Stethoscope and Equiptment for EMS (Choosing One, Wearing One, Etc.)

[kylek044]

Ok - I am a stethoscope fanatic. I'm finishing up my EMT classes. I have some questions.

First, what stethoscope? Everyone says to go for cheaper ones so they don't get beaten up...but I wouldn't want to compromise quality. Is it possible to take care of a descent stethoscope so I can still hear without ruining it?

How do you carry your stethoscope? In one of those belt holster things? Around your neck? Pros? Cons? Is anyone still reading this?

Do you have a full jump kit?

What do you carry with you?

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[greytmedic]

I only use the stethoscope that comes with the ambulance. They're cheap but they work. As for carrying it, I don't. It starts the call off in the ambulance jump bag but eventually gets thrown onto the bench. When I get the ambulance ready for the next call it goes back into the jump bag. I use cheap stethoscopes all the time and have never had a problem, even on noisy scenes. If you want to buy your own personal stethoscope just make sure it has a highly visible label with your name that can not be taken off. I have heard of many stethoscopes getting up and walking away.

As for a jump kit, are you talking about on the ambulance or in my own car? On the ambulance, yes. In my car, no, which means I don't carry anything with me.

 

[TerraMedicX]

Ok - I am a stethoscope fanatic. I'm finishing up my EMT classes. I have some questions.

First, what stethoscope? Everyone says to go for cheaper ones so they don't get beaten up...but I wouldn't want to compromise quality. Is it possible to take care of a descent stethoscope so I can still hear without ruining it?

How do you carry your stethoscope? In one of those belt holster things? Around your neck? Pros? Cons? Is anyone still reading this?

Do you have a full jump kit?

What do you carry with you?

Oh dear...

OK...so stethoscopes...if you're an EMT and not planning on continuing onto a higher level of medicine where you're expected to have a higher understanding of breath sounds and heart tones, then you're ok with a less expensive type of steth. I would recommend the sprauge, because I find that the two tube design produces good sound for listening to blood pressures and gross breath sounds. If you plan on continuing to higher levels, you MAY want to invest in a more expensive steth like a Littmann or one of the higher end Welch Allen. A more expensive steth will probably last you a lifetime if you take good care of it (and 3M will service your Littmanns for free within the first five years, which I HIGHLY recommend). The less expensive steths are perfectly good though...and most ambulances I've seen have a couple of those so you wouldn't even need to buy one! 😀 (If you're unsure this may be a good way to go since you don't loose anything and it gives you a chance to see if you actually NEED your own! I only really use my own stethoscope when I'm working on respiratory or cardiac patients...otherwise I generally use the ones on the ambulance). As for care...try not to slam in in the door of the ambulance on your first day out with it (personal experience...). Also keep it out of direct sunlight say on the dash or backseat of your car. Most everyone keeps their steths around their necks at some point, there are two problems with this that I would point out. One, most manufacturers say that this will cause the material used for the tubes to stiffen and break down, and it seems to be true in my experience. Two, its an easy noose for crazy people to strangle you with!! The best choice I've found is to hang it on a hook in the back of the ambulance, or keep it in your pocket if you've got those large cargo ones.

Now...on to those other questions...

Full jump kits...wow, this is probably the embarassing, dirty little secret of many EMS workers. When we all start out, we all want EVERYTHING!! When I got my first responds many moons ago (ok, eight years 😛 ), I went ahead and bought a rather nice jump kit with everything I could think of. In the years since...I've used it three times and nother more then some gauze pads and tape. I now only put it in my car when I'm going on camping trips of something of that type.

What you carry is also along the same lines as above. There is a saying in most of EMS, the less you carry, the longer you've been in EMS. If you dont' know already...as an EMT, your biggest job is to have a pen for your paramedic when he forgets/looses his...in fact, you should probably have like five of them, 'cause we'll loose yours too!! 😎 Seriously though, I used to carry a pouch of non-latex gloves back in the day when we had latex on the bus, and I was allergic to them. Other then something like that, a good pen, maybe a back up one and a watch with a second hand are all you NEED. I know a lot of people who are religious about safety glasses, and its probably a good idea, but I just can't make myself do it. Also, you may want to have a small tube of Vick's vapor rub...if you don't know why...you'll figure it out!

That's my two cents...if you want more specific advice I'm happy to elaborate. If you don't know already, EMS is one of those professions where you WILL be made fun of by your co-workers...repeatedly and intensely! So if I'm being a little mean, its only to prepare you! 😀

Nate.

EDIT: Just saw greytmedic's post and remembered YES with the marking your steth!! I actually have my name engraved on the tubing of mine (cost like $5-10 more).

 

[kylek044]

Thanks guy - the only reason that I asked was because I know that EMS is one of those deals where you get made fun of...so I'd rather get it here then in person.

The reason I mentioned the stethoscope is because the instructor mentioned that "sure most rigs have a few stethoscopes, but just think about how many people's ears they have been in! if you're one of those germ-people, it would be advisable to get your own." I think part of my dilemma was in that I do plan on going further in medicine - but I wasn't sure if I should get my fancy-future-doctor-stethoscope now or hold off with a sprague or something.

Thanks for the responses.

 

[jonb12997]

I got a really nice Littman given to me by the volunteer ambulance squad that I rolled with during high school and college... (we only had 5 EMTs in the department -400-500 calls/yr- at the time, so they could afford to get us all one). I guarded that thing with my life while I was in the ambulance, and I now use it in Med School. It was nice that I didn't have to drop $150+ for a new stethascope when I started school.

That being said, if I was working full time as a medic in a busy suburban/urban department, I probably wouldn't use an expensive scope like that in the ambulance. I'd probably use one like the ones that comes in the kit with the matching BP Cuff. that way if it gets crushed, stepped on, dropped, ripped, or broken in some sort of way, It wouldn't be that big a deal.

My advice, if you're going onto a future medical career (outside of pre-hospital EMS), I think it might be worth it to get one and just keep it stashed somewhere for like someone else said, the resp/cardiac pts. Other than that, use the cheap one that is thrown around in the jump bag/ambulance.

 

[jbar]

Thanks guy - the only reason that I asked was because I know that EMS is one of those deals where you get made fun of...so I'd rather get it here then in person.

Truth be told, you're goingt to get some static is almost any department as the new guy. You don't know things, you wear funny things, you have nams for things that they don't use. It happens, and usually is pretty light hearted. Don't worry too much about about getting made fun of, you just have to find your own style. I had a new partner who was trying to tell me how much stuff I could have on my belt, he didn't like me having truma shears on there. He was just trying to be the boss. So the next day I got showed up for shift wearing a reflective safety vest, two stethascopes around my neck, three radios on my belt, and truama shears coming out of every pocket. We got a good laugh out of it and then I wore what I wanted from then on.

 

[jonb12997]

So the next day I got showed up for shift wearing a reflective safety vest, two stethascopes around my neck, three radios on my belt, and truama shears coming out of every pocket. We got a good laugh out of it and then I wore what I wanted from then on.

NICE!!

I was definitely one of those crazy EMTs who had the huge jump kit and everything... I even had an O2 tank in my car (looking back, probably wasn't the smartest thing to do)... Now all I carry in my car is a pair of latex gloves in case I happen across a bloody car accident, oh, and a pair of trauma shears!

 

[Vee]

I use the scope on the truck and I have pink shears in my pocket. Mostly because they're cute, and come in handy when a stubborn bag of chips won't open 🙂

 

[True Anomaly]

At the end of my EMS career, all I carried was a Leatherman and a pen. Oh, and my iPod, cuz you can't spend much time in the truck listening to crap radio.

 

[Guyton]

My $20 stethescope got me through eight years on the squad and four years of med-school. If you have to have a $100 dollar stethescope to hear the patient's breath sounds, they are not adequate. If you need it to hear the heart tones, they are muffled. The rest of it is academic in the pre-hospital setting, and largely subjective in house. To tell you the truth, I could care less if my patient has a 2/6 holosystolic ejection murmur radiating to the axilla, and I inwardly chuckle when I hear my colleagues bandy that crap about. Save your money and buy a pair of good boots.

 

[emtcsmith]

My $20 stethescope got me through eight years on the squad and four years of med-school. If you have to have a $100 dollar stethescope to hear the patient's breath sounds, they are not adequate. If you need it to hear the heart tones, they are muffled. The rest of it is academic in the pre-hospital setting, and largely subjective in house. To tell you the truth, I could care less if my patient has a 2/6 holosystolic ejection murmur radiating to the axilla, and I inwardly chuckle when I hear my colleagues bandy that crap about. Save your money and buy a pair of good boots.

word?

 

[MedicFL]

I have been a medic for four years now and I can say that I still have my cheap littman they gave us in class the classic two its like 30 bucks or so, works perfect. Half the time I just use the one on the rig but I do whip off the ear pieces off with prep pads. I only thing on my belt is a small surefire flashlight.

 

[MDtooB]

I bought a littman while I was still an EMT-B and I love it! It is so much better than the $10 stethescopes and the beauty of littman is if it breaks, you can send it back to them and they will fix if for free! ALso, they are more comfortable in the ears and blocks out a lot more background noise which is handy on a loud trauma scene!

 

[nyemt2005]

I got myself a Littman for around 80 bucks because I couldn't hear anything with the cheap ones on the bus, and I have to say it has been the best 80 dollar investment I have ever made. I love it, and I plan on using it for as long as I'm in the healthcare field. Alot of times people will ask for my scope because they know I have a decent one instead of using the POS's they put in the ambulance or jump bag. The way I make sure it doesn't break is by keeping it on me at all times unless I let someone borrow it in which case I get it back as soon as they're done. I also keep my scope in the side pocket of my EMT pants when I'm not using it. Sometimes I'll wear it around my neck but that's only when I'm taking vitals in the bus. I don't really like it around the neck because it gets caught on things like doors and seatbelts.

 

[Wackie]

I had to invest a little in a stethoscope. I can't hear enough to take BP's with the cheap ones.
A friend of mind worked for a trophy shop and engraved my last name on it. If it isn't in my ears it's in my pocket or on the bench. I don't like the bell swinging around while around my neck, hitting me, possibly hitting the patient.
Having a nicer one is a bit of a PIA because you're worried about losing it. I wish I could hear from the cheapies. 🙁

 

[GreatPlains]

Ok - I am a stethoscope fanatic. I'm finishing up my EMT classes. I have some questions.

First, what stethoscope? Everyone says to go for cheaper ones so they don't get beaten up...but I wouldn't want to compromise quality. Is it possible to take care of a descent stethoscope so I can still hear without ruining it?

How do you carry your stethoscope? In one of those belt holster things? Around your neck? Pros? Cons? Is anyone still reading this?

Do you have a full jump kit?

What do you carry with you?

Any stethoscope will work. I have used $2 stethoscopes and accomplished what I needed. It's so damn loud anyway you'll not be able to take advantage of anything fancy. Now, having said that, I spend about $70 on mine. But I never use it. I don't want to lose it, or have it grossly contaminated.

Jump kit: Personally, I don't stop at accident scenes or volunteer to render aid as a general rule. It's my job, not my life. I like to leave work at work. Nothing irritates me more than the random off-duty LPN, RN, EMT or whatever that has stopped on a scene I'm working. They become more of a liability than anything else.

I carry a flashlight, trauma shears, and a roll of transpore tape. Some people I work with carry a kelly forceps. I don't know why. Less is more. The more you carry, the more you can lose.

I've seen people carrying half the damn bus in their pockets. They look like some SWAT team member. IV drip sets, catheters, narcotics, kerlix, 4x4s. But when you need it, you never think to look in your pockets anyway.

As someone said, the best money you'll ever spend is on good boots and socks. The rest is incidental.

 

[AnthonyM83]

You'll do fine with a cheap Sprague one, but I won't lie, a Littman makes it easier to hear BPs in the back of the moving rig. It's a nicer convenience, so if you can afford it I'd get it, but certainly not needed.

Stethoscope always stays in the back of the ambulance or in the jump bag...none of this around the neck style. It falls off or swings around and hits things, possibly your patient, when leaning over.

 

[viostorm]

Buy a nice Littman if you can afford it. Get your name engraved. Don't leave it on ambulance.

 

[deleted87716]

When I was an EMT, I used an old Littmann Classic that somebody had given me. I could never hear squat with the crummy Spragues that we had on the truck, probably because of their poor air sealing. The Littmann fit me better, plus it was small and light enough that I could carry it in my pocket if I wanted to.

As for carrying gear, I preferred to keep it "bare bones." I had a Ripoffs holster on my belt that held trauma shears, a small Maglite, and a seatbelt cutter, and I kept a couple extra pairs of gloves in my pants pocket. That was pretty much it. Everything else I needed was on the truck.

I knew a couple of guys who carried so much crap on their belts that they looked like Batman, but that wasn't the look I was going for. 😉

 

[146233]

I've got a Littman Master Cardiology. Sometimes you just have to be able to hear those lung/heart/bowel sounds, blood pressures, cardiac bruits, etc. Spragues and the other crappy $3-at-the-drug-store variety they throw on ambulances are just about worthless, especially when you're actually driving a giant diesel machine with the sirens blaring.

-z

 

[bigguy]

aka acute pulmonary edema. it's your world, we just live in it, in fact, by the time these patients get to the ER these patients should be totally stable... and you need a stethoscope and a brain to figure it out... but mostly just a brain, in fact, a little percussion with your middle finger could give you a dull note and even the dullest of us could conclude effusion... so you don't really even need a steth for this disease.

whatever stethoscope you do get, just make sure you don't blow off a systolic murmur in a patient with acute pulmonary edema, it could be a ruptured mitral valve in an acute MI which very well could be a ticket to the O.R.

someone named guyton was earlier in this post claiming he chuckled when he heard his colleagues talking about a 2/6 holosystolic murmur radiating to the axilla....this is totally important to know about for a paramedic treating a patient with the "paramedic's disease", just remember, it's not what goes on the ears, it's what's between them that counts!🙂

 

[KD1655]

My department puts Littmans on the ambulance and in the bags 🙂 so I get to use a good stethoscope without having to pay for it, best of both worlds

 

[Compass]

The thing about Littmanns, is that... sometimes... ahem... people "borrow" them >.>

On the other hand, this, which I use, which works...

http://www.amazon.com/SPRAGUE-RAPPA...0-3260034?ie=UTF8&s=hpc&qid=1188180339&sr=8-3

If it breaks, oh well, I lost $10. $10 well spent for my training. If I make it last to med school 2 years down the line, that's fine. If I don't, THEN I'm getting Littmanns.

The main issue is ambient noise, lots of it, when riding the unit. However, do what you can, and palpate the heartbeat as well. A good visual cue for BP is that the needle will also flicker during the heartbeat within the beating range, so if you watch that, it'll help you as well.

Stethoscope carrying, you can carry it in a pocket, if you really have to. I have a BP cuff-thingy case (my parents got a complimentary hygiene kit from cross-ocean flight, and I harvested it) so that I can tell which one's mine. If you take it out and use it, DO NOT swing it around your neck like this!

http://www.stvincents.org/Asset/iu_images/inset_right_nursestethescope.jpg

DO NOT, DO NOT, DO NOT. The issue with this, is if your patient grabs your stethoscope, you are in deep trouble! When you carry it, carry it with either the prongs around your neck so when it's grabbed, it pops right off, or over one shoulder. If your patient yanks it then, he's got a free stethoscope until we get another one from the unit, but if he takes YOU with it, you're in trouble, since stethoscope tubes are kind of heavy duty.

Jump kits. Unless you're planning on hunting down for car accidents, rarely will you ever need one. The most I have in my car is a first aid kit. One of the more sturdy ones with modular replacement boxes, comes in at about $20 at local Costco. Also contains a BP cuff for no other reason than... I needed one for practice.

 

[gotmeds?]

Which stethoscope? Why, your partner's, of course. "Hey Justin, hand me your $500 Littman Ultradoppler Cardiology 12 that you bought the day you got your EMT cert, will you?"

 

[146233]

Which stethoscope? Why, your partner's, of course. "Hey Justin, hand me your $500 Littman Ultradoppler Cardiology 12 that you bought the day you got your EMT cert, will you?"

 

[fiznat]

I've got a Littman Master Classic (about $80) that I've had for a long time. I would have had the same one for even longer, but my previous one somehow sprouted legs and walked away one day. So yeah, what people say about theives in the ambulance is true. If you buy a decent one, keep your eye on it.

I keep it around my neck at all times. Sometimes it bothers me, and once I even got a small bruise next to my eye when the thing swung around on a trauma and hit me in the face... haha. I've also been hit in the tooth by the thing-- that hurt also. Despite all that though, I really like having it on my neck and always knowing where it is. When I need to listen, I instinctivly reach towards my chest, and it is always there. I dont like carrying it in my pocket or anywhere else because I am not used to it, and I feel like the earpeices would bend/break.

Its habit... whatever works best for you. As far as how much to spend, I wouldn't drop all that money on a hugely expensive electric scope or master cardiology, but I would reccomend getting a decent personal scope that you can rely on. That way, you are responsible for making sure it works, and you know where the thing has been. Who knows what horrible things the ambulance scopes have been subjected to... no way, I'll use my own gear thanks.

 

[FIREitUP]

we have double tubed spragues on our bus, and i must say, THEY SUCK. I can't hear anything (only when its silent at a patient's house or something) due to the terrible seal in your ears.
however, spragues now make a single tube one, which is by no means a littman, but it is definitely better.
if you do buy a littman, keep your eye on it!

 

[puckstopper84]

I bought a prestige fresh out of EMT school, that lasted 3 months. then a few months later I bought a littman that lasted less than a week. My current stethoscope came out of the lost and found minus the diaphragm and ear pieces, I used the spares from my prestige for that, and it works pretty good. I guess my lesson I learned is not to buy one but to find one.

PS the former owner of the scope is OK with me having it, I don't condone stealing.

 

[Vee]

we have double tubed spragues on our bus, and i must say, THEY SUCK. I can't hear anything (only when its silent at a patient's house or something) due to the terrible seal in your ears.
however, spragues now make a single tube one, which is by no means a littman, but it is definitely better.
if you do buy a littman, keep your eye on it!

and have it engraved. i have lost so much stuff over the years by leaving it in the ambulance (admittedly, i shouldn't have forgotten it, but what kind of crappy people find stuff that they know belongs to the last crew and keep it?)... winter hats/gloves, a scope or 2, vest, even a stupid coffee mug.

now i put my name on EVERYTHING.

 

[emttim]

Personally, I use a Littman Lightweight II SE and it works great for me. I don't have a jump kit or any of that stuff; I just keep a CPR mask in my trunk just in case. I usually just wear my stetho around my neck because when I'm responding to a call or whatever, I don't want to have to dig inside a jump bag or anything for it, I want it ready to use at all times since you use it a decent amount on calls since there's a minimum of 2 sets of vitals as well as lung sounds.

Go with whatever brand and price you feel comfortable with but I would recommend Littman myself. The main reason I use Lightweight over any of the others is because, as the name implies, it weighs a /lot/ less than the other stethos so it's not nearly as annoying around your neck...you barely even notice it's there.

 

[leviathan]

I got the Cardiology III as a gift from the parents. It usually gets stuffed in my cargo pockets, but I wonder if that is going to damage the tubing when it gets coiled around into a ball.