Stethoscopes- two sided or one sided?

[fiznat]

I've been a paramedic for a number of years, and I've always used my trusty Littmann Master Classic II. Its one of their models with the "tunable" diaphragm. I've never really paid that much attention to the "tunability" of my scope because I don't often have a need to listen to much other than blood pressures and lung sounds. I almost never listen to heart sounds, and even when I do it is isn't exactly a refined assessment.

In any case, I am wondering if my trusty scope will work well for me in medical school (starting this fall). Do you guys find the tunable diaphragms work well, or would I be better off getting a standard two-sided scope with a separate bell and diaphragm? I don't want to spend more money if I can help it, but if this scope is going to set me back...

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[ShyRem]

depends on what you like. I used my Littmann Classic SE II for years on the ambulance (yes, I too was a paramedic before med school). I moved up to a Littmann III and then a master cardiology. I find the cardiology far superior to my ears. Other folks have done well with even the plain sprague rappaport (although I personally can't hear crap with those). For me, the tunable diaphragm works well. For others, not so much.

Yes, it's a lot of money. I think it depends what you want to hear... if you're going to be doing something like psychiatry, then who cares. If you're going to be doing internal med where hearing a soft bruit, murmur, rub, or gallop is important then pony up the dough.

And lest you say "oh, I'm going to do EM", that's what I thought too. I changed my mind like many other students.

Bottom line: what you have now is fine to start with. You may choose to upgrade as you progress and figure out your specialty.

 

[group_theory]

I find that having a separate bell (instead of a tunable diaphragm) is best when you want to hear gallops like S3 or S4. Unless your ears are well trained to pick them up, it's hard for students to hear those gallops using a tunable diaphragm. It's also easier to hear those low pitch sound with a bell than a tunable diaphragm if you're in a relatively loud environment

I would argue that being able to pick up those extra heart sounds is essential to being a good clinician in diagnosing that's wrong with your patient (and diagnosing that's wrong with your patient is half the battle in clinical medicine), especially if you're interested in Emergency Medicine, or Internal Med, or Family Med, or Surgery or Pediatrics.

 

[munchymanRX]

I've heard a lot of votes for the Caridiology III on these boards. Probably going to end up going with that.

 

[TexasPhysician]

2-sided. I have the Harvey Elite. It is cheaper than Littman and works better in my opinion.

Littman - Acura
Harvey - Honda

They both perform well, but Acura/Littman is cooler

 

[vanbamm]

Spend 25 bucks and get the basic two-sided- ur gonna need the bell and diaphragm, and if you can get good with that, you will be a pro when u graduate and can buy better equip.