# Where do you keep your stethoscope?



## ParamedicStudent (Nov 11, 2017)

Serious question lol.

Just wondering, where do yall keep your stethoscope. I've seen many (if not most) medics don't even carry stethoscopes. Do you keep yours in a pocket? Jump bag? Hip bag? Or you just use the rig one?

Also, I used a hip bag during my internship, as per school policy. Now out in the field, I carry it anyways, due to habit. Is it weird? Thanks


----------



## Akulahawk (Nov 11, 2017)

When I first started out as an EMT I usually just stowed my steth around my neck, much as I do now. When I transitioned to being a medic I began to stow it in a cargo pocket on my pants. It was still quite accessible and out of the way most of the time. Stowing it in a pocket also kept it from easily being used as a weapon against me, not that I've ever had that happen. When I first started working as an RN in the ED, I was allowed to wear pretty much any color scrubs and brand that I wanted, so it was also very easy to stow my steth in a pocket of my scrub pants. My current employer basically requires a specific style but I can kind of "get away with" some variation in the pants. My provided scrubs do not have pockets that are really useful for stowing my steth in them so I have reverted to wearing my steth around my neck as I used to. Although we can use hip packs, mine is quite large and would be rather more of a nuisance than a help. A smaller pack would do but I have most of what I need at hand in my scrub shirt pockets anyway.


----------



## VFlutter (Nov 11, 2017)

https://www.amazon.com/BATCLIP-BLACK-clip-stethoscope-misplacement/dp/B0038S8E9U


----------



## NomadicMedic (Nov 11, 2017)

I usually leave mine in the truck.


----------



## GMCmedic (Nov 11, 2017)

Mine stays on the back of the cot.


----------



## DesertMedic66 (Nov 11, 2017)

GMCmedic said:


> Mine stays on the back of the cot.


This. I want it on scene with me as I like to listen to lung sounds in a more quiet environment but I also don’t want to hang it around my neck.


----------



## hometownmedic5 (Nov 11, 2017)

Mine stays in my backpack until I need it, which in practical application is very rarely and is almost universally related to a missing or broken truck scope. There’s a fisher price in the house bag, another hanging from the bench net, probably two more in the truck. I’m mostly deaf in one ear and I can appreciate Kortokoffs sounds and appreciate adventitious breath sounds with enough clarity to separate rhonchi from rales from wheezing with the cheapest functional stethoscope. 

Stethoscopes have been a status symbol for many years in EMS. A physician may need the clarity afforded by a high end stethoscope, but as a medic I really dont, and as an EMT you almost certainly don't. My practice isnt hampered at all by using a cheap scope. I am firmly convinced that every single person who “cant hear anything” through truck stops either doesn’t actually know what their listening for or where to find it; or is more deaf than I. It’s almost psychosomatic in its presentation. If our society didn’t tell us we need a 200 dollar scope to auscultate blood pressures, I dont think we’d think it was necessary. 

If we as a group spent half the time learning how to use a stethoscope properly as we spend talking about scopes, comparing scopes, judging other people’s scopes and perpetuating the cycle of making the new kids believe they need a fancy scope, we’d all be better providers....


----------



## StCEMT (Nov 11, 2017)

I keep mine in my pants pocket. I was lucky enough to have a uniform/supply budget from my last employer right before I left, so I splurged on their dime and got the Cardiology IV. I don't particularly want to lose it for obvious reasons. I don't leave it tossed aside on the truck simply because I have forgotten stuff that way before, so if it is always in my pocket then I will never forget it.


----------



## Jim37F (Nov 11, 2017)

My last few jobs all had stethoscopes provided both in the jump bag and have one either on the counter top/in the gap between the bench and the wall(usually rolled up in a bp cuff)/hanging off of the webbing at the end of the bench seat.....sometimes 2 or 3 of those options.

So if I had decided to carry my personal steth (my last job used cheaper, lower quality ones than mine) it usually stayed in its pouch and was kept either on the counter, or even on top of my bag in the little pass thru between the jump seat and the cab, that way I always knew where it was and wasn't going to get mixed up with any of the others and forgotten at the end of shift.


----------



## Tigger (Nov 11, 2017)

Dashboard (with some nice safety glasses). We have stations so it isn't really sitting out getting fried. My personal bag lives in the O2 compartment usually so it's difficult to keep it there. We don't keep any in the bag but usually fire has one in their bag if I forget it (which is a lot).


----------



## TransportJockey (Nov 12, 2017)

Mine lives in the truck in my bag with my DSLR and chargers. It bugs me around my neck because it hits my radio strap and mic. It's accessible when I get to the truck if I have a tough time hearing with the one in the bag or the one hanging from the stretcher hangars on the wall.


----------



## DrParasite (Nov 12, 2017)

It really depends on my employer, and their uniform requirements.  If they allow cargo pants, it ends up in one of the side pockets.  If they mandate 4 pocket ****ies, than it ends up around my neck.  I used a nurses's scope holster, which I liked, except it kept popping off my belt every time I sat down.  I did purchase a Stethocope sock, for added customization and to make it more comfortable on my neck.  Since I had a new job and am on the engine, I keep my personal scope with a watch wrapped around its neck in my SCBA mask bag, so if I go on a fire, I wear my mask, and if I go on a medical, I grab my scope.

However, I never wore it around my neck on psych calls, for obvious safety reasons.

The truck scopes are usually the super cheapies, which are great for a BP is a quiet environment and that's about it.  My scope was a black littmann master classic, but I left it in the truck's jump bag at the end of my shift, and two day later went to retrieve it, only to find it gone, and no one had seen it (which was odd, since it had my name all over it).  Since then, I keep an EMS bag with me that has all my personal EMS equipment (radio holsters, gloves, scope, belt, helmet, winter hat and gloves, etc), which stays in the are between the patient compartment and the front of the truck.  When I leave for the day, everything goes back into the trunk of my car.  When I was a volunteer, that bag came with me on every call.


----------



## Colt45 (Nov 12, 2017)

Where I'm at we can wear any EMS pants as long as they are a certain color. I chose some with a few side pockets. That's where I keep mine. It stays out of the way when I don't need it and it readily accessible when I do.


----------



## Chris07 (Nov 12, 2017)

I’ll tell you where I never had my stethoscope....around my neck.

Not only is the “around the neck” clichè, but it also gives a combative patient a good handle to grab a hold of and drag you in closer.

In the field, I used to have a cheap company issued scope on the back of the stretcher, and I’d have my nicer personal one on the webbing in the back of the ambulance. This was not only for easy access, but so that I wouldn’t as easily forget to take it home.


----------



## Tigger (Nov 12, 2017)

Chris07 said:


> I’ll tell you where I never had my stethoscope....around my neck.
> 
> Not only is the “around the neck” clichè, but it also gives a combative patient a good handle to grab a hold of and drag you in closer.
> 
> In the field, I used to have a cheap company issued scope on the back of the stretcher, and I’d have my nicer personal one on the webbing in the back of the ambulance. This was not only for easy access, but so that I wouldn’t as easily forget to take it home.


Don't particularly care about cliche... I don't even bother bringing it on a psych calls and I don't operate under the assumption that everyone wants to attack me.


----------



## DrParasite (Nov 13, 2017)

Chris07 said:


> In the field, I used to have a cheap company issued scope on the back of the stretcher, and I’d have my nicer personal one on the webbing in the back of the ambulance. This was not only for easy access, but so that I wouldn’t as easily forget to take it home.


Just so I understand how your operate.... inside the house, or outside of the truck, during your initial patient assessment, which often guides you later interventions or determining sick vs not sick, you use the cheap scope that you on the cot;  it's only once you get into the truck do you use your nicer scope to assess your patient with a quality medical device, after you have already started down the treatment path with the cheapie scope....

Please tell me I am wrong.....


----------



## NomadicMedic (Nov 13, 2017)

You can’t hear wheeze vs crackles or diminished breath sounds with a cheap scope?

That’s about all I use my scope for in the initial assessment. I’m listening for adventitious breath sounds.

And for what it’s worth, you can make the sick/not sick determination without equipment. The first 15 seconds as you walk in should be when you’re deciding sick/not sick.


----------



## DrParasite (Nov 13, 2017)

NomadicMedic said:


> You can’t hear wheeze vs crackles or diminished breath sounds with a cheap scope?.


I knew of an agency that provided this type of scope:





while it did meet the state requirements for being a scope, you couldn't hear a freight train if you put it right on the engine.  That's what happens when you get a $2 scope.  Wheezes and crackles might have been possible depending on how cheap of a scope.... diminished, well, was it diminished lunch sounds or did the scope suck and that was why everything sounded diminished?

I'm also of the belief that I want to use all my toys to guide my treatment and assessments: a lifepak 15 doesn't do the patient much good initially if I leave it in truck (although I can use it to further my assessment once we get said patient into the truck).


----------



## NomadicMedic (Nov 13, 2017)

Agreed. I’m certainly not belittling the use of a good vs cheap scope, but in most cases it doesn’t really matter in the first few minutes. You can usually do a better, thorough assessment in the truck. 

If I’m going on a call where I think I need my scope right away, I grab it when I grab my eye protection. 

Our service bought Littmann scopes for all the jump bags. I think it was a waste of money, but I guess it’s nice to have if I forget my personal scope.


----------



## Chris07 (Nov 13, 2017)

Tigger said:


> Don't particularly care about cliche... I don't even bother bringing it on a psych calls and I don't operate under the assumption that everyone wants to attack me.


Have I worn the steth around my neck? Absolutely. When you use it and the bag isn't in reach to put it away, the neck is the perfect natural temporary storage place. While I can understand the convenience of having it around your neck all the time while on a call, I personally do not like having something dangling around my neck. After reading my post, I can see it was worded in a fashion that made it sound like "if you wear it around your neck, you're doing it wrong". That was not my intention at all, so let me clarify that.

On day one of my orientation at AMR 5 years ago, our regional safety person mentioned the whole "don't wear it around your neck because it allows someone to grab onto you". It's something that I personally took to heart, and along with my personal preference of not wearing it around my neck in general, it proved to be a very minor reason for me. Did I approach each person as someone who was going to hurt me? Absolutely not, but I liked to be at least minimally cautious, since I didn't make enough to put myself into a bad situation.



DrParasite said:


> Just so I understand how your operate.... inside the house, or outside of the truck, during your initial patient assessment, which often guides you later interventions or determining sick vs not sick, you use the cheap scope that you on the cot;  it's only once you get into the truck do you use your nicer scope to assess your patient with a quality medical device, after you have already started down the treatment path with the cheapie scope....
> 
> Please tell me I am wrong.....



The stethoscopes we were provided were better (albeit only a little bit) than the plastic disposable ones you just posted. Perhaps instead of costing $2 they costed $10. Were they flimsy? Yes. Did they work? Yes, reasonably.

Determining if someone is sick takes multiple factors into account and my lack of ability to listen to one's lung sounds doesn't prevent me from making that determination. If they're pale, cool, diaphoretic, and tripoding with accessory muscle use, do I NEED to listen to their lungs right then and there to determine this person is sick? No, but it would be nice to get a whole picture. As a BLS provider in the LA County system, does the fact I am able to check lung sounds immediately at patient side really affect my immediate action plan? If they show signs of moderate to severe respiratory distress (and are _Sick_), my concerns are vitals, O2, moving to the cot, and beginning to load them up in anticipation of either rapidly transporting BLS if we are very close to the ED or waiting for ALS to show up. Whether or not I hear rhonchi in their living room isn't going to change my immediate plan of action at the BLS level.

Our stethoscopes were more than capable of doing on scene work (BP and basic lung sounds). Admittedly, if I was first on scene, which was often the case only about 25% of the time, I would take my personal stethoscope in with me, but I often forgot to grab it off the webbing.


----------



## n00bmedic (Feb 14, 2018)

I don't use a personal stethoscope anymore. I was on my second one, which got stolen. From now on, I'll use the garbage ones on the truck. Said garbage scope resides in the bag, or, if I've used it and might need it again, hanging on the O2 bottle on the stretcher.


----------



## Aprz (Feb 14, 2018)

I had a personal stethoscope that I liked having on the gurney. It was always there if I decided to auscultate breath sounds in the home versus in the ambulance. I really liked it on the gurney when nobody was on the gurney so I could easily see it. Ironically, I kept losing it in mysterious ways. The last time I had a stethoscope, my partner put it on the back of it when the patient sat on the gurney. Pulling the patient out of the ambulance, I felt drag like something was stuck, but we didn't see anything, and pulled hard. The stethoscope had caught onto the rail in the back and the tubing ripped. I've been using the rig/bag stethoscope ever since. We have on stethoscope in our med bag that we carry on scene (we only carry our stuff on scene if fire isn't first, I like to have it if we are going to walk far eg going through the airport) and then there is one hanging on the catch net the ambulance. It's okay to lose those ones... They are very cheap, but I feel like I hear the same with it compared to my Littman. I used to try to do heart tones, but I have gotten lazy.


----------



## MSDeltaFlt (Feb 18, 2018)

I keep mine on the "uh-oh" net until I get on scene.  Then I wear it.  Once back in the truck it goes back on the "uh-oh" net.


----------



## reaper (Feb 18, 2018)

I mainly use the truck scope. I can hear fine with it. Once in a while I will carry my personal scope. It always hangs around my neck, when carrying it. Funny, in 28 years I have never had a pt grab my scope when around my neck.


----------



## LanceCorpsman (Feb 26, 2018)

I use my own and usually keep in my back pocket walking around. Just don't wear it around your neck. I think it looks kind of douchy and make an excellent objet for that psych patient to get a hold of.


----------



## Tigger (Feb 27, 2018)

LanceCorpsman said:


> I use my own and usually keep in my back pocket walking around. Just don't wear it around your neck. I think it looks kind of douchy and make an excellent objet for that psych patient to get a hold of.


Or don't wear your scope around your neck with psych patients?


----------



## epipusher (Feb 28, 2018)

I hang mine around my rear view mirror when off duty.


----------

