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It’s All About What You Want To Hear

There are different stethoscope to choose from in terms of head types – single head, dual-head, and triple-head stethoscopes. Single heads are the all-around type. Because it hears low-frequency signals very well, it allows you to focus on the sound you are getting from the diaphragm. This makes it ideal for taking vital signs and some quick and simple heart sound assessment.

If you need to have a more rounded take of what you are hearing, then a dual-head type is the better option for you. It has both the diaphragm and the bell, giving you the ability to get both high (diaphragm) and low (bell) frequency sounds. This makes it more versatile as far as sound detection is concerned.

If you really want to have more refined, very clear listening capabilities, then the triple-head stethoscope is for you. It can hear heart sounds considered to be critical as far as heart assessment is concerned. The downside is that it’s heavy and pricey.

The best thing to do is to conduct the hearing test yourself. Slip on a stethoscope, put the turnable diaphragm on your own chest, or on the chest of your companion, and listen carefully to the heartbeat. Pay attention to how loud it is. Compare different stethoscopes and find the loudest one. Your choice may lead you to discover or miss out on something significant in a patient.

Stethoscopes can vary in prices as well. Littmann is generally a high-end stethoscope that is well made and durable but has a heavy price tag, with some as high as $300. Do you really need to spend $ 300 for a premium stethoscope? Well, that depends on your job and your budget. I have been a nurse for 25 years and I have had many stethoscopes over the years and, yes, some I have lost after spending a few hundred dollars. I have broken up my selection into three sections – high-end, middle range and lower end.

Highend Stethoscopes:

1.  3M Littman Master Cardiology. Price= $ 184.00
2. MDF ProCardial. Price = $ 160.00
3. Riester Cardiophon 2.0. Price= $ 143.00

Mid-Range Stethoscopes:

1. 3M Littman Classic III. Price = $85.00
2. 3M Litman Lightweight II. Price = $ 46.00
3. MDF Rose Gold MD. Price= $ 80.00
4. ADC Adscope 615. Price = $ 60.00

Low-Range Stethoscopes:

1. MDF Acoustica Lightweight. Price = $25.00
2. Clinical Grade Stethoscopes. Price = $20.00
3. Prestige Medical Clinical 1. Price = $ 32.00

Our recommendation for Great quality, Great Price =  3M Littman Classic III. Price = $85.00

How to Choose the Right Stethoscope 

Nurses are modern-day warriors and every day they get into a fierce battlefield. It is just right that they are equipped with the best gear that should make work easier. What many consider to be the most important weapon in their arsenal is the stethoscope. Getting the right one can make all the difference in a nurse’s very tough daily grind. So how do you choose the best stethoscope?

First of all, a little history about who invented the stethoscope. The stethoscope was invented in France in 1816 by Rene Laennec. Laennec invented the stethoscope because he was uncomfortable placing his ear on woman’s chest to listen to heart sounds. George Phillip Cammann perfected the design in 1852 of the stethoscope that used both ears and it has been the standard ever since. In the 1960s, David Littmann, a Harvard Medical School professor, created a new stethoscope that was lighter than previous models and improved acoustics.

Now, stethoscopes play an important role in auscultation, a clinical skill that every medical professional should learn. During auscultation, abnormal sounds detected may indicate issues in the heart, lungs, abdomen or major blood vessels. To listen to the heart, the medical professional has to listen to the four main regions of the heart where the valve sounds can be heard the most, which include the regions above your chest and slightly below your left breast. Through the stethoscope, you can listen to the patient’s heart sounds, how often each sound occurs, and how loud it is. Littmann’s has an instructional poster showing the key auscultation sites to help you better visualize the pulmonic, aortic, mitral and tricuspid areas.

Since traditional heart sounds are rhythmic, any variation may mean that the patient has a leaky valve or some parts of the heart are not getting enough blood. The doctor can order more tests for the patient based on the unusual heart sounds.

To listen to the lungs, you have to compare the sounds that you hear from one side to what you hear from the other side as well as the sounds from the front of the chest to the ones you hear from the back of the chest. You would hear a difference in the sounds of airflow if airways are narrowed, blocked or filled with fluid. Littmann also has an instructional poster for pulmonary auscultation to identify the parts of the chest where you can put the stethoscope, such as the zones, trachea, and axillae.

A rub sound, something that emits the same sound as sandpaper rubbing together, may mean irritated surfaces around the lungs. Wheezes, low- or high-pitched, can also be heard using a stethoscope.

1. Stethoscope Sound Training, Khan Academy heart Sounds

2. Stethoscope  Sound training Lung Sounds

There are a few main selection points you need to cover to find the stethoscope that can provide for your unique needs.

How Do You Intend To Use It?

If you have to use it to hear through the heart, then you need a cardiology stethoscope. It works best for cardiac assessment thanks to its superb sound amplification.  It is available in single- and double-head chest piece. Cardiology stethoscopes usually have bi-lumen chest piece tubes designed into a single tube design to prevent any noise that might be created by double tubes rubbing together.

Are you working in a pediatric ward? Then you might want to have something that works best for kids. Pediatric pieces are smaller in size with the bell part just an inch in diameter. The diaphragm is contoured so that it fits perfectly with little children, allowing for better sound detection compared to larger stethoscopes.

Like the one designed for pediatric bodies, the infant stethoscope is smaller, just ¾ of an inch in diameter. The headpiece is contoured so that it can easily be used for newborn babies.

There are also versatile Sprague Rappaport stethoscopes that can be used to assess pediatric, infant, and adult patients. They have separate chest piece tubes, one for each piece, that meet at the metal clip but are connected separately to the headpiece.

How Long It Will Last

As a busy nurse, you need the best stethoscope that won’t easily break, something that can be frustrating when you’re in the middle of helping a patient. Invest in one that will last for years, something that you can learn more about when you start reading stethoscope reviews and comparing the different models available in the market. Make sure it meets your basic needs. Check the headset and find one with a spring design. Ask the vendor for its part replacement and warranty programs. The more confident the vendor is in its product, the better their warranties usually are.

Will It Be Comfortable for the Patient?

While you ensure your comfort in using your stethoscope, you should also consider your patients’ comfort. An excellent nurse stethoscope would keep your patients from squirming while allowing you to use them for prolonged periods of time during a long shift. A great model would have an adjustable headset and at least three different sizes of ear tips so you can choose the most comfortable one to use and the best one at removing external noise. It should have a longer tubing that will allow you to use it while giving your patient a more comfortable and safer amount of space.

How Easy Is It to Clean?

Given your constant exposure to patients with various diseases and carrying different bacteria and viruses, your stethoscope often ends up getting contaminated. According to research, 80% of stethoscopes get contaminated with infectious bacteria. This is why it is important to find a stethoscope that is easy to clean. Wiping it down with alcohol pads should do it, according to experts, but they discourage using alcohol gels because of their lotion ingredient that may lead to sediment buildup in the instrument. You should also determine when you need to replace stethoscope parts to keep it clean and durable.

Further Considerations

These are your stethoscope options. It can be overwhelming with the many things to consider plus the availability of many good brands out in the market today. The secret is knowing and really understanding your needs. Here are some additional pointers to consider when looking at each of the stethoscope parts:

• Eartips. The earpiece must fit perfectly in your ears. The keyword here is comfort. Try it on your ears and see if it is properly angled for crisp sound playback. The ear tips should be the perfect size that can seal out the sound from the outside.
• Chest piece. Make sure the chest piece is made from stainless steel – it conducts sound better. Ones that are made in titanium are also good choices for their durability and performance. It is also ideal to buy a chest piece with a hand-polished finish both on the outside and the inside. Those with unfinished internal sides have perforations and can absorb sound, which can prevent you from hearing a crisper and cleaner sound.
• Tubing. The tubing must be made from a thick, pliable material so that it does not crack or break while keeping out external noise. The thick tubing determines its ability to isolate acoustics from external noise. Longer tubing also keeps you at a safer distance from the patients.

It also helps to use a stethoscope with hand polished tubing. This is often ignored by cheap manufacturers. But more than having a less than pleasant-looking stethoscope when it is unpolished outside, it becomes even less impressive if it is also unpolished inside because it will have a low-quality acoustic performance and present more challenges in coming up with a diagnosis for the patients.

• Diaphragm. The diaphragm should be made from a good, flexible material. Ideally, it also should have the non-chill rim.
• Stem. For the best sound experience, find a nurse stethoscope that has the same material as the chest piece. An excellent steam has to snap into place to minimize sound leakage as much as possible.
• Leaf spring. This is often disregarded in cheap stethoscopes, but this is a small but significant part of a stethoscope that you should pay close attention to. Those models that come with a non-adjustable, tight headset may not fit nurses with large heads, while those with fairly loose tension may not have a snug enough headset to reduce the ambient noise from the outside. It would be better to pay more for a premium stethoscope if it meant getting one with a leaf spring that makes it easier to adjust your stethoscope to your
• Stethoscope parts for life. Some manufacturers generously offer customers consumable parts for free for as long as they own the stethoscope. These consumable parts often include non-chill rings, ear tips, retaining rings, diaphragms, and ID tags. The usual requirements for owners are to register their product upon buying it. Others are even more generous that they would send the replacement parts to you for free. The only downside, which isn’t much of a bother at all, is that they will use your contact information to reach you every now and again to ask for your feedback about your stethoscope.
• Materials. The materials used to make a stethoscope will be a huge factor in setting its durability. Among the best are stainless steel tubing and antimicrobial plastics. Both are noted for their durability and performance. Although they might be slightly heavier than other options, they are worth what they can give you in return. If you want a lighter stethoscope, you can try one that is made of copper, but it may be weaker in terms of bacteria resistance compared to steel. Models made of steel can endure regular cleanings and are more bacteria resistant.

Where sound is concerned, go for titanium and stainless steel stethoscopes. These materials can pick up and transfer sound better. It would be ideal if you look for stethoscope parts such as the tube, diaphragm, and chest piece that are made of the same materials for improved performance. But don’t buy those with aluminum diaphragms since the softer metal is too hollow to provide accurate readings.

Investing in a good nurse stethoscope will all be worth it if it means convenience in helping you assess your patients, having something that you can count on during emergencies, owning an important medical tool that will last a lifetime, and comfort from using something that fits you well.