So I just got my new master cardiology

[fisherrman]

Hey guys please help...
Just got my gift littman master cardiology, It's my first stethescope experience, I put it a test on myself, it was okay on card sounds , easily heard but not like loudspeaker as I expected.
I cant hear any radial sound.
My friend who has the littmann classic 2 put it a test and she said theres no difference with these two steths.
She also said to me she tried her professor's steth master cardiology 1year ago and she didnt realize any difference with master and classic2 back then too.
There must be someone who tried these two stethescopes, is there any difference at all between them?
Please help me bec If it isnt okay to hear this way I will send this stethescope to the service .

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[sloop]

Hey guys please help...
Just got my gift littman master cardiology, It's my first stethescope experience, I put it a test on myself, it was okay on card sounds , easily heard but not like loudspeaker as I expected.

Welcome to the world of cardiac auscultation. Heart sounds are difficult to hear, and are even harder in a hospital room with beeping IV pumps, another team rounding on the patient next to you, etc. Even though this shouldn't really be the case, you'll soon realize that like 80%+ of non-cardiologist doctors are mostly just going through the motions anyway. People who don't truly listen to hearts for a living will hear some obvious stuff like a severe systolic ejection murmur or a loud s3, but most of this **** is subtle.

If you were expecting a "speaker," you need an electronic stethoscope (btw, don't buy one of those).

I cant hear any radial sound.

Good. You shouldn't. As a rule, vascular bruits are bad.

My friend who has the littmann classic 2 put it a test and she said theres no difference with these two steths.
She also said to me she tried her professor's steth master cardiology 1year ago and she didnt realize any difference with master and classic2 back then too.
There must be someone who tried these two stethescopes, is there any difference at all between them?
Please help me bec If it isnt okay to hear this way I will send this stethescope to the service .

Relax, dude. Stethoscopes are not magic. They're basically just sophisticated and finely tuned versions of taking your ear and placing it directly on your patient's chest. I think you expected too much from a stethoscope.

 

[username456789]

Is this a serious thread?

 

[Psai]

The stuff between your ears is more important than the stuff in your ears

 

[fisherrman]

Welcome to the world of cardiac auscultation. Heart sounds are difficult to hear, and are even harder in a hospital room with beeping IV pumps, another team rounding on the patient next to you, etc. Even though this shouldn't really be the case, you'll soon realize that like 80%+ of non-cardiologist doctors are mostly just going through the motions anyway. People who don't truly listen to hearts for a living will hear some obvious stuff like a severe systolic ejection murmur or a loud s3, but most of this **** is subtle.

If you were expecting a "speaker," you need an electronic stethoscope (btw, don't buy one of those).



Good. You shouldn't. As a rule, vascular bruits are bad.



Relax, dude. Stethoscopes are not magic. They're basically just sophisticated and finely tuned versions of taking your ear and placing it directly on your patient's chest. I think you expected too much from a stethoscope.

Thank you for your answer

 

[WheezyBaby]

It's more about being able to figure out what you're hearing, not making it "loud enough to hear". A cards guy can use this

and "outlisten" you with your master cards

 

[fisherrman]

It's more about being able to figure out what you're hearing, not making it "loud enough to hear". A cards guy can use this

and "outlisten" you with your master cards

Yeah no question

 

[Morzh]

Agree with what's been said - it doesn't really matter unless you're a cardiologist (even then it's arguable).

But to answer your question: I went through med school with the master cardiology and it was more than adequate for my needs. I'm not sure I've ever used the classic ii, but the most popular stethoscope among my classmates, by far, was the cardiology iii. To be honest I felt I could hear a litter clearer with my master, but I believe this was 90% because I was used to my own stethoscope's sound.

I like the master cardiology's tunable diaphragm. I know it's a weird concept to people who've never used anything but the cardiology iii's stand-alone bell and diaphragm pieces, but after getting over the small learning curve I love being able to directly fine-tune the pressure of the diaphragm to the precise point where I hear a sound the clearest. Imagine a tympani drum that you can manually tighten or loosen to play higher or lower pitches as you please.

But by far my favorite thing about the master cardiology? The tunable diaphragm also lightens it up to ~6 oz vs the cardiology iii's ~13 oz. 5 hour ICU rounds with your scope hanging over your neck and you appreciate the difference! I also think it looks snazzier with its shiny silver back.

Also, it's really hard to listen to your own heart/lungs with any scope... the positioning is all weird and there's way too much interference and rubbing of the tubing.

Tl;dr: You got a $190 scope as a gift - just keep it! Also anybody with a cardiology iii or classic reading, just keep what you've got! None of them are worth swapping.

 

[throwaway948738]

You've got a fancy steth. good for you.

But can you read an EKG?

 

[cbrons]

When is portable ultrasound going to replace this garbage 200 year old technology so we can stop getting ridiculous exam questions about diastolic mumurs that no one can hear outside of an NBME exam

Sent from my SM-N910P using SDN mobile

 

[fisherrman]

Agree with what's been said - it doesn't really matter unless you're a cardiologist (even then it's arguable).

But to answer your question: I went through med school with the master cardiology and it was more than adequate for my needs. I'm not sure I've ever used the classic ii, but the most popular stethoscope among my classmates, by far, was the cardiology iii. To be honest I felt I could hear a litter clearer with my master, but I believe this was 90% because I was used to my own stethoscope's sound.

I like the master cardiology's tunable diaphragm. I know it's a weird concept to people who've never used anything but the cardiology iii's stand-alone bell and diaphragm pieces, but after getting over the small learning curve I love being able to directly fine-tune the pressure of the diaphragm to the precise point where I hear a sound the clearest. Imagine a tympani drum that you can manually tighten or loosen to play higher or lower pitches as you please.

But by far my favorite thing about the master cardiology? The tunable diaphragm also lightens it up to ~6 oz vs the cardiology iii's ~13 oz. 5 hour ICU rounds with your scope hanging over your neck and you appreciate the difference! I also think it looks snazzier with its shiny silver back.

Also, it's really hard to listen to your own heart/lungs with any scope... the positioning is all weird and there's way too much interference and rubbing of the tubing.

Tl;dr: You got a $190 scope as a gift - just keep it! Also anybody with a cardiology iii or classic reading, just keep what you've got! None of them are worth swapping.

Thank you very much for your time and your response.I will keep it of course, I just wanted to know if theres anythng wrong with it.And intrestingly I can hear my heart sounds better compared to the other people.
Everywhere its been told that this is the ultimate non electronic stethescope one can buy.
Just dissapointed when my friend told me its slightly better if not equal compared to the cllasic 2.

 

[fisherrman]

You've got a fancy steth. good for you.

But can you read an EKG?

Yes my grades are very high and thats sortof how I ended up being gifted with this stethescope

 

[Instatewaiter]

When is portable ultrasound going to replace this garbage 200 year old technology so we can stop getting ridiculous exam questions about diastolic mumurs that no one can hear outside of an NBME exam

Sent from my SM-N910P using SDN mobile

Probably when they cost a lot less than 10K each:
https://www.medexsupply.com/diagnos...ml?pid=74398&gclid=CKjpvomfps0CFVAjgQodSCYErw

Also, performing an echo can be tricky and those portable machines aren't all that great.

 

[throwaway948738]

Yes my grades are very high and thats sortof how I ended up being gifted with this stethescope

you're too humble.

 

[fisherrman]

you're too humble.

Thank you

 

[OnePunchBiopsy]

Hey guys please help...
Just got my gift littman master cardiology, It's my first stethescope experience, I put it a test on myself, it was okay on card sounds , easily heard but not like loudspeaker as I expected.
I cant hear any radial sound.

Auscultation requires lots of practice. I started with a Cardio III and I remember my first week on the wards; the joints of my fingers were always disrupting the heart sounds. A few words of advice:

1.) Focus on listening for S1 and S2. If you have difficulty hearing them, palpate for a radial pulse while auscultating; the pulse should come right after S1.
2.) Listen to patients whenever possible. You need to hear lots of normal before picking up abnormal things.
3.) The American College of Cardiology has a great resource called "Heart Songs," it is what I used during my second year to learn the murmurs. I always listened to them while running on the treadmill.
https://www.acc.org/education-and-meetings/products-and-resources/heart-songs

There must be someone who tried these two stethescopes, is there any difference at all between them?

A master cardiology has a compressible membrane that can alternate between diaphragm auscultation and bell auscultation with varying pressures (more pressure = diaphragm, less pressure = bell). The Cardio III has this as well. The Classic II has a separate diaphragm and bell on opposing sides, and has a thinner tube that allows it to fold easier in your pocket.

 

[fisherrman]

Auscultation requires lots of practice. I started with a Cardio III and I remember my first week on the wards; the joints of my fingers were always disrupting the heart sounds. A few words of advice:

1.) Focus on listening for S1 and S2. If you have difficulty hearing them, palpate for a radial pulse while auscultating; the pulse should come right after S1.
2.) Listen to patients whenever possible. You need to hear lots of normal before picking up abnormal things.
3.) The American College of Cardiology has a great resource called "Heart Songs," it is what I used during my second year to learn the murmurs. I always listened to them while running on the treadmill.
https://www.acc.org/education-and-meetings/products-and-resources/heart-songs



A master cardiology has a compressible membrane that can alternate between diaphragm auscultation and bell auscultation with varying pressures (more pressure = diaphragm, less pressure = bell). The Cardio III has this as well. The Classic II has a separate diaphragm and bell on opposing sides, and has a thinner tube that allows it to fold easier in your pocket.

Thank you for your advices they're great.

 

[trini818]

I was actually worried about having this stethoscope because I thought it might be too much for me and I would not know how to use it properly. I got my master cardiology for free when I was an HHMI fellow in grad school, but I was thinking about buying a cardiology III like most other med students. My current boss assured me though that I would be fine with the fancier one and not to spend more money. I hope he is right...

 

[fisherrman]

I was actually worried about having this stethoscope because I thought it might be too much for me and I would not know how to use it properly. I got my master cardiology for free when I was an HHMI fellow in grad school, but I was thinking about buying a cardiology III like most other med students. My current boss assured me though that I would be fine with the fancier one and not to spend more money. I hope he is right...

Do you use it? The master Imean...Its not like loudspeaker right ?(which is fine)

 

[trini818]

Do you use it? The master Imean...Its not like loudspeaker right ?(which is fine)

I have used it a couple of times mostly just messing around with it. It is not like a loud speaker. I am sure using it more will help me figure out it intricacies.

 

[fisherrman]

I have used it a couple of times mostly just messing around with it. It is not like a loud speaker. I am sure using it more will help me figure out it intricacies.

That gives me comfort thank you(Its not like loudspeaker) I guess there is nothing wrong with my product...

 

[Traumahawk]

Word to the wise: stethoscopes, like a lot of medical equipment, do involve a moderate to sub-massive amount of marketing hype. No 'scope is going to sound like a loudspeaker or enable you to hear individual alveoli inflating. Beyond the disposable isolation-cart stethoscopes and the $9.99 "nurse's stethoscopes" you see at uniform shops, any reasonable stethoscope is going to offer generally comparable performance. Greater people than I have argued the merits of Classic vs Cardiology, Littmann vs Welch Allyn vs ADC, bell vs tunable diaphragm, and so forth since time immemorial. It all pretty much comes down to preference. Far more than your equipment, auscultation does require large amounts of practice. Listen to as many people as you can. Get your friends, family, people in the coffee shop, whoever, to donate their chests to science for five minutes. You'll get reasonably good at distinguishing "normal" quickly and might find yourself picking up a few abnormals as you gain practice. The auscultation practice recordings out there are also quite useful. In addition to Heart Songs, every major manufacturer offers one, usually free for download with your purchase, and there's also a good auscultation practice app from University of Michigan.

That said, nearly everyone in our shop uses a Cardiology III or equivalent. The option to put a second, smaller diaphragm on the bell of a Cards III is highly useful in emergency practice, where you might have to bounce between peds, "patients of size" and cachectic folks within a 15-minute span. We only have two staff who use electronic ears, and one has severe hearing deficits and the other is the kind of guy who has his 'scope equipped with fenestrated nanocrystal unobtainium resonators and hand-tuned by Tibetan monks. (Of course, in a busy emergency department where you're lucky to hear anything over the general din, this earns him massive amounts of ridicule...)

 

[Psai]

Word to the wise: stethoscopes, like a lot of medical equipment, do involve a moderate to sub-massive amount of marketing hype. No 'scope is going to sound like a loudspeaker or enable you to hear individual alveoli inflating. Beyond the disposable isolation-cart stethoscopes and the $9.99 "nurse's stethoscopes" you see at uniform shops, any reasonable stethoscope is going to offer generally comparable performance. Greater people than I have argued the merits of Classic vs Cardiology, Littmann vs Welch Allyn vs ADC, bell vs tunable diaphragm, and so forth since time immemorial. It all pretty much comes down to preference. Far more than your equipment, auscultation does require large amounts of practice. Listen to as many people as you can. Get your friends, family, people in the coffee shop, whoever, to donate their chests to science for five minutes. You'll get reasonably good at distinguishing "normal" quickly and might find yourself picking up a few abnormals as you gain practice. The auscultation practice recordings out there are also quite useful. In addition to Heart Songs, every major manufacturer offers one, usually free for download with your purchase, and there's also a good auscultation practice app from University of Michigan.

That said, nearly everyone in our shop uses a Cardiology III or equivalent. The option to put a second, smaller diaphragm on the bell of a Cards III is highly useful in emergency practice, where you might have to bounce between peds, "patients of size" and cachectic folks within a 15-minute span. We only have two staff who use electronic ears, and one has severe hearing deficits and the other is the kind of guy who has his 'scope equipped with fenestrated nanocrystal unobtainium resonators and hand-tuned by Tibetan monks. (Of course, in a busy emergency department where you're lucky to hear anything over the general din, this earns him massive amounts of ridicule...)

This is untrue. You can't hear anything with crappy scopes. Have you ever tried to use those disposable fisher price ones for infected rooms? It's such a waste of time, might as well not bother

 

[TheFutureFatMan]

I use the Card III. I had a classic prior. Card III sounds better, but...my Classic was beat to hell.

 

[fisherrman]

Word to the wise: stethoscopes, like a lot of medical equipment, do involve a moderate to sub-massive amount of marketing hype. No 'scope is going to sound like a loudspeaker or enable you to hear individual alveoli inflating. Beyond the disposable isolation-cart stethoscopes and the $9.99 "nurse's stethoscopes" you see at uniform shops, any reasonable stethoscope is going to offer generally comparable performance. Greater people than I have argued the merits of Classic vs Cardiology, Littmann vs Welch Allyn vs ADC, bell vs tunable diaphragm, and so forth since time immemorial. It all pretty much comes down to preference. Far more than your equipment, auscultation does require large amounts of practice. Listen to as many people as you can. Get your friends, family, people in the coffee shop, whoever, to donate their chests to science for five minutes. You'll get reasonably good at distinguishing "normal" quickly and might find yourself picking up a few abnormals as you gain practice. The auscultation practice recordings out there are also quite useful. In addition to Heart Songs, every major manufacturer offers one, usually free for download with your purchase, and there's also a good auscultation practice app from University of Michigan.

That said, nearly everyone in our shop uses a Cardiology III or equivalent. The option to put a second, smaller diaphragm on the bell of a Cards III is highly useful in emergency practice, where you might have to bounce between peds, "patients of size" and cachectic folks within a 15-minute span. We only have two staff who use electronic ears, and one has severe hearing deficits and the other is the kind of guy who has his 'scope equipped with fenestrated nanocrystal unobtainium resonators and hand-tuned by Tibetan monks. (Of course, in a busy emergency department where you're lucky to hear anything over the general din, this earns him massive amounts of ridicule...)

Yes I agree but I never said salesmen tell us 'this stethescope is guaranteed to hear any sound anywhere'.
I just said that the people who used classic 2 and master cardiology compare them as classic is trash, master is gold.And my pal said theres no difference between her classic and my master... just thought if my master has any problems...I am doing what you said , listening to everyone I know, in fact Today I couldnt hear anything from a woman with my master and it really upsets me .

 

[Traumahawk]

This is untrue. You can't hear anything with crappy scopes. Have you ever tried to use those disposable fisher price ones for infected rooms? It's such a waste of time, might as well not bother

...and I absolutely agree with you, which is why I specified, "beyond the disposable isolation-cart scopes and the $9.99 uniform store cheapies." You'd have to be an auscultation ninja to hear artifact noise with those, let alone actual heart and lung sounds.

However, once you upgrade from the Doc McStuffins models to actual clinical instruments (the dividing line generally starts at any manufacturer's classic-type model - Littmann Classic II, ADC 603, WA DLX, etc), the arguments start becoming academic very quickly. To reference fisherrman's post, one person can argue that the Littmann Master series is trash and Classic is the only way to go, and another person can say the Master is godly and all others are mere toys, and a third will diss Littmann as pure marketing and extol the Harvey Elite, and they'll all be "right" - with an N of 1, of course. The "right" pair of ears is the pair that works best for you. If that's a Master Cardiology, great. If it's some old BATS Sprague-Rappaport, cool. As long as you can hear what you need to hear with it, the rest is just bragging rights.

Yes I agree but I never said salesmen tell us 'this stethescope is guaranteed to hear any sound anywhere'.

Lo these many years ago, a few of my fellow nursing students did fall for precisely this kind of hype, floated by unscrupulous salespeople at school-sponsored equipment fairs. I suspect sales tactics have not changed much since then. Of course, said students were sorely disappointed to show up to Med-Surg 1 with their +20 Stethoscope of Awesomeness and find out that 95% of auscultation is between your ears, not in them...

 

[Crayola227]

inspect the tubing and really try to convince yourself it's hollow and there wasn't any manufacturing error

maybe try having someone more senior to you try it out, ask them "hey I got this new stethoscope and I'm having a hard time hearing through it, and I don't know if that's just me and inexperience. It would be great if some more experienced ears could try it out."

while you're at it, you could also ask to try someone else's stethoscope

this might help you figure out if it's equipment vs operator error

sounds silly, be sure you're putting it on right, the curved earpieces should be going on so that they are pointing forward

worst case, you ask the manufacturer to swap it out just to rule out manufacturing problem (it would be rare for 2 in a row to be busted)

 

[Psai]

...and I absolutely agree with you, which is why I specified, "beyond the disposable isolation-cart scopes and the $9.99 uniform store cheapies." You'd have to be an auscultation ninja to hear artifact noise with those, let alone actual heart and lung sounds.

However, once you upgrade from the Doc McStuffins models to actual clinical instruments (the dividing line generally starts at any manufacturer's classic-type model - Littmann Classic II, ADC 603, WA DLX, etc), the arguments start becoming academic very quickly. To reference fisherrman's post, one person can argue that the Littmann Master series is trash and Classic is the only way to go, and another person can say the Master is godly and all others are mere toys, and a third will diss Littmann as pure marketing and extol the Harvey Elite, and they'll all be "right" - with an N of 1, of course. The "right" pair of ears is the pair that works best for you. If that's a Master Cardiology, great. If it's some old BATS Sprague-Rappaport, cool. As long as you can hear what you need to hear with it, the rest is just bragging rights.


Lo these many years ago, a few of my fellow nursing students did fall for precisely this kind of hype, floated by unscrupulous salespeople at school-sponsored equipment fairs. I suspect sales tactics have not changed much since then. Of course, said students were sorely disappointed to show up to Med-Surg 1 with their +20 Stethoscope of Awesomeness and find out that 95% of auscultation is between your ears, not in them...

Shiet, I somehow skipped right over that when I read your post. To be fair, it's hard to get through a block of text