onto the learner, not the equipment. This makes learning more enjoyable (because you are sure that its you when you can't hear it, and you are more likely to hear an adventitous sound for the first time with it).

As far as which top-of-the-line scope you get? Who cares. Cardiology III works well, I've used Littman throughout my medical and pre-hospital career, and its looks cool. I think the Welch-Allyn is too kooky looking, regardless of whatever 0.1% advantage it may give. Three heads. Seriously. I totally chose Cardio III over Welchy because of looks. Sue me. At that level, they are basically quality the same.

Im in Medicine

 

[LoveandHate]

I've said this many times before. I'd like to think that it is the FARMER and not the TRACTOR that causes the bad crops. And, for sure, you give a novice a Cardio III and they are no better than the novice with the yellow one they keep in isolation rooms. But here's my argument.

If you are a novice, and you "can't here" what other people hear, you are likely to make up excuses. Really, you're likely to say "oh I heard it" (forcefully nodding your head as if by agreeing you make yourself more believable). BUt in your head, you'll say things like "oh that was too subtle" or "oh, he's got a better scope." And I know this sounds hokey, but if you give a novice a great scope (and a great teacher) the only burden is on the novice, not the equipment.

My girlfriend has a murmur. I'm pretty into the physical exam. No master, but pretty damn good. I couldn't hear her murmur without making her do 25 jumping jacks (which is pretty awesome in and of itself) to get her heart rate and contractility up. At rest, no way. I was using a Master Classic II. Ok, then I got a CArdio III. At rest, all the way. No jumping jacks required.

Bottom line, a better scope gives the learner more confidence and shifts the responsibility onto the learner, not the equipment. This makes learning more enjoyable (because you are sure that its you when you can't hear it, and you are more likely to hear an adventitous sound for the first time with it).

As far as which top-of-the-line scope you get? Who cares. Cardiology III works well, I've used Littman throughout my medical and pre-hospital career, and its looks cool. I think the Welch-Allyn is too kooky looking, regardless of whatever 0.1% advantage it may give. Three heads. Seriously. I totally chose Cardio III over Welchy because of looks. Sue me. At the level, they are basically quality the same

😎 👍

 

[xanthomondo]

Its the Farmer, not the tools, right?
But a Diesel Tractor sure is better than a pair of oxen​

I've said this many times before. I'd like to think that it is the FARMER and not the TRACTOR that causes the bad crops. And, for sure, you give a novice a Cardio III and they are no better than the novice with the yellow one they keep in isolation rooms. But here's my argument.

If you are a novice, and you "can't here" what other people hear, you are likely to make up excuses. Really, you're likely to say "oh I heard it" (forcefully nodding your head as if by agreeing you make yourself more believable). BUt in your head, you'll say things like "oh that was too subtle" or "oh, he's got a better scope." And I know this sounds hokey, but if you give a novice a great scope (and a great teacher) the only burden is on the novice, not the equipment.

My girlfriend has a murmur. I'm pretty into the physical exam. No master, but pretty damn good. I couldn't hear her murmur without making her do 25 jumping jacks (which is pretty awesome in and of itself) to get her heart rate and contractility up. At rest, no way. I was using a Master Classic II. Ok, then I got a CArdio III. At rest, all the way. No jumping jacks required.

Bottom line, a better scope gives the learner more confidence and shifts the responsibility onto the learner, not the equipment. This makes learning more enjoyable (because you are sure that its you when you can't hear it, and you are more likely to hear an adventitous sound for the first time with it).

As far as which top-of-the-line scope you get? Who cares. Cardiology III works well, I've used Littman throughout my medical and pre-hospital career, and its looks cool. I think the Welch-Allyn is too kooky looking, regardless of whatever 0.1% advantage it may give. Three heads. Seriously. I totally chose Cardio III over Welchy because of looks. Sue me. At that level, they are basically quality the same.

Im in Medicine

So when you upgraded your scope you admit you could instantly hear the murmur better but then still blame "the listener" for not having confidence?

Maybe the Cardio III gave you better sound that actually makes a difference when listening?

 

[mishaS]

I'm an M1, so I can't really give any useful feedback on which is actually better, but based on all of the threads I got the Harvey Elite because it seemed liked there were more converts who went to Welch Allyn than the other way around (though this could be because there are so much fewer people who get a Welch Allyn to begin with) but more importantly because I don't think a tuneable diaphragm is a good idea for anyone who is learning auscultation. Having a tuneable diaphragm, and no knowledge of what to listen for seems like a terrible learning combination, because to learn how to hear the sound you have to hear the sound correctly, and to do so you have to use your scope correctly, which to learn you need to be able to know what the the murmurs sound like, but to hear them properly... You get the idea, it seems like a chicken vs. egg dilemma.

The Welch Allyn, having a bell built to be an actual bell, instead of a pediatric diaphragm that's removable making a bell (I believe I've read the shape difference has effects), and the fact that Littmans don't have adjustable biaural's (which the $15 Sprague Rappaport I have has) were also reasons I went with the Welch Allyn.

Either way though, they're both solid scopes, and neither should be the limiting factor in hearing heart sounds. Frankly, those things that drove me over the top, in the scheme of things, are probably extremely minor; I'm just obsessive with this sort of thing, and read wayyyyyy too many reviews before I buy anything (which research has apparently shown makes you much less satisfied overall than if you just blow your money without thinking about it).

Incidentally, while I've had the scope though, I think I might have caught a murmur in myself, which now I'll have to make an appointment to see my doc, to have him confirm/deny my suspension.

edit*
And for the record, I think the Harvey Elite is sexier than the Cardio III 😛

 

[tiedyeddog]

edit*
And for the record, I think the Harvey Elite is sexier than the Cardio III 😛

You guys are weird.

 

[tkim]

The Harvey is an inch longer than the Littmann, which is key - you want as much distance between you and the stinky patient. Loss of sound by one inch of distance will not be detectable by a human ear.

Littmans nowadays have aluminum binaurals, which completely throw off the balance of the steth. Harveys still have stainless steel binaurals.

I have the old style Littman Cardiology IISE, which was like my old beloved Cardiology I with a heavy chestpiece and binaurals, the IISE has aluminum binaurals.

The Harvey has a triple-leaf binaural spring versus the double leaf in the Littmann.

So, bottom line - more stainless steel parts, longer tubing, triple leaf binaural - go with Harvey. That will be my next steth, though my Littmann is still going strong.

 

[mishaS]

For what it's worth, I've heard the DLX is better than the Harvey in terms of sound quality, but the rubber ring and plastic end to the bell really make life easy because you don't have to remember to warm your stethoscope.

 

[tkim]

For what it's worth, I've heard the DLX is better than the Harvey in terms of sound quality, but the rubber ring and plastic end to the bell really make life easy because you don't have to remember to warm your stethoscope.

Then difference is the acoustic head, since it uses the same tubing and binaurals. I wouldn't get the triple head - I don't take myself that seriously. And others would stop taking me seriously if I sported one of those.

 

[DeadCactus]

The Harvey has an acoustic benefit that you probably couldn't actually recognize without sophisticated testing. It's also heavier and less flexible than the Cardiology III.

It really doesn't matter. Get the Harvey if you psychologically need acoustics better than you can actually notice; get the Cardiology III if you want something more convenient and less cumbersome.

I have a Harvey. I like my Harvey, it's just heavy and I doubt I'd notice an acoustic difference. If I buy another, it'll probably be a Cardiology III. Or maybe not. Damn the anal engineering nerd in me...

 

[mishaS]

Then difference is the acoustic head, since it uses the same tubing and binaurals. I wouldn't get the triple head - I don't take myself that seriously. And others would stop taking me seriously if I sported one of those.

I don't understand this culture of discouragement towards getting better stethoscopes. I've read, repeatedly, that those who get electronic stethoscopes are laughed at unless they have hearing loss, which is the only thing that makes it ok to have one. If a stethoscope lets you better auscultate, and lets you detect a heart murmur that otherwise could have been missed, and improves your patients' outcomes, how the hell can it be discouraged? If we start seeing serious cuts, and doctors are less able to send every single suspected murmur to get an ultrasound, it seems something like good auscultation skills with a good scope could be of great benefit.

Above all else, the notion doctors judging each other on something so superficial seems completely counter to both the ideas of us being intelligent, and independent thinkers.

 

[tkim]

I don't understand this culture of discouragement towards getting better stethoscopes. I've read, repeatedly, that those who get electronic stethoscopes are laughed at unless they have hearing loss, which is the only thing that makes it ok to have one. If a stethoscope lets you better auscultate, and lets you detect a heart murmur that otherwise could have been missed, and improves your patients' outcomes, how the hell can it be discouraged? If we start seeing serious cuts, and doctors are less able to send every single suspected murmur to get an ultrasound, it seems something like good auscultation skills with a good scope could be of great benefit.

Above all else, the notion doctors judging each other on something so superficial seems completely counter to both the ideas of us being intelligent, and independent thinkers.

Lighten up, Francis.

 

[Druggernaut]

I don't understand this culture of discouragement towards getting better stethoscopes.

Are you going to carry around extra batteries all the time? They'll die eventually, and then you'll be left with an isolation stethoscope the rest of the day. I'd rather use something that would work well all the time.

 

[tiedyeddog]

I don't understand this culture of discouragement towards getting better stethoscopes.

Because the better 'scopes cost a ton more money than lower performing ones, and your average M1 might not end up using it all that much after medical school.

 

[mishaS]

Lighten up, Francis.

Heh, ok dude. I wasn't freaking out, I just think the mentality I've heard about repeatedly is pretty ridiculous, and that this attitude, of putting social acceptance above patient welfare, is a sign of social immaturity. I'd expect that kind of **** in high school, not medical school, let alone among practicing doctors in a professional environment.

Because the better 'scopes cost a ton more money than lower performing ones, and your average M1 might not end up using it all that much after medical school.

Define "a ton more" because, last I checked, a decent stethoscope cost less than two textbooks which are used for one class, you could use a good scope for years. Compared to what medical school costs, it's a drop in the bucket. Hell, I'm not even talking about in medical school, I'm talking about the attitude of doctors, who surely could afford to spend even $300 on an electronic scope if they thought it would be a useful tool. It sounds to me that cost isn't the issue here as much as a mocking attitude towards "try hards."

Are you going to carry around extra batteries all the time? They'll die eventually, and then you'll be left with an isolation stethoscope the rest of the day. I'd rather use something that would work well all the time.

I don't know if other scopes use some sort of exotic battery, but the Littmann 3100 uses a AAA, which I imagine would be available in any hospital storage. At the children's hospital I volunteered at, whenever a toy ran out of batteries, we could just go into a treatment room and grab some. Anyways, like I've said, I'm saying everyone should get an electronic scope, only that it bothers me that there is pressure to not get whatever you think might be best, because other doctors might snicker at you behind your back.

 

[tkim]

Heh, ok dude. I wasn't freaking out, I just think the mentality I've heard about repeatedly is pretty ridiculous, and that this attitude, of putting social acceptance above patient welfare, is a sign of social immaturity. I'd expect that kind of **** in high school, not medical school, let alone among practicing doctors in a professional environment.

Med school is high school. Residency the frat hazing/secret society ritual you never had. Realizing this now makes it more understandable come clinicals and beyond.

 

[mishaS]

Med school is high school. Residency the frat hazing/secret society ritual you never had. Realizing this now makes it more understandable come clinicals and beyond.

I do see this, but, again, doesn't it bother you that people who are supposed to be intelligent are so lacking in their free thinking abilities?

 

[tkim]

I do see this, but, again, doesn't it bother you that people who are supposed to be intelligent are so lacking in their free thinking abilities?

Not since med school.

 

[tiedyeddog]

Define "a ton more" because, last I checked, a decent stethoscope cost less than two textbooks which are used for one class, you could use a good scope for years. Compared to what medical school costs, it's a drop in the bucket. Hell, I'm not even talking about in medical school, I'm talking about the attitude of doctors, who surely could afford to spend even $300 on an electronic scope if they thought it would be a useful tool. It sounds to me that cost isn't the issue here as much as a mocking attitude towards "try hards."

I understand what you're saying. But many people don't even end up buying the "required" books, because they wouldn't use them anyway. If you bought the best of everything that is suggested you would end up spending thousands of dollars more, when you might not even use most of it.... It all adds up.

 

[bluegene]

Truly thank you all for sharing suggestions and your experiences. Seems like the stethoscopes both have their ups and downs and in general are fairly equal. I've now ordered the Harvey Elite out of sheer curiosity as I've previously tried the Cardiology III.

It'll be exciting to try out!

 

[OveractiveBrain]

So when you upgraded your scope you admit you could instantly hear the murmur better but then still blame "the listener" for not having confidence?

Maybe the Cardio III gave you better sound that actually makes a difference when listening?

Uhm. That was the point. Better scopes = better learning and more confidence.

I don't understand this culture of discouragement towards getting better stethoscopes.

The culture is wrong. I encourage people to upgrade their stethoscope. 300 dollars over 3 years on top of 50,000 a year really isnt much of a dent for medical students. What I think people are feeling is "learning how to use the stethoscope is hard, so I dont want to use one. Since I dont use it, why spend money on an expensive one? People who have an expensive one must be trying too hard (NERDS!)... just order the echo." I personally believe there is power in the physical exam; how powerful it is is based on how good the examiner is at doing the exam.

 

[mishaS]

Uhm. That was the point. Better scopes = better learning and more confidence.



The culture is wrong. I encourage people to upgrade their stethoscope. 300 dollars over 3 years on top of 50,000 a year really isnt much of a dent for medical students. What I think people are feeling is "learning how to use the stethoscope is hard, so I dont want to use one. Since I dont use it, why spend money on an expensive one? People who have an expensive one must be trying too hard (NERDS!)... just order the echo." I personally believe there is power in the physical exam; how powerful it is is based on how good the examiner is at doing the exam.

+1

I'm glad I'm not the only one who feels this way.

I understand what you're saying. But many people don't even end up buying the "required" books, because they wouldn't use them anyway. If you bought the best of everything that is suggested you would end up spending thousands of dollars more, when you might not even use most of it.... It all adds up.

Oh, I agree. So far I haven't bought a single book (I had a netters already), required or otherwise. I also have no intention of buying an otoscope, ophthalmoscope, or any of the other gadgets our school "requires," even though we might use them once, and they can be found in pretty much every medical office, on the wall. You know when an you ask an ophthalmologist resident about whether you need a scope, and he offers to sell you the one he got for med school for a massive discount, barely used, that it's a waste. I guess I just feel that you'll really get your money's worth with a good stethoscope because it will be something you will use heavily in your clinical rotations, and possibly afterwards depending on your career choice.