Stethoscope, more of a symbol than a tool

[RobertAlfanoNJEMT]

I feel like the stethoscope has become more of a symbol than an actual tool. It has limited uses, you can listen to someone's breathing, oscillate their bp, and a couple of other things but I mean I don't know that it is so important that everyone has to be wearing one all the time, and that we can't use the cheap disposable ones that are used in trauma bays. I feel like it is mostly a way of saying hey look I do medical stuff or a way to represent your status. Also with the diversity of stethoscopes I feel like people also use it to express their personal tastes too. Like how people add something to their school uniform to show their individualism. Let me know what you guys think..

 

[DesertMedic66]

BP, lung sounds, heart tones, fetal heart sounds (maybe), help confirm placement of NG/OG tubes, help confirm placement of ET tube.

Does it need to be around your neck all the time? Probably not.

The disposable steths that I used during my OB shifts (the only place I have actually seen them) were ok in the clinical setting. I could not imagine using them in the field.

 

[epipusher]

Rear view mirror only.

 

[Flying]

What. You want me to press my ear against the chest of a diaphoretic person?

 

[chaz90]

Firstly, auscultate =\= oscillate.

Do you not consider lung sounds an absolutely vital part of the practice of medicine? I listen to lung sounds on almost every patient I assess as part of a basic physical examination. In my opinion, it's fundamentally important. They help guide my initial treatment decisions, assist in trending their efficacy, and diagnose problems in some cases. Waveform capnography, pulse oximetry, and the remainder of a physical exam also help out here, but LS are a huge piece.

I don't auscultate blood pressures all the time as I use the NIBP function of my monitor more frequently, but proficiency in manual blood pressures is also pretty integral to EMS, particularly as a BLS provider who likely doesn't have an automated option available.

I am far from an expert on heart tones, but I still like to listen to them. My understanding is that modern diagnostic tools in hospital have greatly decreased their historical importance, but it's interesting to piece together known pathologies with unusual heart sounds.

I don't carry my stethoscope around on my neck when not on a call. It's kept in the back seat of my unit in my personal gear bag. When I arrive on scene of a call, I take it out and place it around my neck. I use it on that call, then clean it and put it back in my bag. Sure, some people use it as a symbol, but I'd get annoyed with it around my neck all day. You don't have to use an expensive cardiology stethoscope, but I've found it worth the money to get one that's comfortable, doesn't have rubbing sounds from the tubing, and transmits sounds loud enough for me to hear them clearly.

What's wrong with people using it to express their personal tastes a bit too? No one is disputing that funky colors and finishes are "necessary", but some believe if you have a tool you may as well personalize it. To each their own!

 

[RobertAlfanoNJEMT]

Firstly, auscultate =\= oscillate.

Do you not consider lung sounds an absolutely vital part of the practice of medicine? I listen to lung sounds on almost every patient I assess as part of a basic physical examination. In my opinion, it's fundamentally important. They help guide my initial treatment decisions, assist in trending their efficacy, and diagnose problems in some cases. Waveform capnography, pulse oximetry, and the remainder of a physical exam also help out here, but LS are a huge piece.

I don't auscultate blood pressures all the time as I use the NIBP function of my monitor more frequently, but proficiency in manual blood pressures is also pretty integral to EMS, particularly as a BLS provider who likely doesn't have an automated option available.

I am far from an expert on heart tones, but I still like to listen to them. My understanding is that modern diagnostic tools in hospital have greatly decreased their historical importance, but it's interesting to piece together known pathologies with unusual heart sounds.

I don't carry my stethoscope around on my neck when not on a call. It's kept in the back seat of my unit in my personal gear bag. When I arrive on scene of a call, I take it out and place it around my neck. I use it on that call, then clean it and put it back in my bag. Sure, some people use it as a symbol, but I'd get annoyed with it around my neck all day. You don't have to use an expensive cardiology stethoscope, but I've found it worth the money to get one that's comfortable, doesn't have rubbing sounds from the tubing, and transmits sounds loud enough for me to hear them clearly.

What's wrong with people using it to express their personal tastes a bit too? No one is disputing that funky colors and finishes are "necessary", but some believe if you have a tool you may as well personalize it. To each their own!

Wow you wrote a lot... Not saying there is anything wrong with it, it was more a personal analysis than anything as I do just the same thing but I'm just pointing out that it is not as nessicary as EMTs make it out to be.. Like you probably use a pen light on every call but not every EMT is carrying around there own personal fancy pen light

 

[TransportJockey]

Wow you wrote a lot... Not saying there is anything wrong with it, it was more a personal analysis than anything as I do just the same thing but I'm just pointing out that it is not as nessicary as EMTs make it out to be.. Like you probably use a pen light on every call but not every EMT is carrying around there own personal fancy pen light

Maybe once you get a little more education and some time in the field you will see that a steth is a required piece of equipment in the field. And pen lights are disposable, cheap pieces of gear. They're not even in the same realm as scopes.

 

[Flying]

Okay seriously.

Listening to air moving in someone's lungs is pretty important. Really important.
Asking and knowing: wheezing, crackling, wet, or normal? When and for how long? Is it related to the history?
All of that is important.

Sure stethoscopes are symbolic. That's because they're ubiquitous. So many medical providers use them so much all the time. We gotta know the answers to the above questions (every 5 or 15 minutes if taking a test).

Don't let the lack of substance in many "symbolic" things in our culture make you attribute any lack of utility to this particular tool. There's nothing wrong with EMTs blinging out here and there. "X is more symbolic than is of any use" is easy to say for a lot of things today, but you're dead wrong in this case.

"Lights and sirens are more of a symbol than a tool." Now THAT's a topic.

 

[TransportJockey]

Heh, I'd say a stethoscope is much more useful and has saved more lives than L&S

 

[RobertAlfanoNJEMT]

I'm not saying that they are useless I'm just saying are they so important that everyone on the squad has to have one and that it has to be the nicest most expensive most "blinged out" one that is on the market? I don't think so and thats my opinion

 

[Flying]

I'm not saying that they are useless I'm just saying are they so important that everyone on the squad has to have one and that it has to be the nicest most expensive most "blinged out" one that is on the market? I don't think so and thats my opinion

People whacking out does not give any importance to anything. You're right.

Here is your original post:
I feel like the stethoscope has become more of a symbol than an actual tool. It has limited uses, you can listen to someone's breathing, oscillate their bp, and a couple of other things but I mean I don't know that it is so important that everyone has to be wearing one all the time, and that we can't use the cheap disposable ones that are used in trauma bays.

It's a symbol, not a tool for the jolly vollies in your area. You've recognized that. You're confusing symbolism with lack of utility in how you wrote your post. That's not how you feel, but that's why we responded in the way we did.

Or maybe, we just want to have a nice tool in our kit because everything else is pretty paltry in comparison? I mean, I have rode in 20 year old ambulances with yellowing equipment that need desperate cleaning every time I come on shift. Just having something nice is assuring.

 

[RobertAlfanoNJEMT]

People whacking out does not give any importance to anything. You're right.

Here is your original post:
I feel like the stethoscope has become more of a symbol than an actual tool. It has limited uses, you can listen to someone's breathing, oscillate their bp, and a couple of other things but I mean I don't know that it is so important that everyone has to be wearing one all the time, and that we can't use the cheap disposable ones that are used in trauma bays.

It's a symbol, not a tool for the jolly vollies in your area. You've recognized that. You're confusing symbolism with lack of utility in how you wrote your post. That's not how you feel, but that's why we responded in the way we did.

Or maybe, we just want to have a nice tool in our kit because everything else is pretty paltry in comparison? I mean, I have rode in 20 year old ambulances with yellowing equipment that need desperate cleaning every time I come on shift. Just having something nice is assuring.

Yea I get that.. the way I said it came off a little weird I didn't mean to say that its uses aren't important I was trying to say that having your own personal one on hand all the time isn't necessarily a necessity... I get the idea that it is nice to have something nice, personally mine cost about $150..

 

[OnceAnEMT]

I tend to drag mine through a cave and clean clumps of mud off of it after. The last thing I want is an expensive steth, let alone an electronic one.

Not to derail the derailed, but I just have to ask, does anyone "bling out" their stethoscope with a roll of tape? Never saw this before working in the ED, and its quite funny. Half of the nurses do it, and I'm yet to ever see the roll get used...

 

[DesertMedic66]

I tend to drag mine through a cave and clean clumps of mud off of it after. The last thing I want is an expensive steth, let alone an electronic one.

Not to derail the derailed, but I just have to ask, does anyone "bling out" their stethoscope with a roll of tape? Never saw this before working in the ED, and its quite funny. Half of the nurses do it, and I'm yet to ever see the roll get used...

I usually keep an adapter to place a nebulizer on our CPAPs. When I need the adapter I can never seem to find it.

 

[Tigger]

When I buy things that I use a lot, I like to buy nice things. There's a reason your mechanic uses Snap-On (or equivalent) tools instead of stuff he picks up at Wal-Mart. Sure they do the same thing, but it's nice to know that it'll work right and last for a long time.

Because as it turns out, a stethoscope actually is an important tool. Tools have a designed purpose, and a steth is no different. Of course it has limited uses, how many actual uses does a circular saw have? Do you use one to pound nails too? Lung sounds are important, blood pressures are important, and heart sounds might be too. I'd like to be able to assess those things reliably.

Mine lives on the dash (we have a station so no sunlight issues) next to my safety glasses. I do want it around on every call, so I like to know where it is. And yes, it is somewhat of an image thing. Patients associate healthcare with them, and what does your doctor do every time you go in for a physical? Ascultate. We are the "experts" on scene, look and do the part.

 

[Tigger]

I tend to drag mine through a cave and clean clumps of mud off of it after. The last thing I want is an expensive steth, let alone an electronic one.

Not to derail the derailed, but I just have to ask, does anyone "bling out" their stethoscope with a roll of tape? Never saw this before working in the ED, and its quite funny. Half of the nurses do it, and I'm yet to ever see the roll get used...

I don't understand the need to carry tape about my person, but personal preference. There's enough tape in our bag for well, something nefarious I'd imagine. Mine has a bunch of reflective tape on it, helps it stay mine and if I drop it in a ditch at night it's much easier to find...

 

[squirrel15]

Wow you wrote a lot... Not saying there is anything wrong with it, it was more a personal analysis than anything as I do just the same thing but I'm just pointing out that it is not as nessicary as EMTs make it out to be.. Like you probably use a pen light on every call but not every EMT is carrying around there own personal fancy pen light

You don't stick a pen light in your body. Different people hear differently and are shaped differently. So different styles of stethoscopes are necessary

 

[RobertAlfanoNJEMT]

You don't stick a pen light in your body. Different people hear differently and are shaped differently. So different styles of stethoscopes are necessary

you can't honestly say that the number one factor that contributes to the purchase of most peoples steth is functionality though

 

[RobertAlfanoNJEMT]

I tend to drag mine through a cave and clean clumps of mud off of it after. The last thing I want is an expensive steth, let alone an electronic one.

Not to derail the derailed, but I just have to ask, does anyone "bling out" their stethoscope with a roll of tape? Never saw this before working in the ED, and its quite funny. Half of the nurses do it, and I'm yet to ever see the roll get used...

every time I see that being done its by someone who is working at a facility.. not out in the field...

 

[chaz90]

Yea I get that.. the way I said it came off a little weird I didn't mean to say that its uses aren't important I was trying to say that having your own personal one on hand all the time isn't necessarily a necessity... I get the idea that it is nice to have something nice, personally mine cost about $150..

I don't think it's a necessity to have your own all the time. The tool does not make the provider. If I forget mine on a call, I use the one in the gear bag and life goes on. For all the above mentioned reasons though, I choose to buy and use my own most of the time.