THE BEST STETHOSCOPES IN 2017

THE BEST STETHOSCOPES IN 2017

Stethoscope NameDescriptionFeatures
LITTMANN CARDIOLOGY III STETHOSCOPE ($305)

littmann cardiology
The 3M Littmann Cardiology III stethoscope is a perfect piece for clinicians. The Littmann Cardiology III stethoscope remains one of the best-purchased tools in the medical field. This medical device offers its users a tunable diaphragm on both sides. These tunable diaphragms, helps its users to obtain an exceptional acoustic reading.
Workers in the medical field can use the Littmann Cardiology III to get a proper reading while treating their pediatric and adult patients. Here are some other unique features it offers:


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• There is more versatility in converting the pediatric side of the device to an open bell for low frequencies. You should include the non-chill bell sleeve.
• The dual-sided chestpiece in the Littmann provides a variety of auscultation for both adults and kids.
• The Littmann Cardiology III provides two tunable diaphragms. These diaphragms capture high, and low frequency sounds when lightly moved.
• There is a two-in-one tube design that helps eliminate the interference of noise when outer tubes rub against each other.
• It comes with an anatomically designed headset, which is angled to meet the ear canal path.
Currently, the 3M Littmann Cardiology III has 4.6/5 stars from Amazon reviews.
LITTMANN LIGHTWEIGHT II STETHOSCOPE ($48)

Littmann Lightweight II stethoscope remains amongst the best stethoscope for nurses and nursing students over the years. This entry-level medical instrument is available in the market for an affordable price.
The Littman Lightweight comes with a tunable diaphragm and a dual-sided chestpiece. With this device, student and nurses can carry out an excellent acoustic reading for blood pressure. It also comes in a teardrop shape to ensure that the task at hand is quickly done.

buy-it-now stethoscope
• The Littmann Lightweight weighs about 118 grams, which makes it the lightest adult Littmann stethoscope available in the market.
• The stethoscope provides solid acoustic performance when taking blood pressure reading, and making some physical assessments of adult patients.
• It comes in a teardrop shape to ensure that blood pressure reading is quickly done.
• Its tunable diaphragms respond to the slightest pressure, and when it does, it could capture both low and high frequency sounds dependent on the tuning.
• The Littmann Lightweight has an anatomically designed headset that is patterned to fit the ear canal path.
• It also has a non-chill rim to provide comfort to the patient.
Currently, the Littmann Lightweight is rated 4.4/5 stars by 3,927 reviewers on Amazon.
LITTMANN CLASSIC II STETHOSCOPE ($68)

The 3M Littmann Classic II Stethoscope remains a well-designed tool for reading infants in the medical field. This device, designed in the fashion of all Littmann Classic stethoscopes, is reliable and can be used all day for monitoring, physical assessment, and diagnosis of infants.

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• a dual-sided chestpiece with high sensitivity.
• The Littmann Classic II comes in a compact design and durable form. With these features, this tool is ready to offer several auscultation and dependability.
• It has an anatomically designed headset that has been designed to fit perfectly with the ear canal path of any user.
• Its tunable diaphragm responds to slight pressure and delivers high, and low frequency sounds without the chestpiece being turned.
• It comes with a Non-chill rim and diaphragm to provide comfort to patients
• There is a Latex-free material supplied for allergy sensitive users.
Currently, 361 users rate the Littmann Classic II a 4.5/5 star on Amazon.
LITTMANN MASTER CLASSIC II STETHOSCOPE ($104)

The 3M Littmann Master Classic is an exceptional, cost-effective stethoscope. This award-winning stethoscope is uniquely designed to offer professionals in the medical field, a dependable report, and easy-to-use features.

The 3M Littmann Classic II Stethoscope remains a well-designed tool for reading infants in the medical field. This device, designed in the fashion of all Littmann Classic stethoscopes, is reliable and can be used all day for monitoring, physical assessment, and diagnosis of infants.

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• The Littmann Master Classic comes with a tunable diaphragm, which responds to slight pressure and captures high and low sound frequency.
• It comes with an ergonomic design and an excellent acoustic sensitivity. These key features ensure that its users are can obtain reliable sound reports with ease.
• The Master Classic II has a 1.7-inch chestpiece size.
• It also comes with a well crafted anatomical headset that fits perfectly against the ear canal path.
• The availability of Non-chill rim and diaphragm ensures comfort to patients.
• Also, the Master Classic II has a latex-free material for users with sensitivity allergy.
This medical instrument is available for purchase online and has a 4.5/5 star rank in Amazon by users.
ADSCOPE 615 PLATINUM STETHOSCOPE ($44)

Technology and render its services for professional users. This stethoscope integrates traditional bell acoustic response and diaphragm uniquely. It comes with an oversized chest piece and uses light pressure and firm pressure for low and high sound frequency.

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• With its adjustable frequency design (AFD), offers an easy to use one-sided chestpiece with a unique auscultation like the traditional bell
• With it's oversized and well-crafted ovoid chest piece, the acoustic is a CNC precision machine in lightweight zinc alloy. With these materials, the AIDESCOPE 615 Platinum stethoscope provides beautiful performance experience and ergonomics.
• It comes with a headset crafted and designed with flexible 22-inch PVC tubing, Adsoft Plus silicon ear tips and stainless binaural. All these materials make the headset of AIDESCOPE 615 the best when it comes to acoustic seal and wearing comfort.
• There is an additional Adsoft Plus ear tips pair, and a scope ID tag.
• When registered, there is a lifetime warranty and free consumables for users.
Currently, this stethoscope is given a 4.4 star by reviewers on Amazon.
LITTMAN MASTER CARDIOLOGY STETHOSCOPE ($178)

The Littman Master Stethoscope is another masterpiece the Littmann firm has to offer professionals in the medical field. This medical instrument is known as the best acoustic response instrument in the Littmann stethoscope line. This cardiology equipment provides its users many features; these features are listed below.

buy-it-now stethoscope
• The Littman Master stethoscope provides a handcrafted enthralling Chestpiece, which delivers the best acoustic performance in the Littman’s line of Stethoscope.
• Its chest piece comes in a 2-inch size.
• There is a two-in-one lumen tube for noise elimination during external tubes friction
• It comes with a special-procedure adaptor for infants and pediatric auscultation. With this feature, the Littman Master stethoscope offers versatility.
• There is a comfortable headset designed for an anatomical purpose, which fits well in the ear canal path.
• Also, the Master stethoscope comes with a tunable diaphragm that easily responds to pressure. The diaphragm efficiently captures low and high sound frequency.
This medical instrument has a 4.6/5 star online from online reviewers on Amazon.
ADC ADSCOPE 609ST STETHOSCOPE ($18)

This uniquely designed Stethoscope is targeted at entry-level medical practitioners and comes at a very affordable price. It has a 100-gram weight, making it an ultra-lightweight product from the ADC stethoscope product line. Here are some unique features it offers;

buy-it-now stethoscope
• It has a highly sensitive non-chill diaphragm for better amplification.
• Its headset has a reinforcing yoke that is molded into flexible 22-inch PVC tubing.
• The headset comes with a lightweight aluminum binaural in a matching satin finish.
• Its headset also comes with an ADSoft Plus silicon eartip for the best acoustic seal and wearing comfort.
• The ADSCOPE 609ST comes with an additional pair of Adsoft Plus ear tips.
• The stethoscope comes with a five years warranty and free consumables.
As of recent, the ADC ADSCOPE 609ST Stethoscope has a 4.1-star rating from reviewers on Amazon.
With the help of stethoscope advisors, expert rating and reviews, we present to you a list of the best stethoscopes available in the market. It is our desire for those interested in acquiring a stethoscope this 2017, be able to make the right decision. Hence, we have compiled a list of seven stethoscopes that stands out of the crowd and will help our nurses, doctors, and nursing students in their cardiological jobs.

Litmann Cardiology iii: Comparison with other stethoscopes

stethoscope brands

The Litmann Cardiology iii stethoscope is soon becoming outdated. Littmann has recently come out with the Cardiology IV, the next generation in cardiology-grade stethoscopes.

However the good news for us is that this means sales! As the stock turns over more likely than not the Litmann cardiology ii will be put in a discount, to make room for the newer model.

In this article we’ll take a look at how this stethoscope holds up against other leaders in the field.

Litmann Cardiology iii

We can’t start off our comparison review without taking a look at our main star. The Littmann cardiology 3 stethoscope.

Litmann cardiology iii, 3M Littmann Cardiology III Stethoscope, Black Plated Chestpiece and Eartubes, Black Tube, 27 inch, 3131BE

First off it features a dual-sided chest-piece for both adult and pediatric patients. So no need to switch in between auscultations.
Secondly this one also features Littmann’s “Tunable Diaphragm”- technology where you can hear high and low-frequency sounds by simply changing the pressure you apply to the chest-piece.
The fact that it has a dual lumen tube design, ensures that there is no sound interference from 2 external tubes rubbing together.
Lastly the angled headset is designed in such a way that the earpieces align with the path of the ear canal. Offering more comfort to the user!

It’s incredibly light, coming in at 13.6 ounces. It comes in a variety of colors and the one featured here is the black version.

The Litmann cardiology iii has a 5-year warranty and is made in the USA.

Now let’s compare this one to some other, cardiology-grade stethoscopes on the market.

 

MDF stethoscopes versus Littmann

First up are the MDF stethoscopes.

litmann cardiology iii, MDF ProCardial ERA Cardiology Lightweight Dual Head Stethoscope with Adult, Pediatric, and Infant-Neonatal convertible chestpiece - All Black (MDF797X-BO)

Let’s take a look at MDF’s ProCardial ERA Cardiology Lightweight Dual Head Stethoscope.

I don’t understand fully why but MDF makes good stethoscopes and I am unsure why people aren’t falling for these beauties more. The Procardial ERA stethoscope is also a lightweight, weighing in at 1.25 lbs.
However the litmann cardiology iii only weighed 13.6 ounces, which is 0.85 lbs. Score one for Littmann!

As is the case with most MDF stethoscopes, this one also comes with a lifetime guarantee. Coupled with a free-spare-parts-for-life program, this more than makes Littmann bite the dust. 1-1 all.

One major point that Littmann has over MDF stethoscopes is that Littmann has the “tunable diaphragm”-technology. It has it patented and uses it throughout their stethoscope lines.

The MDF ERA stethoscope comes with a whole host of attachments and interchangeable parts which can have an adverse effect on usability. Plus not to think that you need to store those changeable parts somewhere and they might get lost. I wonder how much their free-spare-parts-for-life program is costing them on a yearly basis!

Reports are out there that the tubing is too stiff and the acoustics not what you’d expect from a cardiology grade stethoscope.

Looks like the Litmann cardiology iii has got this one in the bag!

 

Vorfreude stethoscope versus Littmann

The Vorfreude stethoscope is Germany’s answer to US’s Littmann. You can see this both in design and funtion. Just pay attention to how the chest-piece of the Vorfreude stethoscope looks like versus the one on any Littmann stethoscope.

The shape of the stethoscope looks A LOT like a cursively written “L”.

However looks don’t say anything about acoustic performance. And this is where Vorfreude really holds their own.

Several users online have reported that the acoustic performance of Vorfreude holds up to for example the Litmann cardiology iii.

But unfortunately that is where the comparisons end. It seems that the Vorfreude stethoscope is a victim of its low price. While this is an incredibly affordable stethoscope, the finished product leaves a lot to the imagination. after only a few weeks of intensive use, the plastic ring that holds the diaphragm up tends to loosen. As a result the diaphragm pops out. at the same time the earbuds that come with this product tend to fall off again.

So if you are a hobby-builder or like to construct stethoscopes on a continuous basis, this is the stethoscope for you! For everyone else, here is the link to the Littmann cardiology 3 stethoscope on Amazon.

 

RA Bock versus Litmann Cardiology iii

 

R.A. Bock Cardiology Dual-Head Stethoscope w/ Stainless Steel Chestpiece

 

RA Bock has spent a lot of time and effort in making a copy of the Littmann Cardiology stethoscope-series. And they freely admit this as well.

Look-wise, weight-wise and size- wise they are right on the money.

Even functionability. The RA Bock cardiology stethoscope features push-over eartips, just like Litmann. It has a chest-piece that is tunable, just like a litmann cardiology iii stethoscope.

They even offer a lifetime warranty that covers the binaurals, tubing and stainless steel stethoscope head.

They do state that while diaphragms and eartips wear out over time and are not covered in the lifetime warranty, they’ll sell replacements for less money than it would cost you to pay the shipping on the MDF free-parts-for-life program.

Although they didn’t directly mention MDF by name, you can deduct it by the way the text is written. Seems the competition in the stethoscope world is fierce!

Upon unboxing however the tubing does feel stiff and there are reports of the bell having fallen off completely from the tubing.

I’d stick with a litmann cardiology 3 in this case as well.

 

 

editor’s note:

This is more a confession than a note. I am very well aware that throughout this article I have used “Litmann” with a single “t” compared to Littmann. Which is the correct name for Littmann stethoscopes. However through research I have found that there are more hits in search engines for Litmann cardiology iii than there are for Littmann cardiology iii. Hence to bring this article and information to the masses, I have used the wrongly written “Litmann” throughout.

I hope you forgive yet enjoy!

Blood pressure monitor: which one to buy?

Blood pressure monitors come in a variety of shapes and sizes. So how can you be sure you got the best blood pressure monitor for your money? Read on and find out how!

In the next few chapters I’ll try and separate the good from the bad and the beautiful from the ugly in the world of blood pressure monitors. Amongst sphygmomanometers, another, more scientific name for blood pressure gauges, there is a wide variety. Depending on what and where you intend to use your monitor, your choices will be largely based on whether you want an alaog or a digital device.

Digital Blood pressure meters

Let’s start off with the best digital blood pressure meter out there today:

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The automatic digital upper arm cuff blood pressure monitor from Vive Precision. Please note that Vive Precision is not paying me to advertise their products on my website. If they would I wouldn’t be spending my time writing this detailed guide for you, believe me!

Vive Precision is known for their accuracy and detail eye for quality. Each and every blood pressure monitor is individually tested for accuracy. This helps ensure you that the reading you get is your actual blood pressure. No need to doubt the result!

The large and bright display is there to make sure you have no trouble reading the result off the screen. Due to the backlight you can now also effortlessly take your measurements at night or just when you wake up! No need to switch on those lights that early in the morning.

The main reason why to my opinion this is the best blood pressure monitor out there is the fact that you get a full 2-year guarantee with this device. Also everything is included right from the get-go. You get a one-size-fits-all cuff, 4 AAA batteries and an illustrated user’s manual. The second you unbox this beauty you are good to go! and retailing at less than $50 this is a must-have device to have in your home.

Follow this link to check it out for yourself on Amazon!

So are there no downsides to this device?

Actually… There are. Some people have reported great inaccuracies with their device when operating it straight out of the box. Sometimes the devices are wrongly calibrated leaving the factory and this can result in faulty readings. Usually you notice by the fact that your blood pressure, according to the monitor, would be sky-high.

If this is the case with your blood pressure monitor, please do the following:

First of all, remove the batteries. Replace them and go through the steps for setting the unit exactly as is told in the instructions manual. This will enable you to reset the device. Pay attention that when you get to page 8 in the instructions manual, you repeat step 2 and 3 to calibrate the unit.

If you did this as explained above, take a reading again and it will be your correct blood pressure!

 

Another good, slightly more expensive blood pressure monitor is the Omron 10 series wireless upper arm blood pressure monitor.

 

Omron 10 Series Wireless Upper Arm Blood Pressure Monitor with Cuff that fits Standard and Large Arms (BP786/BP786N) with Bluetooth Smart Connectivity, best blood pressure monitor, blood pressure gauge, blood pressure meter, best blood pressure meter, best blood pressure gauge

What’s so good about this one?

In addition to the big digital screen comparable to the Vive Precision, the Omron blood pressure monitor allows you to store the last 200 measurements. For more than one person even! As a result you can now fully track how your blood pressure develops. Does that new diet really work? Should I actually eat MORE sodium than before? These questions will now remain answered as you track the development of your blood pressure.

The cuff is however not as versatile as the Vive Precision. This one fits arms with a circumference between 9 and 17 inches. So if you are petite this might not be the best blood pressure monitor for you.

Another possible drag with this blood pressure monitor is that you need to set the time and date before every reading. As a result it is quite cumbersome to get it done as there are a few extra steps that need to be taken. However this is in your benefit thought as increased tracking helps provide more accurate readings.

For example the Omron 10 series offers you the possibility to get average readings. If you take 3 readings within 10 minutes this blood pressure meter will give you the running average of those 3 readings. As a result you get a much more accurate read-out!

Please note that unfortunately the Bluetooth pairing with smartphones only works if your phone is an iPhone. For Android phones the Bluetooth pairing will NOT work!

 

Best analog blood pressure monitors

The real McCoy however are the analog blood pressure monitors. However they need to be paired up with a stethoscope if you want to work with them. In the previous link I made a list for you with the best stethoscope and best analog sphygmomanometer.

My choice for analog blood pressure monitor is the MDF Calibra Aneroid sphygmomanometer. Not only is it one of the most reviewed blood pressure meters on Amazon, it boasts the best reviews as well.

MDFbest blood pressure monitor, blood pressure gauge, blood pressure meter, best blood pressure meter, best blood pressure gauge, MDF® Calibra Aneroid Sphygmomanometer - Lifetime Calibration Warranty - Blood Pressure Monitor with Adult Sized Cuff Included - Black (MDF808M-11)

MDF offers you a 3 year warranty on this gauge. Also make sure to check out for special promo’s where you can get a free stethoscope with your purchase. Find out more about these promotions on this page. They offer good stethoscopes too and I wrote a review on some of them here.

This blood pressure meter is latex-free yet stick and crack-resistant. Should any of the tubing crack then note that this device has a 3-year warranty as mentioned above. Or read here on how to prevent tubing from cracking.

Each and every device is stress tested 3000 times and calibrated 5 times.

 

How to use a blood pressure monitor

Before you can even start you need to take care of a few things.

  1. Many things can cause a temporary rise in your blood pressure and as a result give you a false reading. As such make sure you haven’t eaten a big meal at least 30 minutes before taking a reading, or that it has been a long time since your last cup of coffee. Also measure your blood pressure some time after you have last gone to the toilet!
  2. Make sure you always use the same arm when you measure your blood pressure. If possible try and remember the arm your doctor or nurse uses and use that same one at home.
  3. Before taking your blood pressure try and rest for at least 5 minutes. Sit upright in a comfortable position at a table, with your feet firmly on the ground and your arms resting on the table in front of you.
  4. The cuff around your arm needs to be roughly at the same level as your heart in order to get really accurate readings. So make sure that you have a pillow or cushion ready to give your arm some extra support. Don’t hold up your arm as the exertion might cause your blood pressure to spike!

Next it is time to measure your blood pressure.

Digital devices

Digital blood pressure monitors are the best blood pressure monitor to use at home. As long as you follow the instructions provided with your device such as making sure the tubing points up and is aligned along the visible arteries in your arm.

However analog meters come with a bit of a challenge. What you need is a stethoscope. You’ll be listening to so-called Korotkoff sounds. See the video below for a full how-to in measuring BP!

 

I hope you have found this guide useful! Let me know in the comment section below if I have missed the mark completely or if there is something more you’d like me to add!

Stethoscope brands – A short overview

stethoscope brands

There are several stethoscope brands out there. Most of you probably know Littmann as being the lead-name in the world of stethoscopes. However A lot of you won’t have heard of “Vorfreude” or “ThinkLabs“.

First let’s take a look at the biggest of the stethoscope brands out there: Littmann.

Littmann stethoscopes

stethoscope brands, littmann stethoscopesstethoscope brands, littmann stethoscopestethoscope brands, littmann stethoscopestethoscope brands, littmann stethocopestethoscope brands, littmann stethoscopes
Classic IIIMaster Classic IICardiology IIICardiology IVMaster Cardiology
Acoustic Performance899910
Ideal For Diagnosis and Physical AssessmentDiagnosis and Physical Assessment‎Cardiology/High PerformanceCardiology/High PerformanceCardiology/High Performance
Warranty2 Years 3 Years5 Years7 Years7 Years
Chestpiece Design/MaterialDouble Sided/Machined Stainless SteelSingle Sided/Plated and Polished AlloyDouble Sided/Machined Stainless SteelDouble Sided/Machined Stainless SteelSingle Sided/Cast Stainless Steel
Available Color/Finishes18 Colors/ 4 Finishes9 Colors/ 2 Finishes16 Colors/ 6 Finishes7 Colors/ Stainless Steel Finish7 Colors/ 3 Finishes
Diaphragm – tunable: hear different frequency sounds without turning over or repositioningRedesigned Single-piece Tunable Diaphragm on each side of the ChestpieceTunable DiaphragmTwo Tunable DiaphragmsRedesigned Single-piece Tunable Diaphragm on each side of the ChestpieceTunable Diaphragm
Tube DesignSingle Lumen TubingSingle Lumen TubingDual Lumen TubingDual Lumen TubingDual Lumen Tubing
Weight/Length150 grams, 27″/69cm160 grams, 27″/69cm175, 180 grams Available in 22” / 56cm and 27” / 69cm167, 177 grams Available in 22” / 56cm and 27” / 69cm175, 185 grams Available in 22” / 56cm and 27” / 69cm
Made in the USA

Littmann has quickly become the marketleader in stethoscopes. 3M bought the patent to make Littmann stethoscopes from doctor Littmann somewhere in the 60’s and they’ve been making them ever since.
As a whole 3M is a gigantic company that has processes in place that guarantee superior quality. As a result these stethoscopes guarantee you high-quality acoustics.

However between the models themselves there are big differences in quality.

For example a Littmann Classic has been reported to better convey low-frequency sounds than a Littmann LightWeight. As a result I have not listed the LightWeight here either.

 

Vorfreude stethoscopes

Among the stethoscope brands there is a new player on the US markets. Vorfreude.

This German engineered stethoscope has been receiving rave reviews both on Amazon and on various online forums.

Lighter than Littmann

First off the Vorfreude stethoscope is light. About 5 % lighter than a Littmann Master Cardiology. Even though it has the same dimensions!
As a result the likelyhood of you having a strained neck is diminished when you carry your Vorfreude around your neck. Additionally the diaphragm edges have a mirror finish to prevent corrosion and pitting.

In addition this stethoscope comes in at a fraction of a cost compared to a Littmann.

 

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Stethoscope brands copy each other

The funny thing is is that the industry is really small. Especially in the stethoscope industry where you have a big player such as Littmann, the smaller fish tend to look what the bigger one is doing and then copy them.

So in the same sense that Littmann has a tunable diaphragm, so does Vorfreude. However they have rebranded their technoogy as “PressFrequency”. But the working principle remains the same in both. The chestpiece does not have a bell-side. Just a diaphragm. Simply press down harder on the chestpiece to hear the high-frequency sounds.

Lastly the dual lumen tube design and single head eliminate ambient noise interference. Which is a major plus if you are an EMT.

 

 

ADC Adscope stethoscopes

 

In several reviews online ADC Adscope has gone out to rival Littmann as you can clearly make out from the review video above. Cost-wise they come in at several multiples less than Littmann. As mentioned in the Vorfreude section also ADC isn’t the biggest player amongst the stethoscope brands and as such tends to copy the technology Littmann brings out. However they can’t call their technology a “tunable” chestpiece since Littmann has the copyrights to that. ADC’s “AFD technology” however does exactly that. If you want to hear more higher frequency sounds simply press down harder on the chestpiece and you’ll be fine!

 

stethoscope adc adscope clinician american diagnostic acoutstic adjustable frequency headset eartip stethoscope adc adscope clinician american diagnostic acoutstic adjustable frequency headset eartip stethoscope adc adscope clinician american diagnostic acoutstic adjustable frequency headset eartip stethoscope adc adscope clinician american diagnostic acoutstic adjustable frequency headset eartip
ADC Adscope 603 ADC Adscope 609 ADC Adscope 612 ADC Adscope 615
Scope Type Clinician Clinician Clinician Clinician
Chestpiece Type Combination Combination AFD Technology AFD Technology
Chestpiece Material Stainless Aluminum Zinc Zinc
Chestpiece Finish Satin Satin Satin Brushed
Diaphragm Diameter 1-3/4″ 1-3/4″ 1-1/2″ 2 3/16″
Headset Type Clinician Clinician Clinician Clinician
Headset Material Stainless Aluminum Stainless Stainless
Eartip Type Adsoft Plus Adsoft Plus Adsoft Plus Adsoft Plus
Total Weight 5.8 oz 3.5 oz 4.9 oz 5.4 oz
Colors and Finishes Tactical finish with black tubing, copper finish with black tubing, or stainless finish with one of twenty-two tubing colors Tactical finish with black tubing or aluminum finish with one of seventeen tubing colors Zinc/aluminum finish with one of five tubing colors Tactical finish with black tubing or zinc/stainless finish with one of nine tubing colors

 

 

MDF stethoscopes

As American as they come, MDF is a small manufacturer stethoscopes and other healthcare devices. They’ve been in business since 1971 and are headquartered in LA. They are known for competing on price with Littmann. However they both provide roughly the same quality stethoscope.

Depending on who you ask the reason why they can offer such a low price is because they manufacture their products in Asia. At the same time cheaper substitutes have been used by MDF where Littmann would maybe use a more expensive material. Mostly people have commented that the diaphragm quality is that of a cheap stethoscope and the bell part is plastic.

A big benefit however of this stethoscope brands is their lifetime warranty and free parts-for-life program.

See below how the MDF stethoscopes pare up to the Littmanns.

 

Customer Rating 4 out of 5 stars (751) 4 out of 5 stars (2079) 4 out of 5 stars (3747) 4 out of 5 stars (625) 4 out of 5 stars (751) 4 out of 5 stars (28)
Price $$ $$$ $$ $ $ $$$$
Sold By Coastal Clothing Company Amazon.com Corydor MDF Instruments Official Store Amazon.com MDF Instruments Official Store
Color All Black (BlackOut) Black Tube Black All Black (BlackOut) Tactical Black All Black (BlackOut)
Item Dimensions 6.42 x 12.91 x 2.2 in 6.61 x 12.72 x 1.73 in 5.13 x 9.75 x 1.75 in 5 x 9.5 x 1.6 in 0.94 x 31 x 4.19 in 16.3 x 32.8 x 5.6 in
Item Weight 1 lb 5.29 ounces 4.2 ounces 0.6 lb 4.48 ounces 0.51 lb
Size Adult One Size Metal/Resin Composite Chestpiece Adult One Size Adult

 

 

Welch Allyn stethoscopes

One of the oldest stethoscope brands out there. Welch Allyn was started in 1915 and started originally producing medical equipment for eye doctors. Later in an effort to corner a bigger side of the market they branched out and started making top-notch stethoscopes. They are more of a top-line brand which shows in the price-tag. These stethoscopes usually go for between $100 and up to $250.

However they do produce one-time use stethoscopes to run diagnostics on highly infectious patients. These can be thrown away after use as to not risk any further spread of infection. These stethoscopes obviously are not as costly as their regular ones and tend to go for less than $8.

Although Welch Allyn focuses on producing stethoscopes for generalists, their line does include cardiology-grade stethoscopes. Because of this they have received a stable following of users in the medical field due to their catering to generalists. Particularly their Harvey and Elite lines are common due to their dependability and their relatively low price.

 

Vintage stethoscope – Which one is Your favorite?

I’m sure some people reading this article have fond memories of their doctor. However that image isn’t complete without a vintage stethoscope swung around their neck.

Vintage stethoscopes generally stand out from their modern counterparts in design. Depending on how far back you want to go, you can have stethoscopes that have no tubing whatsoever! Others date back from before there was an official bell-type chestpiece.

1870’s style Ford stethoscope

A lot of innovation in the medical field was done in the early Americas of the late 19th century. W.F. Ford had several patents regarding stethoscopes. It was he who helped develop the bi-aural stethoscope that we have come to know today. However a big issue they were facing back then was how to keep the tension right in the tubing. Therefore he came up with a quick fix and added a spring in the middle.

Nowadays Labtron makes stethoscopes in his honor. Although they have forgone the spring system in the middle the bell still hints back to the old-days. See for yourself in the pictures below:

vintage stethoscope, vintage ford style stethocope

They are currently selling on Amazon for less than $20. So if you are on the lookout for a vintage stethoscope in a Ford-style, here’s your chance!

Vintage 1940’s obstetrician’s stethoscope

This particular vintage obstetrician stethoscope, which is also known as a fetal stethoscope, was made over 70 years ago in Ukraine. It is currently stored in a Ukranian military medical warehouse. As it has to come overseas it might take a while before the item reaches you so keep this in mind when you order!

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vintage stethoscope, vintage fetal stethoscope, vintage obstetrician's stethoscope

 

 

 

 

 

 

 

 

 

According to the seller this is a unique piece so supply is extremely limited!

Lastly we’ll feature the grandfather of all stethoscopes.

Vintage Sprague Rappaport stethoscope

We’re still in the 1940’s. It was then that Sprague and Rappaport set out to make a better version of the stiff stethoscopes they had grown accustomed to. Together they aid down the golden standard for what was to become the standard stethoscope everyone has come to know and love. Ultimately Hewlett and Packard ended up manufacturing their stethoscopes. They are now in direct competition with 3M who manufactures the Littmann series stethoscopes.

Below is a kit on Amazon I found that sells everything a beginning doctor-to-be needs in his or her kit!
vintage stethoscope, vintage sprague stethoscope, vintage rappaport stethoscope, vintage sprague rappaport stethoscope

This set features a vintage stethoscope combined with a Sphygmomanometer, which is a blood pressure gauge and -cuff, and a carrying bag.

Litmann Stethoscope Sale

litmann stethoscope sale, stethoscope price

Litmann stethoscopes are usually on sale in a variety of places. Which Litmann stethoscope sale is next depends largely on the age of the model under review. Usually the models that are about to become obsolete due to the arrival of a newer model gets put on sale.

Amazon in general offers decent sales from time to time. As a result in the review of the most commonly sold stethoscope models here below, the links in there will take you to their respective Amazon pages.

Unfortunately I cannot say in realtime whether or not the stethoscopes reviewed are on sale. You’ll have to go check it out for yourself.

Other places than Amazon to look for a Litmann stethoscope sale

However Amazon is not the only marketplace that offers a Litmann stethoscope sale from time to time.

I have personally had really good experiences from stethoscope.com. Usually when you go to their main page they offer a whole list of featured items. Most of the times in this mix are a lot of Littmans.

Secondly Allheart offers good sales from time to time and prisewise they give competitive prices on their Litmann selection. I once asked for a batch offer from them and in that particular case they came out on top pricewise.

If you are looking for a discounted deal then other than Amazon those would be the two other sources I’d start looking. However as mentioned, the links below will take you to Amazon so to make it easy for you I listed some of the features Litmann stethoscopes have.

 

Littmann stethoscopes:

Headset tension is easily adjusted. Simply squeeze together or pull apart the eartubes. Snap-tight, soft-sealing eartips conform to individual ears for an excellent acoustic seal and comfortable fit. Eartips snap firmly onto the ends of the eartubes and, for safety, require a significant effort to remove.

Resilient next-generation tubing retains its shape and flexibility even after folding tightly into a pocket. It provides longer stethoscope life due to improved resistance to skin oils and alcohol. Secondly it is less likely to pick up stains. In addition  the next-generation tubing is not made with natural rubber latex. This is  a benefit to sensitive medical professionals and their patients. Lastly to play its part in the protection of human health and the environment, the next-generation tubing does not contain phthalate plasticizers.

3M Litmann Stethoscopes are used by millions of medical professionals around the world who are dedicated to achieving the best patient outcomes. Litmann stethoscopes offer superb acoustic performance, consistently high quality, and outstanding value. Wearing a Litman stethoscope is an expression of your commitment to medicine, and personal success.

 

Check the overview below to see if Amazon is doing a Litmann stethoscope sale.

Overview:

 

Classic III, Littmann, Stethoscope, stethoscope allergies Master Classic II, Littmann, Stethoscope, stethoscope allergies Cardiology III, Stethoscope, Littmann stethoscope, stethoscope allergies Littmann, Cardiology IV, Cardiology, Stethoscope, stethoscope allergies Master Cardiology, Cardiology, Littmann, Stethoscope, stethoscope allergies
Classic III Master Classic II Cardiology III Cardiology IV Master Cardiology
Acoustic Performance 8 9 9 9 10
Ideal For Diagnosis and Physical Assessment‎ Diagnosis and Physical Assessment‎ Cardiology/High Performance Cardiology/High Performance Cardiology/High Performance
Warranty 2 Years 3 Years 5 Years 7 Years 7 Years
Chestpiece Design/Material Double Sided/Machined Stainless Steel Single Sided/Plated and Polished Alloy Double Sided/Machined Stainless Steel Double Sided/Machined Stainless Steel Single Sided/Cast Stainless Steel
Available Color/Finishes 18 Colors/ 4 Finishes 9 Colors/ 2 Finishes 16 Colors/ 6 Finishes 7 Colors/ Stainless Steel Finish 7 Colors/ 3 Finishes
Diaphragm – tunable: hear different frequency sounds without turning over or repositioning Redesigned Single-piece Tunable Diaphragm on each side of the Chestpiece Tunable Diaphragm Two Tunable Diaphragms Redesigned Single-piece Tunable Diaphragm on each side of the Chestpiece Tunable Diaphragm
Tube Design Single Lumen Tubing Single Lumen Tubing Dual Lumen Tubing Dual Lumen Tubing Dual Lumen Tubing
Weight/Length 150 grams, 27″/69cm 160 grams, 27″/69cm 175, 180 grams Available in 22” / 56cm and 27” / 69cm 167, 177 grams Available in 22” / 56cm and 27” / 69cm 175, 185 grams Available in 22” / 56cm and 27” / 69cm
Made in the USA

Stethoscope Allergies: Cause and remedies

stethoscope allergies

Stethoscope allergies are caused by a response by the body’s immune system to certain elements within the stethoscope. Usually an allergy to stethoscopes is caused by the fact that the patient has an acute latex-allergy. Latex, or rubber, is commonly used in the tubing of the stethoscope. It can also appear in the chestpiece. As a result contact with the patient’s body is almost inevitable.

In general though stethoscope allergies can be divided into two sub-cases. Allergies due to latex- or rubber allergy and allergy to metal.

Stethoscope allergies caused by rubber

If you happen to have bad luck and are allergic to latex, while at the same time you were checked out with a stethoscope that featured latex, chances are you developed an allergic reaction. This allergic reaction is also called “Contact Dermatitis“. Any medical term that ends in “-itis” tends to mean inflammation.
You don’t need me to tell you how inflamed the affected body parts will look. Simply judge for yourself by the pictures below.

stethoscope allergiesstethoscope allergies

 

 

 

 

 

 

 

 

 

The picture on the left shows the result of what is called “a scratch test” or “patch test”. This is a common way to find out if you are allergic for a substance. During this test the doctor, probably a dermatologist, applies a variety of allergic agents in small doses to your skin. However he or she keeps track of which agent goes where for future reference. As time goes by, usually a couple of hours, any reactions you may have will become clear.

Due to the fact that the doctor has marked which substance he or she put where it’s easy to see what you are allergic to. What we see in the test is that this particular patient in the upper-left picture has a positive reaction to Thiuram.

Stethoscope allergies caused by rubber usually have 2 main causes. Either people are allergic to the natural saps in latex-rubber. Or then they are allergic to the rubber-accelerators that are commonly added to rubber. Thiuram is one such accelerator.

On the picture in the right we see a man who has an allergic reaction on his upper thigh. Most likely this has been caused by the elastic band in his underwear.

What are rubber accelerators?

Rubber accelerators are chemicals used to speed up the manufacturing process of rubber (vulcanization). This process makes untreated natural rubber latex suitable for use in the manufacture of many rubber products.

Unfortunately most rubber or latex products include rubber accelerators. They range from clothing and outdoor equipment to cosmetic and…you guessed it… healthcare equipment.

Common reactions to rubber accelerators:

Location Cause Features
Hands
  • Rash caused by rubber gloves often distinguished by sharp cut-off at wrist
  • May be worse over pressure areas
  • May be similar to a photodermatitis
  • Thiuram in oral Antabuse may cause swelling of the hands and feet and water blisters on the hands and fingers
Face
  • Cosmetic applicators, e.g. eyeshadow sponge, eyelash curler
  • Latex Swim or safety goggles
  • Rubber headphones
  • Surgical/examination gloves worn by dentist or doctor
  • Rubber pillows
  • Rash occurs mainly on the eyelids where rubber cosmetic sponges have been used.
  • There’s a chance you develop a rash around the mouth or any site of the body where the dentist or doctor’s hands have touched the skin.
Feet / shoe dermatitis
  • Shoes made with rubber, e.g. sneakers, tennis shoes
  • Rubber insoles for shoes
  • Latex or rubber boots
  • Rubber cements used in joining shoe uppers, the outer leather and linings
  • Rubber box toes, the most common cause of shoe dermatitis
  • Rash usually begins on the base of the big toe and gradually extends to the other toes and onto the feet
  • Recurrent eruptions may occur over many years and may be misdiagnosed as psoriasis, eczema or athlete’s foot
  • Can often become disabling without proper diagnosis and treatment
Genitals
  • Condoms
  • Contraceptive diaphragms

 

If you weren’t allergic to rubber before it is highly possible you got allergic due to chronic exposure. Usually people who work in the medical field develop rubber allergies over a certain course of time. It is a little ironic that rubber allergy develops in this way when you are trying to protect yourself from other allergens using special protective wear.

 

Treatment

Of course ideally you would want to avoid any contact with latex if you have a latex allergy. However that is not always in your control and accidents unfortunately do happen. As a result it is important to be aware of the possible treatments if you develop dermatitis.

A home-made solution could be to treat the affected are with diluted vinegar. However a far better solution is to go see a dermatologist. They will subscribe you some topical corticosteroids. A short course of these will speed up the healing dramatically. This in combination with antihistamines should have you up and running in no-time!

 

Allergies caused by metals

Copper stethoscope allergies

Although copper is quite abundant nowadays, people do still develop contact dermatitis after contact with copper or copper alloys. The allergic reactions that occur are similar to the ones that manifest itself in people with a latex allergy.

The immune system overreacts to a substance that the body mistakenly perceives as harmful. White blood cells produce antibodies, which enter the bloodstream and attach to cells. This prompts the release of histamines that cause allergic symptoms such as skin rash, diarrhea, nausea, muscle pain, fatigue and hair loss.

As a result stethoscopes that have copper or copper alloys in them should be avoided in an effort to decrease any possible allergic reactions in your patients.

Nickel allergies

Another common culprit of contact dermatitis is nickel. The same guidelines for the above mentioned allergens apply to nickel. Avoid at all cost for the sake of your patients and yourself.

However should one of your patients develop contact dermatitis, then a round of topical corticosteriods combined with antihistamines should do the trick!

 

Non-allergenic stethoscopes

Obviously to reduce the chance of an stethoscope allergies you need to avoid the allergenic agent completely. Below is a quick overview of stethoscopes that do not feature any allergenic agent discussed above.

Littmann stethoscopes have become the standard stethoscope in the country. This is due to their superious acoustics as well as their use on non-allergenic materials. None of the Littmann stethoscopes have any latex components or phtalate plasticizers in the tubing. As a result you can be safe these stethoscopes will not cause any allergic reactions in your patients.

Below is a table in which the most common stethoscope models are ranked next to each other. The links will take you to Amazon where you can study them further.

Overview:

 

Classic III, Littmann, Stethoscope, stethoscope allergies Master Classic II, Littmann, Stethoscope, stethoscope allergies Cardiology III, Stethoscope, Littmann stethoscope, stethoscope allergies Littmann, Cardiology IV, Cardiology, Stethoscope, stethoscope allergies Master Cardiology, Cardiology, Littmann, Stethoscope, stethoscope allergies
Classic III Master Classic II Cardiology III Cardiology IV Master Cardiology
Acoustic Performance 8 9 9 9 10
Ideal For Diagnosis and Physical Assessment‎ Diagnosis and Physical Assessment‎ Cardiology/High Performance Cardiology/High Performance Cardiology/High Performance
Warranty 2 Years 3 Years 5 Years 7 Years 7 Years
Chestpiece Design/Material Double Sided/Machined Stainless Steel Single Sided/Plated and Polished Alloy Double Sided/Machined Stainless Steel Double Sided/Machined Stainless Steel Single Sided/Cast Stainless Steel
Available Color/Finishes 18 Colors/ 4 Finishes 9 Colors/ 2 Finishes 16 Colors/ 6 Finishes 7 Colors/ Stainless Steel Finish 7 Colors/ 3 Finishes
Diaphragm – tunable: hear different frequency sounds without turning over or repositioning Redesigned Single-piece Tunable Diaphragm on each side of the Chestpiece Tunable Diaphragm Two Tunable Diaphragms Redesigned Single-piece Tunable Diaphragm on each side of the Chestpiece Tunable Diaphragm
Tube Design Single Lumen Tubing Single Lumen Tubing Dual Lumen Tubing Dual Lumen Tubing Dual Lumen Tubing
Weight/Length 150 grams, 27″/69cm 160 grams, 27″/69cm 175, 180 grams Available in 22” / 56cm and 27” / 69cm 167, 177 grams Available in 22” / 56cm and 27” / 69cm 175, 185 grams Available in 22” / 56cm and 27” / 69cm
Made in the USA

Stethoscope: what is it and how is it used?

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The whole point of making this website. The mighty stethoscope.

A stethoscope is a medical device that is used, generally, by doctors, nurses and other medical professionals. They use it predominantly to perform checks on the heart and lung functions. These checks are called auscultations. Thanks to a stethoscope medical professionals can easily hear if your heart or lungs function properly.

Usually heart function and lung function sounds routine and clean. So if there are any murmurs that occur during the auscultation, the medical professionals will know something is up and further investigation is needed.

To a lesser degree mechanics also use stethoscopes. During the running of an engine stethoscopes can be used to determine any faults that might happen in the cylinder of a combustion engine. Unfortunately you cannot open a cylinder during a running engine to check out faults as this would intervene with the normal functioning of an engine. Therefore a stethoscope allows them to perform diagnostics on the engine. Much like a medical professional with a human body.

 

History of the stethoscope

It was invented in France by the french scientist Rene Laennec in Paris. This innovation came from necessity. He felt uncomfortable placing his ears on women’s chests in order to listen to heart sounds. As a result he decided to come up with a device that would add a little bit more distance between him and his patients.

The first prototype he came up with looked like an ocular device pirates would use.

stethoscope

He would place his ear on one end of this primitive stethoscope and the other end would end up on his patients’ chests. The design for this device has a lot of similarities with an old hearing aid device called an “ear trumpet“. Rene noticed that a rolled up notebook would amplify the sound of a beating heart without physical contact with the patient. He called his device a stethoscope. The term stethoscope has its origins in Ancient Greek. “Stethos” means chest and “Scope” which can be loosely translated as a listening device.

The earliest forms of stethoscopes that resembles the ones we know today came out in 1855 and were invented by Golding Bird. These were the first ones to feature flexible tubing. This next level of innovation was meant to provide extra comfort to the people performing auscultations.

 

Current practice

stethoscope

 

Stethoscopes as we know them today are arguably the most recognizable piece of medical equipment out there. They are THE sign of medical professionals. Studies have also shown that images of people in lab-coats get a huge bump in confidentiality if they have a stethoscope draped around their neck. automatically people associate stethoscopes with the trustworthiness of a doctor. Even though mechanics, albeit to a lesser degree, are frequent users of stethoscopes as well!

There are those that say that slowly but surely the stethoscope is becoming obsolete. The rise of portable ultrasound devices are slowly fazing out the stethoscopes in hospitals. At least when it comes to cardiovascular research. In checking lungs and bowels for signs of disease however the stethoscope still has its place. However only time will tell for how long.

 

Different types of stethoscopes

Acoustic

acoustic stethoscope with the bell upwards

Probably the best known stethoscope-type. They operate on the transmission of sound from the chest piece to the listeners’ ears, via air-filled hollow tubes. The chest piece usually consists of 2 sides that can be placed on the patients’ chest. a bell and a diaphragm. If the diaphragm is placed on the patients’ chest, acoustic airwaves are produced by the vibration of the plastic diaphragm which travel through the tubing to the listeners’ ears. If the bell is used then the vibrations are directly transmitted to the listeners’ ears. the diaphragm is used to hear high- frequency sounds while the bell best delivers low frequency sounds. Both are necessary to conduct a full scale auscultation. This two-sided stethoscope was invented by Rappaport and Sprague in the early part of the 20th century. Both also have stethoscope types named after them.

One major issue with acoustic stethoscopes has always been that the sound level is really low. This problem was overcome however in 1999 with the invention of the stratified continuous lumen, and the kinetic acoustic mechanism in 2002.

Electronic

The main function of these types of stethoscopes is that they convert analog sound signals into digital ones. This can be achieved in one of two ways.

The first way in which this is done is by placing a microphone in the chestpiece. However this method has a lot of drawbacks. By amplifying the sound directly you have to deal with a lot of background noise that will be inadvertently amplified as well. This can seriously hinder an auscultation.

Another way to do this, and how 3M for instance does it, is to use a piezo-electric crystal. Piezo electric crystals work in such a way that when pressure is applied to them (think a heartbeat), a small electric charge is released. As a result ambient noise is filtered out and you only hear the actual heartbeat in digital form.

The big benefit of electronic stethoscopes is that you can store a patient’s auscultation to form a base-file of that patient. You will always have a future reference to go to if you hear or find something out of place. Secondly as the sounds they produce are digital, you can add a splitter device to the acoustic-outlet. This enables you to add a second pair of headphones. As a result you and your students can listen in on the same auscultation and you can show your students what to look out for.

Fetal

A fetal stethoscope or a fetoscope looks a lot like the old listening trumpet. The device works by placing one end of the stethoscope on the pregnant woman’s abdomen. This allows the listener to listen to the heartbeat of the fetus. A fetoscope is also called a Pinard horn after the French obstetrician Adolphe Pinard.

Doppler

A doppler stethoscope works using the famed doppler-effect. Motion is detected by the change in frequency of the soundwaves. As a result stethoscopes that use the doppler effect as the main detection principle have been shown to be more sensitive in the detection of aortic regurgitations and the detection of impaired ventricular relaxation.

 

How to use a stethoscope

General

Wherever possible it is recommended to do an auscultation in a quiet space. For EMT’s however this is not always possible and for them different stethoscopes have been developed. You can read more on the best stethoscopes for EMT’s here. Mostly the stethoscopes they use have special noise-dampening technology to muffle out the background noise.

The reason why you need to do an auscultation in a quiet space seems self-evident. It is important you focus fully on the sounds you want and need to hear. A noisy environment will only distract you too much from the job at hand.

Next it is important to keep in mind that the positioning of the patient plays an important role during the auscultation. A patient’s lungs can sound different whether he or she is laying on his/her’s side or sitting up etc. To listen to the heart and abdomen it’s recommended for your patient to lay down. However for the lungs you’ll find it easier if the patient is sitting up.

Using the chestpiece properly

Thirdly you need to decide if you want to go for the high-pitched or low-frequency sounds. The chestpiece on your stethoscope most likely will have 2 sides. One’s a bell and the other one is a diaphragm as described in the sections above.

 

stethoscope, how to use a stethoscope

 

The diaphragm is the bottom side pictured in the image above. It basically is a plastic sheet that transmits vibrations from your skin and delivers them via the tubing to the listener’s ears. It is this side you have to use to hear medium to high-pitched sounds.

On the other hand the bell-side is just a chamber that forms between the chestpiece and your patient’s chest. The change in volume of this chamber as a result of for example heart beats causes sound waves to travel via the tubing to the listener’s ear. Use this side for the..you guessed it.. low-pitched sounds.

Note: Always use the chestpiece on bare skin. If your patient still has clothes on while you use your stethoscope chances are you’ll hear nothing but rustling. The same issue persists if you treat someone who is overly hairy. Unfortunately in that case there is nothing the patient can do about it other than shave everything off. However if you face a particularly hairy patient, keep the chestpiece still to keep the rustling to a minimum.

 

Inspecting the heart

Heart sounds are generally medium to high-pitched. So in order to study the heart you need to use the diaphragm on your stethoscope. Place the diaphragm on your patient’s chest. Try to place it in such a way that the diaphragm covers the space on the left upper chest, where the 4th and 6th rib meet. This is almost directly under the breast. Then hold the chestpiece between your index and middle finger. Gently apply pressure until you do not hear your fingers rubbing together anymore.

Ask your patient to breathe normally. Try to listen to the heart for a full minute. During this time you should hear a sound which is best described as a “lub-dub”-sound. Of course it is hard to convey a sound through written text but I have found that “lub-dub” comes pretty close to what you will hear in real life.

These “lub” and “dub”-sounds also have their own, more scientific names. The “lub”- or systolic-sound happens when the mitral and tricuspid valves of the heart close.
The “dub”-sound, or diastolic, happens when the aortic and pulmonic valves close.

 

Count the number of heartbeats

Usually a normal person’s resting heart rate can be anything between 60 and 100 beats per minute. A well-trained athlete however will have a bigger heart. As a result the heart will need to pump less per minute to circulate blood around the body.
A well-trained athlete’s resting heart-rate lies between 40-60 beats per minute.

For infants and kids under 10 years old the normal heart-beat per minute range varies per age. For newborns it is very fast. Between 70-190 BPM.
However then as the kid matures, their heart grows and has to beat less to keep the blood flowing. Once a child turns 2 their heart beats already between 80-130 BPM.
Children between 7-9 have a heartbeat between 70-110 BPM.

 

What to listen for when using a stethoscope

First up if the heart-rate is elevated from the normal, that might be a sign of an underlying condition, or it can be that your patient is just nervous to be examined. That is why it is important to get a good understanding of how your patient behaves under normal circumstances.

However even for the untrained ear here are some pointers to look out or.

  1. If you hear a sound that is more like “lub…shhhh…dub”, that might point to a heart murmur. A heart murmur is caused when blood rushes too quickly through the valves.
    If you hear one there is still not immediately cause for concern as most people do have benign heart murmurs from time to time. However you should advise your patient to go check it out if you do detect one.
  2. If you hear another sound, other than the familiar “lub-dub” then your patient might have a ventricular defect. This third heart sound is referred to as S3 or a ventricular gallop. It sounds like a low-frequency vibration. Advise your patient to go see a doctor if you hear this third heart sound.
  3. Here is a list of normal and abnormal sounds that you can use to practice yourself. Go through this list and maybe after a while you can blindly identify some of the common heart conditions just by sound alone!

 

 

 

Listen for Bruits

The word “bruit” comes from the French word “bruit” and means “noise”. Usually when you detect a heart murmur in your patient you might want to check out if there are any bruit-sounds. They sound similar but are checked in completely different places.

First you need to place your stethoscope using the diaphragm side over one of the carotid arteries. The carotid arteries are 2 big arteries that run in the front of your neck, on either side of the Adam’s apple.

Be careful not to press too hard on the artery as you could cut off blood supply to the brain and cause your patient to faint. Never block off both arteries either as this surely will result in fainting. This is what MMA’s famous “choke-hold” is based on.

A bruit makes a whooshing sound that indicates an artery is narrowed. Here’s usually where the confusion happens. A bruit and a heart murmur can sound almost identical. However a bruit will sound much louder when you listen to the carotid arteries rather than the heart. You can also listen for bruits over the abdominal aorta, renal arteries, iliac arteries and femoral arteries.

A constricted artery is a serious medical issue and requires medical attention. Tell your patient to go see a doctor straight away!

 

Inspecting the lungs

Ask your patient to sit up straight and breathe normally. If you cannot hear any breathing sounds or if the breathing is too shallow to hear any abnormalities then ask your patient to breathe deeper.

Just like when doing a heart auscultation you need to use your diaphragm when checking the patient’s lungs. Listen to your patient’s upper and lower lobes and inspect the front and back.

The aim of the game is to compare both sides of your patient’s lungs and note if anything sounds out of the ordinary.

Normal breathing sounds

Normal breathing sounds are clear and crisp. It sounds like someone would be blowing air into a cup. Here’s a sample of normal lung sounds to train your ears. You can use these sounds to compare them to the ones you hear in your patients.

Abnormal breath sounds shouldn’t be too hard to pick up with your stethoscope. There basically are 4 types:

  1. Wheezing sounds. Especially people with asthma can wheeze from time to time. These sounds are high-pitched and almost sound like someone would have swallowed a chew-toy. If your patient has a really bad asthma problem you can sometimes even hear the wheezing without the need for a stethoscope. This wheezing occurs when the patient exhales
  2. Stridor-sounds sound similar to wheezing but occur when the patient inhales. This is usually the result of a blockage in the back of the throat. Also this can be heard at times without the need for a stethoscope.
  3. Rhonchi sounds sound like snoring. You need a stethoscope to detect these sounds. They are caused when air flows through a “rough” patch in the lungs or because the air-pathway in the lungs is blocked.
  4. Rales sounds sound like popping bubble-wrap or rattling in the lungs. This is heard when a person inhales.

 

 

Abdominal sounds

Divide the abdomen into 4 sections using your patient’s bellybutton as a reference. Listen to the upper left, -right and lower left, -right sections of the abdomen. Use the diaphragm side of the chestpiece of your stethoscope.

Normal bowel sounds sound like when your stomach growls or grumbles. Anything else may suggest something is wrong and the patient requires further attention. You should hear growling in all four sections. However if your patient has just had surgery it might take a while for the growling sounds to return.

Abnormal bowel sounds come in three types:

  1. Lack of bowel sounds. This should raise your suspicion. If you do not hear anything it might be that something is blocked in the patient’s stomach. It could also be indicative of constipation and bowel sounds may return on their own.
    However if they don’t then the patient needs to be checked out by a doctor.
  2. Hyperactive or fast bowel sounds can be indicative of Crohn’s disease, a gastrointestinal bleed, food allergies and a whole other host of not so nice causes. Have your patient checked out straight away. If these fast bowel sounds are followed by a lack of bowel sounds then it could be there has been a rupture or necrosis of the bowel tissue.
  3. Lastly very high-pitched bowel sounds can indicate there is an obstruction in the bowels. Air passing through the gaps of this obstruction is restricted, causing the high-pitched sounds.

 

Turn up your volume to get the most out of this following video!

 

Lastly: checking blood pressure with a stethoscope

This is probably where you and I have seen a stethoscope used most.

You’ll need a “Sphygmomanometer” for this. In simple terms this just means blood-pressure gauge. On our right hand side we can see one. In order to measure your patient’s blood pressure you first need to roll up the sleeve if it’s in the way. If you measure someone’s blood pressure you always need to make sure the blood pressure cuff fits snugly on bare skin.

Press the bell of the stethoscope over the brachial artery just below the cuff’s edge. You can also use the diaphragm if you have trouble hearing with the bell. The sounds to look out for are called “Korotkoff”-sounds. These are low tone knocking sounds that indicate the patient’s systolic blood pressure.

Next inflate the cuff to 180mmHg or 30mm above your expected systolic blood pressure. You can find the reading by looking at the sphygmomanometer. That’s just a fancy word for the gauge on the blood pressure cuff. Then, release air from the cuff at a moderate rate (3mm/sec).

As you release the air, listen with the stethoscope and keep your eyes on the sphygmomanometer (gauge on the blood pressure cuff).

You should hear a knocking sound as air releases fro the cuff. Make a mental note the first time you hear such a knocking sound of the reading on your gauge. This will be the patient’s systolic blood pressure. Keep watching the gauge though as the second knocking sound will come just around the corner.

After this knocking sound stops, note the number on your gauge when you last heard a knocking sound. This is the patient’s diastolic pressure.

Lastly release all the air from the cuff once you noted these two numbers and send your patient home.

Note:

If the systolic pressure is over 120 or diastolic pressure is more than 80, you might want to recheck your patient’s blood pressure once a few minutes have passed. If the second measurement shows again an increased blood pressure it’s time to go see a doctor to find out the cause!

 

Thinklabs electronic stethoscope

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Stethoscopes come in a variety of shapes and sizes. However not all sizes fit everybody. If you have hearing aids for example you might find that a traditional stethoscope can be tricky to use. Here’s where Thinklabs electronic stethoscope comes in.

If you have trouble hearing and are looking for a solution to better perform auscultations then The One Digital Stethoscope fills the bill perfectly. The superb quality of the ear buds that come with this stethoscope work perfectly with hearing aids. The quality and clarity of the heart and breath sounds are amazing.

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Thinklabs headphones have an extra long cable so you can wear them comfortably around your neck when not in use. The anti-tangle flat cable is strong and resists tangling for convenient use in clinical settings.

 The eartips come in 3 sizes, for a perfect fit.

 

Thinklabs headphones

The thinklabs electronic stethoscope is compatible with a variety of headphones that each add their own uniqueness to this product. Due to the fact that everything works on a digital basis you can use different headphones for different results.

 

 

Beats by dr Dre for example are designed to cope with extra bass. As a result these headphones lend themselves perfectly for auscultations. The extra bass provided by the headphones can lay bare any underlying heart murmurs that might be present. At the same time these headphones offer excellent frequency response.

 

Lest not forget we still have to discuss the powerhouse of headphones. The noise-cancelling headphones Bose provides have become the standard of headphones all around the world. With these on your head you will have no trouble doing auscultations on an uncooperative toddler for example. Yo uwill be able to work in peace and hear the sounds you need to hear in all clarity!

Teaching with the One electronic stethoscope

Perhaps the biggest benefit of the thinklabs electronic stethoscope is the fact that it is a digital stethoscope. This enables you to split the audio signal into as many channels as you have splitters available! Now your students can listen in and focus on what they need to hear as you guide them through their very first auscultations.

Thanks to a variety of apps and add-ons Thinklabs provides, you can actually visualize wave-forms. Meaning your students can then visually begin to dissect the signals they hear. As a result various anomalies that come up during an auscultation can be dissected into great detail. This is all to the benefit of the students!

 

 

 

 

 

Medical Grade Stethoscope – Which One is the Right One for me?

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Let’s separate the toys from the real deal. Medical grade stethoscope come in all shapes and sizes. However few can truly be called medical grade. Everything depends on how good the acoustics are in the stethoscope at hand.

Also different medical professions call for slightly different tools. For example if time is of the essence, you’d want to have a stethoscope with a tunable diaphragm. As a result you’ll save some during an auscultation that might mean the difference between life and death.

Best medical grade stethoscope for nurses

This will sound like a drag but as many of you might be aware, the Littmann Cardiology series offer by far the best acoustics of any stethoscope out there. However they’ll cost you an arm and a leg to get one. At the same time you can assess yourself that what is the cost of a Littmann now, compared to a usage of 7 years on average. Then the price aspect of your purchase diminishes considerably.

However for the sake of argument let’s review the Littmann Cardiology 4, which to my opinion is best suited for nurses at the moment.

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  • Outstanding acoustics with better audibility of high-frequency sounds (adult side, firm pressure)
  • Tunable diaphragm: hear high or low frequency sounds by slightly adjusting pressure on the chest piece
  • Dual-lumen tubing: two Sound paths in one tube eliminates the rubbing noise of traditional double tubes
  • Next-generation tubing lasts longer and resists stains. Not made with natural rubber latex or phthalate plasticizers
  • Headset is easily adjusted for individual fit and comfort. Angled ear tubes align with ear canals

 

In short what we are all used to hearing from a Littmann cardiology series. However this does not necessarily mean every nurse needs to buy one today. If money is hard to come by when you start your studies or if you don’t feel like spending the $150+ USD for a medical grade stethoscope then there are other options out there. You don’t even have to change brands!

If your Littmann tubing has cracked, read here what to do next!

 

Other options

 

Introducing the Littmann Classic:

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  • Two-sided chestpiece with tunable diaphragms on both the adult and pediatric sides.
  • Single-piece tunable diaphragm is easy to attach, and easier to clean because its surface is smooth without crevices.
  • Pediatric side converts to a traditional open bell by replacing the single-piece diaphragm with a non-chill rim.
  • Next-generation tubing provides longer life due to improved resistance to skin oils and alcohol; less likely to pick up stains.
  • Small tunable diaphragm is useful for pediatric, small, or thin patients; around bandages; and for carotid assessment.

 

As we can see these stethoscopes look very similar to each other but the main difference lies in the finishing and in the acoustics. That does not mean the acoustics of a Littmann classic would be absolutely terrible. Far from it. However there is a reason why the Cardiology series are recommended to everyone. I also love the slogan of Littmann “For the sounds you NEED to hear”. In that sense the Cardiology is unbeatable.

However as nurses most likely won’t be required to do as intensive auscultations as diagnosticians then nurses will get away with a Classic model.

What about the Lightweight model?

Unfortunately you won’t see the lightweight model listed here. There is a good reason for that as from reviews I have noticed that the lightweight model has acoustic issues. More so the lower frequency sounds seem to be tricky to hear with a Lightweight model. As a result since the purchase price is the same, I recommend going for the Classic model.

 

Best medical grade stethoscope for EMT’s

The job of an EMT is an extremely demanding one. Time is of the essence, often you are working under extremely stressful conditions. I’d like to see anyone try and make a successful auscultation under those conditions!

As an added difficulty level at times auscultations have to be done in an ambulance or outside. This means outside white noise seeping in. As a result you need a stethoscope that can correctly manage and dissipate the background noises. “So you hear the sounds you NEED to hear”. I love that slogan!

Littmann has a stethoscope that does just that:

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By far the best medical grade stethoscope for EMT’s is the Littmann MASTER Cardiology.

  • Chestpiece delivers Littmann’s highest acoustic performance along with handcrafted, eye-catching design
  • Tunable diaphragm responds with a simple pressure change to capture low and high-frequency sounds
  • Two-in-one tube design (dual lumen) eliminates noise interference from two external tubes rubbing together
  • Special-Procedures Adaptor (included) for infant or pediatric auscultation adds versatility to the instrument
  • Anatomically designed headset is angled to meet the path of the ear canal

 

Best medical grade for medical – and nursing students, doctors

You can’t go wrong with a Littmann Cardiology series stethoscope!

 

 

Your next question will be “So does this mean Littmann only offers the best medical grade stethoscopes?”. The answer is that they definitely aren’t the only ones who offer good quality stethoscopes. However they are the most consistent quality-wise.

Other stethoscope manufacturers might have stethoscopes that work just as well, but the tubing won’t last as long. Others might offer cheaper stethoscopes but the acoustics aren’t nearly as good as a Littmann stethoscope.

One stethoscope that stands out though thanks to a pretty hard quality guarantee is the Vorfreude stethoscope. A german engineered wünder-stethoscope. You can check the review I did on that one here.

 

Do you agree or disagree with our list of medical grade stethoscopes? Do you think we missed one? Let us know in the comments below!