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Medical equipment: stethoscopes etc.

Discussion in 'Pre-Medical - DO' started by VM, May 12, 1999.

  1. VM

    VM Senior Member
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    We're supposed to buy a stethoscope and some other equipment even for the first year aren't we? I think we are. Does anyone have any recommendations about what brand/model to buy and where to buy?
     
  2. Duke

    Duke Member
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    I heard that it was better to wait until school started or at least until orientation. Besides, it might be better to ask around to find the best kind of equipment to buy. As far as stethoscopes go, there is a tremendous difference.
    Which leads to my question. Which is the best stethoscope to buy at an affordable price?
    Duke
     
  3. OldManDave

    OldManDave Fossil Bouncer Emeritus
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    everyone I have asked has said to wait until you get to wherever you are going to buy stuff. In fact, several have mentioned extremely cheap prices thru drug and sales reps...guess they start catering early?

    I can, however, give what i know about stethescopes. Most of the residents that I have worked with over the years carried rapaports [sp?]. They are majorly inexpensive. Last time I priced one was under $30. However, in my humble opinion, you get what you pay for!! They stink for anything more than taking BPs. For the money/quality equation...get a Littman. Now don't run out and but one of those $400 Master Cardiac IIIs...You can spend $75~100 on a Littman Classic II with an adult head on it and extended tubing and have an excellent scope for a lifetime. I have carried a Littman Pediatric scope for 9 years and LOVE it still. The only reason I'm on the second was cuz the first one was swiped...and that happens all too often!



    ------------------
    'Old Man Dave'
    KCOM, Class of '03
     
  4. jdaasbo

    jdaasbo Senior Member
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    anyone who sold you a Littmann cardiology III scope for $400 dollars mugged you completely. They probably had a nice dinner afterwards.

    A Littman cardiology III or cardiology Master scope should cost no more than $140. I have seen them for $121 AND $126 respectively. Get a good scope you will need it to hear the cardio sounds (clicks, murmurs, etc.) If you get a lower quality one you are hindering your learning to hear these extremely fine sounds. Other good scopes are the Hewlitt-Packard (spelling?) and Welch-Allyn Tycos. These should cost in the same ball-park as the top of the line Littmanns from above.

    Do not get a single lument scope as the sound quality is poorer. Our Clinical med class at CCOM required us to have double lumen scopes. The Littmanns have one tube, but two lumens within the tube. This is better because then you don't get the noise of the tubes rubbing against eachother when you listen. other manufacturers like Tycos-Welch Allyn have this feature too. double lumen scopes have a n A-fram juncture rather than the Y juncture (these are not technical terms, but perhaps you have a mental image of what I mean).

    Diagnostic kits (ophthalmascope, otoscope, etc.) should cost $250-280 and no more. Many many med students get ripped off because they have no idea what these things should cost. In Chicago, the University of Illinois at Chicago Medical Bookstore prices like these and so do lots of other medical bookstores. There are lots of places on the internet, and most schools sponsor equipment sales which offer similar prices.
     
  5. OldManDave

    OldManDave Fossil Bouncer Emeritus
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    Relax, I did not and would not pay $400 for any scope! However, I have seen Littman Cardio Master IIIs priced at exactly that, circa $400. I even know of a cardiologist who bragged about paying only $300 for his. Go figure!

    Like I said, I love my Littman Pediatric...wonderful sound quality! And your are MOST correct about double lumen scopes and avoiding those whose double tubes are left to rub one another.

    Another recommendation...one from personal experience, if you can, get extended tubing models. There is no degredation in sound quality and the first time some patient, who hasn't brushed their teeth in God knows how long, breaths right in your face cause your have a short-tubed scope...you will KNOW that I SPEAKETH THE TRUTH! [​IMG]



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    'Old Man Dave'
    KCOM, Class of '03
     
  6. edgar

    edgar Senior Member
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    I think you guys are talking about the top-of-the-line Littman that is an electronic stethoscope. The $400 figure sounds about right, I think only a cardiologist would need such a fancy toy. I bought a Master Cardiology (Littman)in October for about $150. This model is the top-of-the-line "conventional" Littman stethoscope.

    EDGAR
     
  7. mevannorden

    mevannorden Member
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    At UOMHS, the Student Osteopathic Medical Association held an equipment sale. Prices from the sale were much better than could've been obtained from the bookstore or any other medical supply store because of the quanity discount. I could've gotten a Littman Master Cardiology scope for about $120, but ended up getting one free through a club raffle (price to enter, $20. Pretty good deal!).
     
  8. ReneeWB

    ReneeWB Senior Member
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    I am planning to wait until school starts to buy any of my medical instruments. However, I remembered that I have a stethoscope which was given to me as a gift several years ago by my mother-in-law. At the time I was planning on starting nursing school; after I decided to go pre-med I just put it away. It has never been used. It is a Marshall Sprague Rappaport type stethoscope (I am just typing what is written on the box). It says it is a five-in-one. I suspect that this is not the best instrument, however I wondered if it would be good for anything during medical school. Or should I just put it back in the drawer. I know absolutely nothing about which stethoscopes are best but have read the previous posters recommendations for Littmans. Can anyone tell me anything about this stethoscope that I have?

    Thanks.

    Renee
     
  9. UHS2002

    UHS2002 Senior Member
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    I agree with OldManDave that the sprague rappaport is basically only good enough for taking BPs and telling if your patient has a heart... I think their popularity came from the show ER, where everybody seems to have one...

    When I worked EMS we had them on the ambulances and, honestly, they sucked!!! Nobody at the ER, in the major level 1 trauma center we transported to, had one of those. All the docs and nurses had Littmans. Using the spragues, in the noisy environment we worked in, you could hardly tell the patient had a heart beat, much less make some more subtle but necessary distinctions about their lung sounds...In the ambulance they were useless even to take BPs, so we always had to use palpated BPs.

    I have a $20 nurse stethoscope that is far better than the spragues we had, which cost about $30-$35. I didn't trust it enough though, to base my decisions on what I heard with it, so I bought a Littman Cardiology SE II and never looked back. I used it for several years and feel very comfortable with it, but it takes a while to get used to it because it has one of those pressure sensitive diaphragms, so I would also recommend that you get a Littman with a diaphragm and bell. Additionally, some schools will not allow their students to use the pressure diaphragm models.

    When you become good at listening to heart and breath sounds, even a cheap $20 model will do, in a pinch, because you have fine tuned your hearing to pick up the sounds. But if you are trying to learn using the sprague, you will always be wondering why everyone hears the murmurs but you...
     
  10. turtleboard

    turtleboard SDN Advisor
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    According to friends already in medical school and physicians I've worked with in years past, it's definitely Littmann all the way.

    I'm starting school in a few weeks and recently purcahsed a Littmann Cardiology III stethoscope (3M's #2 stethoscope, next to the Master Cardio) for $125 off the net. I was advised by my school to get a Littmann brand stethoscope.

    Tim of New York City.
     
  11. jdaasbo

    jdaasbo Senior Member
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    Interesting topic again. I used to use a Littmann Cardio II SE (same thing as Cardio III, except the cardio III has a second peds diapragm that doubles as a bell instead of having a dedicated bell). I was like everyone else: I looked around and saw only Littmanns and thought "those must be the best." So that is what I got. When i started listening to heart sounds in earnest (this summer) i was having a really tough time, especially in the clinic when other things were going on around me. I thought it was just that i wasn't focusing in enough.

    Then i tried someone's Tycos Harvey DLX. It was a world of difference to me. Like finding out you have had cataracts your whole life. I liked it so much better I could justify spending another $150. I just bought it today actually. I found that in comparison to the Littmann the Harvey has a much louder and also deeper sound and tends to pick up less ambient noise. With the Littmann I was always hearing my hand vibrations and blood vessels in my fingers. Also wearing the headset was uncomfortable as the earpieces were always squeezing my ears (the Littmanns are rather spring loaded this way).

    I feel like Littmann must have an excellent marketing campaign, because in my opinion their product is far inferior to the Harvey. This is just my opinion ofcourse and I am sure it is different for different people.

    In the cardiology department where I shadow, the doctors use three different brands of stethoscopes. Most use Littmann Master Cardiologies (in my opinion definately better than the Cardio III, but i still like the Harvey way better). One doc uses a Hewlitt Packard Sprague Model. And two use Tycos Harvey DLXs.

    A word about the Sprague-Rappaport models. Sprague-Rappaport is a generic style. Hewlitt Packard makes a quality one that a lot of people swear by. There are a lot of cheapo $30 spragues made.

    That all said, I think it is a pretty personal choice. I think a lot of people go with Littmann because 90% of the docs out there use it. Also most stores only carry Littmann. If I were buying for the first time, I would find a store that carries all the models from all the companies and listen to them, one after another. Make your decision when you are sure and trust your ears.
     
  12. OldManDave

    OldManDave Fossil Bouncer Emeritus
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    Like jdaasbo & UHS2002 said, listen with several of the scopes---->it is a personal choice. However, AVOID the cheapie $30 rappaport "ER" models. "Suck" doesn't even begin to describe them!

    Personally, I love the Littman's. I have used several different scopes in 10 years as a resp therapist; and that's the brand I still carry. But, there are several other respectible brands and even a few other 'great' brands. I've never used a Tycos...but have heard good things. As far as the Hewlett-Packard, they're nice as far as the traditional Sprague style...but be wary of any scope that has dual tubes that run parallel. You will always have tube rub and pick-up more ambient noise. Littman's are dual tube; but are wrapped together to prevent tube rub.

    I'll be buying a Littman Cardiac III with extra long tubes. I'm telling you, get the long tubes!!

    [​IMG]

    ------------------
    'Old Man Dave'
    KCOM, Class of '03


     
  13. drhenderson

    drhenderson Senior Member
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    I think that electronic stethoscope is called the Hewlett-Packard Stethos. They sent me a contract trying to get me to sell them on Medicalstudent.net, but I had to buy 5, keep them on stock, and sell them for $349 a piece on my site. I'm just a poor second year resident! Forget it! I can barely afford the bag of Ramin noodles I'm eating!

    Anyway, if anyone has used that Electronic deal, please post your experience here!

    Jim Henderson, MD of Medicalstudent.net
    [email protected]

    [This message has been edited by drhenderson (edited July 26, 1999).]
     
  14. OldManDave

    OldManDave Fossil Bouncer Emeritus
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    WOW Dr. Jim...that was damned nice of them!

    ------------------
    'Old Man Dave'
    KCOM, Class of '03


     
  15. cliff

    cliff Senior Member
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    I was told to buy a littman heavy head and to not cut the tubes short. I was told many people advise med students to cut the tubes on their stethoscopes to make it easier to hear certain sounds. It was pointed out to me that you will want the longest tubes possible after you encounter your first large patient.

    Anyway- what is a littman heavyhead?
    thanx.
     
  16. jdaasbo

    jdaasbo Senior Member
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    there is no such thing as a littmann "heavy head". That would be an awfull name marketing wise wouldn't it.

    I think your friend was advising you to purchase a stethoscope that had a chestpiece with some weight to it. This is good advice. More expensive models will be heavier in this regard.

    As far as cutting stethoscope tubes: DONT. Maybe this was done in 1960, but this will mess up your warranty and probably compromise the sound quality. Littmann makes their stethoscopes in two tube lengths. Shorter means better sound quality but has the disadvantage of perhaps limiting your reach.

    As for electronic scopes, I know that both Hewlitt and Littmann are making them. Apparently they are not so good. The Littmann has had its shipping date held back indefinately. The Hewlitt is pretty good at picking up room noise. This is what a cardiologist told me, but he could be wrong (so anyone from either of these companies please don't sue me).

    Remember the apple newton? I think that these early electronic scopes are much the same species of fish, if you will. They will be replace by much better and cheaper later generations.
     
  17. rf

    rf Junior Member

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    I'd recommend waiting until going to school, try out some, see which are the most comfortable-you will be using these for a while. Littman, harvey etc are all good names. At this stage in the game you are not going to be able to differentiate the minute differences in a $400 scope vs one of $100. The most important part of the stethoscope is what lies between the ear pieces.
     

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