Stethoscope

[monkeyMD]

I know there are probably many MANY threads about stethoscopes. But I want a 2013 opinion.

Splurge and get the Littman Cardio III or Littman Classic II SE is fine?
Or even the Littman Lightweight II SE?

Pros, cons, personal experiences all welcome.

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[Anastomoses]

I just went to look at stethoscopes and wtf...what are they putting in them to make them $150???

 

[mdeast]

Definitely the Littmann Master Cardiology. It's stylish, compact, smaller than other stethoscopes, super comfortable ear buds and you can get it in black-on-black (super sexy). It also has a tunable diaphragm/bell based on pressure so you can hear a wider range of low and high frequency sounds.

Your attendings will be jealous. The fact is, unless you go into a select few specialties, you're going to be using the same stethoscope for the rest of your career. It's better to pick up a good one now and learn from the start using it then to purchase a cheaper one and upgrade in the future. Just take the plunge, the nicers ones really aren't that much more in the long run.

http://www.amazon.com/3M-Littmann-Cardiology-Stethoscope-2160/dp/B000F4W1GW/ref=cm_cr_pr_product_top

 

[monkeyMD]

Definitely the Littmann Master Cardiology. It's stylish, compact, smaller than other stethoscopes, super comfortable ear buds and you can get it in black-on-black (super sexy). It also has a tunable diaphragm/bell based on pressure so you can hear a wider range of low and high frequency sounds.

Your attendings will be jealous. The fact is, unless you go into a select few specialties, you're going to be using the same stethoscope for the rest of your career. It's better to pick up a good one now and learn from the start using it then to purchase a cheaper one and upgrade in the future. Just take the plunge, the nicers ones really aren't that much more in the long run.

http://www.amazon.com/3M-Littmann-Cardiology-Stethoscope-2160/dp/B000F4W1GW/ref=cm_cr_pr_product_top

Is the Master cardio =/= cardio III?

 

[Kahreek]

the best anesthetist i knew used whatever was laying around from pharma propaganda, those slick thin stethos, he was such a badass.
You will probably be fine with whatever you get, as long as you do some reading about auscultation.

 

[mdeast]

Is the Master cardio =/= cardio III?

Nope. They're different. Cardio III is great too. Main differences between the two...

1. Cardio III has separate bell and diaphragm. Master Cardiology has an integrate bell/diaphragm that you adjust by pressure.
2. Cardio III is heavier and bigger that the Master Cardiology ( 1 lbs vs. 1/2 lb)
3. Master Cardiology includes a free Peds attachment. Though, I can't say I ever used it even on my peds rotation. Cardio III does not.

As for the Littmann SE....we got this during orientation for free. It's a decent stethoscope. Definitely nothing wrong with it. I keep it as my back-up now, but I think the Master Cardiology series is better. You can definitely feel the difference in quality picking them both up. It's not only the bell/diaphragm itself...the cord, earbuds, etc. are better on the more expensive version. It also just feels less likely to break.

 

[CuttingCorneas]

Nope. They're different. Cardio III is great too. Main differences between the two...

1. Cardio III has separate bell and diaphragm. Master Cardiology has an integrate bell/diaphragm that you adjust by pressure.
2. Cardio III is heavier and bigger that the Master Cardiology ( 1 lbs vs. 1/2 lb)
3. Master Cardiology includes a free Peds attachment. Though, I can't say I ever used it even on my peds rotation. Cardio III does not.

If you want the best of both worlds (peds attachment plus separate diaphragm/bell), I'd suggest the Welch Allyn Harvey Elite. Personally, I'm not a fan of tunable diaphragms (like the Master Cardio) because most people are never taught how to use them properly.

 

[Kahreek]

lol you talk tunable like they had to be in G to work properly or something

 

[CuttingCorneas]

lol you talk tunable like they had to be in G to work properly or something

That's what they called, yo. Personally I prefer e minor.

 

[KGflyboy]

Littman cardio III does have a tunable diaphragm/bell. I have one, and I like it a lot. I don't have experience with the others listed though, so I can't compare.

 

[calvnandhobbs68]

Definitely the Littmann Master Cardiology. It's stylish, compact, smaller than other stethoscopes, super comfortable ear buds and you can get it in black-on-black (super sexy). It also has a tunable diaphragm/bell based on pressure so you can hear a wider range of low and high frequency sounds.

Your attendings will be jealous. The fact is, unless you go into a select few specialties, you're going to be using the same stethoscope for the rest of your career. It's better to pick up a good one now and learn from the start using it then to purchase a cheaper one and upgrade in the future. Just take the plunge, the nicers ones really aren't that much more in the long run.

http://www.amazon.com/3M-Littmann-Cardiology-Stethoscope-2160/dp/B000F4W1GW/ref=cm_cr_pr_product_top

Yeah until you leave it lying around the hospital one day and someone jacks it.

Your attendings could go buy a box of Master Cardiologies if they wanted to...they just know that it doesn't matter unless you're a cardiologist. The standard Littmann Classic (or even beef up to the Master Classic if you're feeling like a baller) is more than adequate. The extra $80-100 in your pocket isn't really something to sneeze at. The vast majority of specialties will never need a top end stethoscope.

However, if you're choosing between the Cardiology III and the Master Cardiology, there isn't really that much of a price difference so it's mostly just personal preference.

 

[Instatewaiter]

the best anesthetist i knew used whatever was laying around from pharma propaganda, those slick thin stethos, he was such a badass.
You will probably be fine with whatever you get, as long as you do some reading about auscultation.

Realistically an anesthesiologist doesn't need to use a stethoscope for anything but making sure there are breath sounds on both sides... Don't listen to the above poster... please.

Littman cardio III does have a tunable diaphragm/bell. I have one, and I like it a lot. I don't have experience with the others listed though, so I can't compare.

I have experience with all of those listed. I started with a littman cardiology III, moved to a welch allyn tycos DLX dual head (like harvey elite) and master cardiology. I have also used both the thinklabs and the Littmann electronic scopes. If you are going to be working in a noisy environment and actually need to hear things, skip the electronic scopes.

Littmann Classic/lightweight- these scopes kinda suck. If you are going to be a surgeon or some other specialty that doesn't need to listen to anything this would be fine and they are much cheaper. Classic 6/10, Lightweight 5/10

Littmann cardio III- a decent scope and the standard scope that most people have. It has a tunable diaphragm and a bell. The bell is nice to have.

The diaphragm is nice and loud but doesn't deliver sounds as clear as some of the nicer scopes. The bell is mediocre. Overall I would give it an 7.5/10


Welch Allyn Tycos or DLX- the diaphragm is less loud but more clear than the Littmann. The bell on the DLX is the best I have ever used. The bell on the tycos harvey is better than the littmann, not as good as the DLX. Score 9-9.5/10

Littmann Master Cardiology- no bell and a tunable diaphragm. The diaphragm is large which makes it difficult to listen to COPD patients (hard to get purchase on a bony chest). The diaphragm is louder than Welch allyn scopes, mildly better than the littmann cardio III in terms of clarity. 9-9.5/10

 

[Instatewaiter]

Most people can get away with a littmann cardiology III (or the allheart comparable). Whenever I see a doctor with a lightweight littmann I think to myself, "might as well just use the disposable plastic piece of **** they have in the contact rooms because you're not hearing much better with a littmann lightweight"

Realistically if you cut the disposable scopes in half, you hear just as good as those crappy cheap scopes. If you want to save money, allheart has some knockoff scopes that apparently decent I think made by Mabis.

 

[NeuroLAX]

I really like my WA Harvey DLX. The bell is separate from the diaphragm, and it feels good in my ears. Plus I got a discount and warranty on it. In retrospect I could have gotten a cheaper steth, but during orientation it was convenient to order everything together at once, and so I did.

My cardio/EKG professor, whose mentor was Dr. W. Proctor Harvey, says he frequently gets asked which stethoscope he likes best. His response is that you should start by looking for something that feels comfortable to you, has good tubing, a bell and a diaphragm. He personally uses the triple head steth. Something like this:

Of course, I would expect someone like him to have something more fancy. Probably a little over-the-top for a medical student.

 

[Instatewaiter]

My cardio/EKG professor, whose mentor was Dr. W. Proctor Harvey, says he frequently gets asked which stethoscope he likes best. His response is that you should start by looking for something that feels comfortable to you, has good tubing, a bell and a diaphragm. He personally uses the triple head steth. Something like this:

That's because Harvey created that scope. That's why all georgetown students get it and why it is called the harvey DLX

 

[monkeyMD]

So go with Cardio III or Master Cardio III?

How do people feel about the Master II?

What is the difference between Classic II and Master II anyway...

 

[J-Rad]

If someone is getting you a gift, get what you like. I still have my Littman Cardio III I got as an MSI 12 years later only having replaced the diaphragms a few times. It works well for me and I use a stethoscope quite a bit in my job.

That said, if I was an MSI not knowing what I was going into I'd buy this: http://www.amazon.com/Omron-Sprague-...e+stethoscopes

Looks cool and you can get it in a multitude of colors, including the favorite all black. At 15-20 bucks you aren't going to get too bent out of shape if it sprouts legs in the hospital as many seem to do. It has good acoustics (rated just below the Cardio III in this review http://www.forusdocs.com/reviews/Aco...view_page7.htm).

When you get toward graduation and you're going into a field in which a good steth is useful, someone will probably want to buy you one for graduation. Go to town then, or just keep the S-R style. Get a few to coordinate your outfits for that matter.

It is true that many specialties make good use of the stethoscope, as it is true that there a good few that don't beyond basic needs (path, rads, surgical specialties). From a purely practical standpoint, nobody is that good at making out the meaning of heart sounds (unless you are a prior PA or NP that listened to hearts a lot) for the first two years of medical school. I've always advocated a good two-lumen stethoscope (they tend to give a better fidelity than single lumen), but there are inexpensive options that are nearly as good-sound quality wise-as the more expensive Cardiology III. The biggest issues-again, from a practical standpoint-are 1) the 0.5% better fidelity that the Cardio II offers will not make you more able to appreciate and understand heart sounds early in your training (really throughtout medical school) and 2) A lot of people lose or have their stethoscope stolen during their clinical rotations. Losing a $15 stethoscope that provides nearly the same sound fidelity stings a lot less than losing the $130+ steth...

Taken from my statements in another steth thread. I use my stethoscope a lot as a pediatric cardiologist.

 

[evilbooyaa]

Who are all these med students that have bought like 5 different stethoscopes in their life? I bought a cardio 3 during pre-clinicals and hven't changed it. Don't plan to unless it breaks/gets stolen.

 

[notbobtrustme]

I got the Cardio-III and it seems fine (it was a gift actually). A bunch of students here got the free stethoscope from the AMA signup that every med school seems to have during the first week, so that's an option.

Realistically, you won't know the differences between stethoscopes until residency and even then, you can probably get by with the basic steth unless you plan on being a cardiologist.

 

[Wordead]

I have a master cardio and a harvey elite. I prefer the harvey elite for everyday; much clearer in my opinion.

 

[Ismet]

I got the MD One steth as a college graduation gift (http://www.allheart.com/mdf-stethoscope/p/mdf777/). It's comparable to the Littmann Classic. I have had no problems so far performing normal physical exams with it, but I'll put it to the test in the next couple weeks when we have cardio sessions. I was wary about using it because it is so cheap, and pretty much everyone else bought Cardio III's when the Littmann rep came to our school during M1, but I've talked to a couple residents and one of my preceptors about it, and they said it will be perfectly fine for med school. Some of my classmates even borrowed mine when they couldn't hear Korotkoff sounds with their Littmanns I still might upgrade for clerkships and keep this one for backup, but if you're looking for a cheap steth that will get you through the basics, this one is great.

 

[Kahreek]

Realistically an anesthesiologist doesn't need to use a stethoscope for anything but making sure there are breath sounds on both sides... Don't listen to the above poster... please.

realistically a med student doesnt need a stetho for anything, lol

you say it like checking breath sounds is not a big deal.

"hmm let me hear this non urgent outpatient, sir i think i hear a mitral prolapse, but lets do a echocardiogram just to be sure."

 

[Kahreek]

I got the MD One steth as a college graduation gift (http://www.allheart.com/mdf-stethoscope/p/mdf777/). It's comparable to the Littmann Classic. I have had no problems so far performing normal physical exams with it, but I'll put it to the test in the next couple weeks when we have cardio sessions. I was wary about using it because it is so cheap, and pretty much everyone else bought Cardio III's when the Littmann rep came to our school during M1, but I've talked to a couple residents and one of my preceptors about it, and they said it will be perfectly fine for med school. Some of my classmates even borrowed mine when they couldn't hear Korotkoff sounds with their Littmanns I still might upgrade for clerkships and keep this one for backup, but if you're looking for a cheap steth that will get you through the basics, this one is great.

i can hear korotkoff sounds with my fingers, ffs

 

[climbouthole]

Ok this is embarrassingly incompetent but I'd rather ask here than someone at my school first. I don't hear well out of a cardio III unless I drop my jaw (lips closed just to complete the image). I can hear in the left ear as normal, but the right ear nothing until the mouth is open. I think this means the ear pieces aren't fitting quite right so when I do that they shift into the correct place? I have no idea, when I use the stethoscopes available in the simulation center at my school they seem to work fine, but yeah that's what's happening with my own cardio III.

Any suggestions?

 

[J-Rad]

Ok this is embarrassingly incompetent but I'd rather ask here than someone at my school first. I don't hear well out of a cardio III unless I drop my jaw (lips closed just to complete the image). I can hear in the left ear as normal, but the right ear nothing until the mouth is open. I think this means the ear pieces aren't fitting quite right so when I do that they shift into the correct place? I have no idea, when I use the stethoscopes available in the simulation center at my school they seem to work fine, but yeah that's what's happening with my own cardio III.

Any suggestions?

Try some different earpieces. Maybe those gel ones.

 

[deuist]

Ok this is embarrassingly incompetent but I'd rather ask here than someone at my school first. I don't hear well out of a cardio III unless I drop my jaw (lips closed just to complete the image). I can hear in the left ear as normal, but the right ear nothing until the mouth is open. I think this means the ear pieces aren't fitting quite right so when I do that they shift into the correct place? I have no idea, when I use the stethoscopes available in the simulation center at my school they seem to work fine, but yeah that's what's happening with my own cardio III.

Any suggestions?

Sounds like the ear buds are closing off in your ear cannals. I use hard plastic ones for that reason. They won't ever close. Pictures are here. I use the Welch Allyn Tycos DLX, by the way. I bought it 8 years ago and I still use it every day.

 

[climbouthole]

Thank you both for your advice, I'll look into new earpieces.

 

[DoctorDermis]

I know there are probably many MANY threads about stethoscopes. But I want a 2013 opinion.

Splurge and get the Littman Cardio III or Littman Classic II SE is fine?
Or even the Littman Lightweight II SE?

Pros, cons, personal experiences all welcome.

First things first - do you potentially plan on going into radiology / derm / pathology / ophto / or some other field that pretty much puts the stethoscope into storage after med school / intern year? if so, then I would probably save the money and go with a reliable budget model such as the ADC ones on amazon.

I have used a variety of stethoscopes from disposable ones in contact isolation rooms, to mid-range ADC / Prestige scopes, the Littmann Classic II & Cardiology III, and a couple of different electronic models.

When listening for softer mumurs or fine crackles, the more robust chest-pieces/bells with stiffer tubing helped discern low-amplitude details much better than the disposable and super low-end $10 dollar scopes...but the mid-range ADC on amazon and the littmann cardiology III had no appreciable difference to my ears. The electronic models are cool and you can record sounds or increase the volume...but they in no way changed the treatment plans for patients.

 

[JGimpel]

Get the cheapest sprague off of allheart for your first 2 years. You'll learn the sounds mostly off of web sites rather than on actual patients. MDF and ADC stethoscopes sound great, cost far less than the Littmans that the drones purchase that don't know any better for your clinical years. You can read the reviews on amazon if you don't believe me. If you still have an inferiority complex and have to have a Littman, a baby-Benz and a Tag to feel one of the group, at least you're getting a stipend then, so ball out.

If a non-cardiologist STUDENT walks around with a triple-head, he's going to get pimped on heart sounds for the rest of his rotation with me for looking so ridiculous!

 

[JGimpel]

Get the cheapest sprague off of allheart for your first 2 years. You'll learn the sounds mostly off of web sites rather than on actual patients. MDF and ADC stethoscopes sound great, cost far less than the Littmans that the drones purchase that don't know any better for your clinical years. You can read the reviews on amazon if you don't believe me. If you still have an inferiority complex and have to have a Littman, a baby-Benz and a Tag to feel one of the group, at least you're getting a stipend then, so ball out.

If a non-cardiologist STUDENT walks around with a triple-head, he's going to get pimped on heart sounds for the rest of his rotation with me for looking so ridiculous!

 

[DoctorDermis]

Get the cheapest sprague off of allheart for your first 2 years. You'll learn the sounds mostly off of web sites rather than on actual patients. MDF and ADC stethoscopes sound great, cost far less than the Littmans that the drones purchase that don't know any better for your clinical years. You can read the reviews on amazon if you don't believe me. If you still have an inferiority complex and have to have a Littman, a baby-Benz and a Tag to feel one of the group, at least you're getting a stipend then, so ball out.

If a non-cardiologist STUDENT walks around with a triple-head, he's going to get pimped on heart sounds for the rest of his rotation with me for looking so ridiculous!

LOL - reminds me of those welch allyn harvey dlx's that I saw on a couple of med students...along with the panoptic in a couple white coat pockets as well

Although...after having had a number of patients in residency where I really wanted to check the eyeballs...the Panoptic would have been MONEY. Unfortunately, I cannot afford one at the moment

 

[Medstart108]

Classic II SE. Its the classic stethoscope and you won't need anything better. My medical school strongly recommended everyone get the Classic II SE.

 

[DoctorDermis]

Classic II SE. Its the classic stethoscope and you won't need anything better. My medical school strongly recommended everyone get the Classic II SE.

I have used both the Littmann Classic II SE and the ADC Adscope 603
- both are smaller in profile that the Cardiology III and cheaper
- However, Save your money and get the ADC...it's less than 1/2 the cost and no appreciable performance difference.
- If you want to be able to discern softer sounds with more clarity, jump up to the cardiology III

 

[wolfvgang22]

Yeah, I got a Littman Cardio III in pre-clinicals. Great looking scope. Unfortunately, I listened to a lot of heavy metal growing up, so I can't hear a damn thing.
Eventually some attending cardiologist cut the tube in half so I could "hear better", I think really it was so he wouldn't have to watch the bell hit me in the nuts when I walked down the hall. Ouch, man.

Then a vascular surgeon took my white coat and stethoscope both while I was busy retracting adipose in the OR. I ended up taking his identical, but engraved Littman Cardio III when I got out. Here's to you, A.K. I hope you enjoyed my granola bar and 42 short coat. I was hungry all day.

So, long story short, I went into psychiatry, so I can just smile and nod a lot, instead of trying to divine atrial gallop over the sound of my stomach. "Yes, hmm, that must be tough. Tell me more about that."

Speaking of stethoscopes, the best $2 I ever spent was this clip on holster:

I'm like a gun-slinger, yo.

 

[DrBodacious]

IIn med school pretty much everyone had a Littman, and recommended Littman, so that is what I bought. I lost my cardiology iii, and someone gave me a DRG stethoscope, and I would say I like it better. It is longer, so you don't have to hunch over to use it. And thee rubber cover is rally easy to clean with hand sanitizer. I don't know if the acoustics are any worse, I certainly don't notice. And I think it is a little cheaper than a cardiology iii. http://www.healthchecksystems.com/doctors_research_group_puretone_cardiology_stethoscopes.htm

And, I got this scope from my wife's aunt, who is a retired cardiologist, so that gives it some credit as a legitimate stethoscope. I have seen them around on occasion but they certainly are not as common as the Littmans.

 

[DrBodacious]

Okay looks like you can get the cardiology iii in either 27 in or 22 in. I must have had the 22 in cardiology iii. I still like the DRG's rubber cover.

 

[volcomx]

Would I look like a fool if I got a brass/black stethoscope instead of a traditional steel/black?

 

[scorm]

Would I look like a fool if I got a brass/black stethoscope instead of a traditional steel/black?

Don't get the brass/black. I contemplated getting it for a bit then realized how much attention it would bring and I ultimately decided not to get it. It's way too flashy (bling bling) in my opinion. Now the black on black looks really nice and low key. I'd opt for that one if you're open to it.

 

[Kahreek]

black on black matte is ideal for stealth health operations.

 

[Medstart108]

Don't get the brass/black. I contemplated getting it for a bit then realized how much attention it would bring and I ultimately decided not to get it. It's way too flashy (bling bling) in my opinion. Now the black on black looks really nice and low key. I'd opt for that one if you're open to it.

If you thought brass/black was flashy you must not have seen the cyan/pink/purple ones lol. I chose brass/black mostly because i wanted a nice balance between flashy and staid.

 

[Kahreek]

i like those rainbow steel heads, it looks like a brand new barbecue grill.

 

[yehhhboiii]

^ wtf...

 

[Doctor Strange]

black on black matte is ideal for stealth health operations.

I've got that color scheme. It's so badass.

 

[Unzbuzzled]

http://www.youtube.com/watch?v=x2FXg0X4phM

I'd go with the master cardio. The slightly larger diaphragm makes the sounds as loud as possible for an acoustic scope. You'll definitely want the clearest sound possible while you're learning your chops- this is important not just for the heart, but for the lungs, vasculature, gut, and other areas of the body. Also, its 7-year warranty means you'll have a calibrated scope throughout nearly all of your training.

 

[Kahreek]

i find that spragues give a better amplification than for example a littmann classic, i have a littmann classic.

 

[Anastomoses]

just ordered the pretty burgundy cardio iii

 

[Shjanzey]

I got the cardio as well. I wear it to all my pre-med classes so that everyone knows I am going to be a doctor one day.

In reality I do it for attention, to ease the pain of the loneliness from studying all the time, even if I lie and say the tests were easy and I was partying all week.

Premed is awesome. I need to get some scrubs now...I don't think enough people know I am premed yet.

 

[Instatewaiter]

i find that spragues give a better amplification than for example a littmann classic, i have a littmann classic.

They don't make the Spragues anymore and it is near impossible to find replacement parts. Those were fabulous scopes. The "spragues" that are out there are medicore copies of the real thing. They are basically nursing scopes.

While we're at it, the leatham is the best stethoscope ever made... It is impossible to find and when you find one, they're usually selling it for a few grand.