# Stethoscope, more of a symbol than a tool



## RobertAlfanoNJEMT (Oct 4, 2015)

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..


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## DesertMedic66 (Oct 4, 2015)

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.


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## epipusher (Oct 4, 2015)

Rear view mirror only.


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## Flying (Oct 4, 2015)

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


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## chaz90 (Oct 4, 2015)

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!


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## RobertAlfanoNJEMT (Oct 4, 2015)

chaz90 said:


> 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.
> 
> ...


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


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## TransportJockey (Oct 5, 2015)

RobertAlfanoNJEMT said:


> 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.


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## Flying (Oct 5, 2015)

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.


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## TransportJockey (Oct 5, 2015)

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


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## RobertAlfanoNJEMT (Oct 5, 2015)

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


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## Flying (Oct 5, 2015)

RobertAlfanoNJEMT said:


> 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.


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## RobertAlfanoNJEMT (Oct 5, 2015)

Flying said:


> 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.
> ...


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..


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## OnceAnEMT (Oct 5, 2015)

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...


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## DesertMedic66 (Oct 5, 2015)

Grimes said:


> 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.


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## Tigger (Oct 5, 2015)

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.


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## Tigger (Oct 5, 2015)

Grimes said:


> 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...


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## squirrel15 (Oct 5, 2015)

RobertAlfanoNJEMT said:


> 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


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## RobertAlfanoNJEMT (Oct 5, 2015)

squirrel15 said:


> 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


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## RobertAlfanoNJEMT (Oct 5, 2015)

Grimes said:


> 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...


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## chaz90 (Oct 5, 2015)

RobertAlfanoNJEMT said:


> 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.


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## Tigger (Oct 5, 2015)

RobertAlfanoNJEMT said:


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


Sure it is. Mine is more functional than the one that might be on the ambulance and is certainly not in the bag. It works better, that's why I bought it. Period.

Seems like you have some sort of agenda here, I can't really figure out why though.


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## squirrel15 (Oct 5, 2015)

RobertAlfanoNJEMT said:


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


Yes I can and I do believe that's the number one factor for it.


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## MonkeyArrow (Oct 5, 2015)

RobertAlfanoNJEMT said:


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


I carry two rolls of tape on a carabiner clipped to a belt loop. I guess I picked it up as I worked in the ER, but it's come in handy often as you often forget the tape while gathering whatever else you need.


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## Juanitabcm (Oct 5, 2015)

I don't think they should be worn all the time, but I will wear it around my neck from the time I walk in to get my patient until I transfer to the hospital.  I like to repeatedly check my patient.


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## Akulahawk (Oct 5, 2015)

I have a very nice stethoscope and I use it all the time for its intended purposes. I am certainly capable of using even the cheap ones for most of my work. As far as the tape roll thing is concerned, I put mine on a hemostat... not on a stethoscope. It can easily fall off and I can simply put my roll anywhere convenient. 

Expensive tools don't make the pro, pros use good tools as necessary and watching them work shows you who is the pro and who is a wacker/Ricky Rescue.


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## CALEMT (Oct 5, 2015)

RobertAlfanoNJEMT said:


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



Ummm yes as a matter of fact it is. I prefer my own stethoscope over the ones on the ambulance. I can hear B/P's and lung sounds 10x better with my own stethoscope vs the cheap ones on the ambulance. That is the primary reason most everyone buys their own stethoscope; because it works better and is more functional. Thats the reason I bring mine to work.


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## Gurby (Oct 5, 2015)

Last week I was considering sticking a needle into someone's chest because they had a pneumothorax and weren't moving air on one side.  Having a good stethoscope was pretty useful in that situation.

A stethoscope is also handy for confirming that your "endotracheal" tube is actually in their trachea and not their esophagus.

Hearing the difference between rales, rhonchi and wheezes can completely change how we treat things (CPAP and nitro vs fluids vs albuterol/ipratropium/etc), and giving the wrong drugs to a sick patient could potentially kill them.

Even at a BLS level, you need a stethoscope to get a diastolic blood pressure... And sometimes you'll find patients with such poor peripheral pulses that you can't palpate a BP, and the only way to get one is to auscultate.

Mine lives in the first-in bag though, and I almost never wear it.


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## StCEMT (Oct 5, 2015)

I don't know where you got your observation from. Working IFT, I pretty much am in some part of transporting patients all day and I get plenty of patients. I use my stethoscope on every single once at least once sometimes 2,3, or 4 times for a longer transport. Then throw in lung sounds, it is definitely helpful to have. Gurby gave a good example of why. And I got my own because I don't like the cheap ones. Used them before and didn't like it. I like to buy quality anything because it lasts longer and works better, not for for a fashion statement.


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## EMT11KDL (Oct 6, 2015)

I have a Master Card, and I use it all the time for the intended use, BP, Lung Sounds, Heart Tones, Gastric Sounds, ext.  The reason why I picked this one was I had used multiple different ones and after being in the military with loud noises, I needed something that assisted me in my patients assessments.  Just because I like the one I have, doesnt mean the cheap-o ones dont work.  They work just fine in most situations, but sometimes I need that little extra for me.  Now the tape thing I do not keep anything on my Stethoscope because I do not carry mine around my neck, it is normally in my leg pocket now or in the jump kit


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## DesertMedic66 (Oct 6, 2015)

EMT11KDL said:


> I have a *Master Card*, and I use it all the time for the intended use, BP, Lung Sounds, Heart Tones, Gastric Sounds, ext.  The reason why I picked this one was I had used multiple different ones and after being in the military with loud noises, I needed something that assisted me in my patients assessments.  Just because I like the one I have, doesnt mean the cheap-o ones dont work.  They work just fine in most situations, but sometimes I need that little extra for me.  Now the tape thing I do not keep anything on my Stethoscope because I do not carry mine around my neck, it is normally in my leg pocket now or in the jump kit


I tried using my MasterCard to listen to lung sounds and could not hear a thing. Am I doing it right?


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## EMT11KDL (Oct 6, 2015)

DesertMedic66 said:


> I tried using my MasterCard to listen to lung sounds and could not hear a thing. Am I doing it right?
> View attachment 2311



The basic MasterCard does not work, you must have the Platinum


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## Flying (Oct 6, 2015)

Will anything happen to my NREMT score if I hit my auscultation limit? Right now I'm about to hit 120.


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## EMT11KDL (Oct 6, 2015)

DesertMedic66 said:


> I tried using my MasterCard to listen to lung sounds and could not hear a thing. Am I doing it right?
> View attachment 2311


I knew after I clicked Post, Someone was going to say something about MasterCard haha


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## DesertMedic66 (Oct 6, 2015)

Flying said:


> Will anything happen to my NREMT score if I hit my auscultation limit? Right now I'm about to hit 120.


Your score for a good NREMT result should be in the 800s. 120 is very low and will surely have trouble getting loans


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## DesertMedic66 (Oct 6, 2015)

EMT11KDL said:


> The basic MasterCard does not work, you must have the Platinum


Ahh so that's my problem. Sadly I do not qualify for the platinum card. Looks like I'll have to leave that for my partner.


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## 18G (Oct 7, 2015)

Personally, I really dislike having my stethoscope around my neck but only because I find it annoying. My stethoscope is very valuable to me while assessing patients. Many providers like to carry their own stethoscope because they take care of it and don't like to put something in their ears that have been in 5000 other people's ears. And yes, quality matters. Not as much as some proclaim but it does matter. If I am going to be making crucial treatment decisions based on what I hear I want to make sure I am hearing the best that I can. 

But yeah, I know the type you speak. The providers who seem to live with a stethoscope around their neck and don't even know how to use it. Or the ones who hang it around their car mirror. But don't let that diminish this tools value.


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## Ewok Jerky (Oct 8, 2015)

RobertAlfanoNJEMT said:


> 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 importa


This is one of the dumbest things I've ever heard. The stethoscope is literally the most important assessment tool in the BLS toolkit, and arguable the ALS kit too. Differentiating lung sounds generates working Dx.



RobertAlfanoNJEMT said:


> I get the idea that it is nice to have something nice, personally mine cost about $150..


Why did you spend so much on a TOOL? Did you get it to look cool?



RobertAlfanoNJEMT said:


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


Absolutely the dumbest thing I've ever heard.


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## Brandon O (Oct 8, 2015)

For some people this is true.

Some people don't need the wing on their car either.

One very smart emergency physician I know has decided that ultrasound has made the stethoscope obsolete (glares over thataway).


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## VFlutter (Oct 8, 2015)

Brandon O said:


> One very smart emergency physician I know has decided that ultrasound has made the stethoscope obsolete (glares over thataway).



Just as learning to differentiate murmurs is worthless in the age of Echo...


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## Ewok Jerky (Oct 8, 2015)

Although determining the origin of a murmur coukd be the difference between a stat echo at 3am and an outpatient w/u.


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## Luno (Oct 8, 2015)

Interesting topic, my two cents for whatever it's worth, I used cheap steths for about 18 months.  But the day that it didn't do what I needed it to do, then I promptly went out and dropped a quarter of a paycheck on one that would.  I'm a firm believer in not buying expensive gear until you can define how you absolutely need it.  This was back in the dark ages when a two week paycheck was about $500 or less...


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## phideux (Oct 9, 2015)

Brandon O said:


> For some people this is true.
> 
> Some people don't need the wing on their car either.
> 
> One very smart emergency physician I know has decided that ultrasound has made the stethoscope obsolete (glares over thataway).



But the Ultrasound machine is a bit bulky and hard to carry around your neck.  

Seriously though, I use my stethoscope all the time, I have 2, middle of the road Littmans,  one stays in my hospital kit, one stays in my ambulance kit. Working in the ER I carry it around my neck. Working on the ambulance,  I carry it in my side pocket, I already have my radio strap and mic around my neck it gets tangled with them if I throw it on my neck.

One quick tip that works for me, I got a set of the veterinary binaurals for my hospital scope, they are  longer and hang around my neck better.


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## NomadicMedic (Oct 9, 2015)

I actually traded in my Littman for an ADR vet scope after using my wife's. I really like the extra tube length and once I put Littman earpieces on it, it was identical in performance. 

But, it's just a status symbol... So I guess it's no big deal.


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## teedubbyaw (Oct 9, 2015)

I sold my littman cardiology and got an ADC cardiology for half the price and works better.


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## Carlos Danger (Oct 9, 2015)

I have a really nice Littman (not even sure of the model) with my name engraved that a good friend gave me when I finished grad school.

It's too nice to carry around and risk losing, so I use whatever cheap disposable ones they leave hanging off the side of the anesthesia cart, or stuffed in the bag on the ambulance.


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## gotbeerz001 (Oct 10, 2015)

RobertAlfanoNJEMT said:


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


I have mine because it actually works much better than the cheap disposable ones the company buys... Secondly, the fact that it only goes in my ears (or a known partner) only strengthens the case. 

I keep my ears in my cargo pocket. 
I also carry a penlight.


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## Bullets (Oct 13, 2015)

I have an ADC 601 that i carry every day and while yes, its technically a "cardiologists" scope i like the dual diaphragm/bell set up. . Lung sounds are an integral part of my assessment and the scope we have in our bags are wither those dual sprauge ones or cheap one with a thin plastic diaphragm. They both equally suck at getting decent sounds. 

But i also carry a pelican AAA light instead of the disposable pen lights. i like the multiple intensity settings and i always carry a light with me on or off duty.

As for the tape, i have a roll on a carabiner on my radio strap. When i need tape i dont like to go digging through the bag looking for a roll just to secure a 4x4 over a venipuncture site or a dexstick,


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## akflightmedic (Oct 22, 2015)

I carry my own cause I don't like Ear-Aids.

Ever grabbed the community stethoscope and realized too late you forgot to clean it at start of shift? Some people seriously need to invest in Q-tips.


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## evantheEMT (Oct 24, 2015)

Does this include doctors and nurses as well? They wear their scopes around there necks all the time.


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## ERDoc (Oct 24, 2015)

Not all of them.  I can't stand to have it around my neck and usually have it in my pocket.  I clean it with the cancer wipes and when I sometimes put it around my neck for lack of a better place to put it, I get a wicked itchy rash.


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## hogwiley (Dec 21, 2015)

Do I trust the average EMT to be able to use it properly to assess lung sounds or anything else? Not really, but it is sort of essential for manually auscultating BP.


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## ZombieEMT (Dec 28, 2015)

TransportJockey said:


> 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.



I think this whole post was quite ridiculous. If you do not see the necessity of the stethoscope in EMS, then you are not doing your job well enough. Even at the BLS level, I use my scope frequently. Blood pressures and lung sounds for the most part, but both are a necessity. While, no, I do not need to own my own, I do prefer to have my own. Some people are just dirty, and I have personally gotten an ear infection from using scopes that are just shoved in a jump back. I know that mine is clean. The quality is also better than the 15 dollar one in the bag. Yes, the one in the bag is efficient in the job, but I can hear much clearer in the back of my ambulance with my own. I never have to repeat a BP because I did not hear it, and never have to tell a medic that I could not hear lung sounds. Also, while you might have good hearing, not everyone does. The 15 dollar scope in a the truck might not be good enough for some. I volunteer with a 72 year old man, who can not hear without a 300 electronic scope, so he bought one. Is it worth it for him? Yes. For me? Probably note. 

Is it a bad thing to want to be individualistic and say something about yourself? I do not think so.

As for the comment about penlights, not the same thing. I do not use a penlight on every call. I do use a scope on every call. The one in the bag or cabinet, will always be adequate for pupil assessment, unless the battery is dead. Buying anything more expensive would be stupid. I also am not stick a penlight in my ear or any other orphous of my body.


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## jlw (Jan 1, 2016)

They are an important tool for ALS and BLS providers alike. I need to hear lung sounds to differentiate between wheezes and crackles to determine if they need a duoneb tx or CPAP, also to rule out a tension pneumo, or confirm ET placement, also sometimes the automated cuff on the monitor just won't read or I don't like what it says so its nice to have a manual cuff/steth as an option.


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## meatanchor (Jan 22, 2016)

I do search & rescue, and find that it's sometimes the only way to get a pulse when it's cold.  It's also very useful for assessing patients for High-Altitude Pulmonary Edema (HAPE), which can be life-threatening.


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## Jane (Jan 25, 2016)

I started out with a cheap stethoscope from CVS when I began EMT school. I quickly found out that it was pretty much useless in the back of a moving ambulance. The ones stocked in the Thomas packs were no better. Auscultating lung sounds was impossible for me. I had no other choice but to invest in a good quality stethoscope. I'm very glad I did so. It helped immensely and more than likely will last a lot longer than the cheap $10 one I originally bought.

I don't wear it around my neck, but I definitely keep it in one of the cargo pockets on my pants so it's always handy.


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## Run with scissors (Feb 1, 2016)

To weigh in, I like it as a symbol. I mean why not? It comforts people to see it. Also, my pen light I carry on me all the time. 

But the question here is, why does it matter your purpose for having one? It gets used the same way.


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## Qulevrius (Feb 1, 2016)

Run with scissors said:


> It comforts people to see it



It's the person who comforts people, not a forked rubber hose with a sound amp. Having it around your neck 'as a symbol' = Ricky Rescue.


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## Run with scissors (Feb 1, 2016)

I disagree.  If a homeless looking man came up to you. With torn clothing and a beard and unbathed. And told you he would diversify your bonds. All he needed was your bank info, you wouldn't let him near your finances would you? 

The appearance is what assures people you can help them.


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## Underoath87 (Feb 1, 2016)

Run with scissors said:


> I disagree.  If a homeless looking man came up to you. With torn clothing and a beard and unbathed. And told you he would diversify your bonds. All he needed was your bank info, you wouldn't let him near your finances would you?
> 
> The appearance is what assures people you can help them.




That's an argument for uniforms, not stethoscopes.  And it's such a terrible comparison in so many ways...

Would you only hire this financial advisor if he had a calculator hanging from a lanyard around his neck, or would it be acceptable for him to leave it in a drawer in his office, or maybe in his briefcase?


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## Gurby (Feb 1, 2016)

Qulevrius said:


> It's the person who comforts people, not a forked rubber hose with a sound amp. Having it around your neck 'as a symbol' = Ricky Rescue.





Underoath87 said:


> That's an argument for uniforms, not stethoscopes.  And it's such a terrible comparison in so many ways...
> 
> Would you only hire this financial advisor if he had a calculator hanging from a lanyard around his neck, or would it be acceptable for him to leave it in a drawer in his office, or maybe in his briefcase?



I have a vivid memory of reading a study where patients rated physicians as more knowledgeable when they wore a stethoscope around their neck vs not wearing one.  I can't find the study right now, so it's possible I'm making that up.  However, a number of studies have been done on how physician appearance influences how kind, competent, etc, patients perceive their providers to be.  Other factors are likely more important, I don't know, but appearance and image certainly do matter too.  

Personally I find stethoscope around the neck to be a little bit cringey unless you just used it, but whatever.


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## Qulevrius (Feb 1, 2016)

Gurby said:


> Personally I find stethoscope around the neck to be a little bit cringey unless you just used it



My point exactly. I wear mine around the neck only if 1) I'm about to use it, 2) I just used it and haven't stuffed it into the pocket yet, 3) I don't want to leave it on the gurney (Littmann's tend to grow legs and walk away). Having it as a 'status symbol' is akin to the 'EMS' collar pins, it's funny to see at 1st, then you just feel sorry for whoever has them.


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## Run with scissors (Feb 1, 2016)

Lol, no, I don't suppose a calculator on a lanyard would sway my opinion. But he has a better chance than if he wasn't wearing it.


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## Kevinf (Feb 1, 2016)

Gurby said:


> ...Personally I find stethoscope around the neck to be a little bit cringey unless you just used it, but whatever.



I personally find it comical when my partner gets the old neck scope caught on the patient as the stretcher is being unloaded.


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## gotbeerz001 (Feb 2, 2016)

Gurby said:


> I have a vivid memory of reading a study where patients rated physicians as more knowledgeable when they wore a stethoscope around their neck vs not wearing one.  I can't find the study right now, so it's possible I'm making that up.  However, a number of studies have been done on how physician appearance influences how kind, competent, etc, patients perceive their providers to be.  Other factors are likely more important, I don't know, but appearance and image certainly do matter too.
> 
> Personally I find stethoscope around the neck to be a little bit cringey unless you just used it, but whatever.


There's another study that says you are far less likely to be sued if you are personable vs skilled. The study goes on to show that patients include responders/doctors in lawsuits if they were curt or hasty even though they did their job properly. Those who may have caused the problem/misdiagnosis but were nice were often left out. 

Takeaway: Patients know nothing.


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## RobertAlfanoNJEMT (Feb 11, 2016)

Qulevrius said:


> My point exactly. I wear mine around the neck only if 1) I'm about to use it, 2) I just used it and haven't stuffed it into the pocket yet, 3) I don't want to leave it on the gurney (Littmann's tend to grow legs and walk away). Having it as a 'status symbol' is akin to the 'EMS' collar pins, it's funny to see at 1st, then you just feel sorry for whoever has them.


I put mine on for every call I go on.. We have some on the rig but I don't really wanna use one that's been in fourty different people's ears... Most of our EMTs where their own steths


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## Reuben De La O (Feb 12, 2016)

I agree with you to an extent. I do believe that they do not need to be worn all the time. Not to mention that they cause strains on your next! Trust me, I wore my stethoscope about 3 times a week during clinicals and class for at least four hours, neck started to hurt. Took it off and didn't wear it unless I was just finishing up with it, My neck instantly felt better. 

As for a symbol, stethoscopes play a huge role in patient care. I personally have a Littmann Classic SE II. I paid 80 for it. It is not right for me. I can't hear a thing out of it somedays. Worse in the rig. Some people I'm sure buy their stethoscopes by the price. Others buy them because they have a good reputation. I always tell students and other people to try a bunch of different stethoscopes and see which one works for you. I wouldn't recommend using a disposable one. They are not nearly as good as the ones you can buy. 

All in all, Don't wear them on your neck. Get one that is right for you.


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## CobraIV (Feb 16, 2016)

I worked with a girl in the ED and she wore one. She had no creditentals other then a CNA and that was questionable. I asked her why she wears a scope and said told me "If I ever get pulled over I can tell the cops I'm a nurse." I lost a few brain cells after she told me that. It drove me nuts because I asked her to practice using the scope to listen to lung sounds or take a b/p manually. She refused saying "It's just an accessorie." I lost all hope for her. The hospital I did work at is closing so the sooner the better.


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## ThadeusJ (Feb 17, 2016)

Today we celebrate (if you so choose) the birth of the father of the stethoscope, René Laennec...just another useless fact to impress your colleagues or win on Jeopardy some day.


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## beaucait (Feb 18, 2016)

RobertAlfanoNJEMT said:


> 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..


I have a stethoscope. It is a personal stethoscope. It is a symbol of the success I have had over the years, being the first in my family to get into college, and being the first on both sides of my family working hard to get a good career in the medical field. It is also a tool at the same time. I use it to listen to heart and lung sounds, and learn the correct places to put it. I learn how to listen for abnormal heart sounds. It is what connects me to my patients. If I have an elderly lady, and she cannot hear what I am saying, you bet I'm gonna let her listen to me talk gently into the stethoscope, so she can hear. It's a symbol, but a meaningful one.
You personalize it so you know it's yours, and you personalize it so it stands out, just like your patient care should. You make it your own because it means something to you.


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## titmouse (Mar 23, 2016)

I have started taking my assessment seriously now in order to break bad habits that I have developed over the years of working in IFT only companies and I consider it being one of my prized tools.


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## gotbeerz001 (Mar 24, 2016)

This is my stethoscope. There are many like it, but this one is mine.
My stethoscope is my best friend. It is my life. I must master it as I must master my life.
Without me, my stethoscope is useless. Without my stethoscope, I am useless. I must place my stethoscope true. I must listen better than my enemy who is trying to kill my patient. I must find him before he ruins my day.


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## ORcowgrrl (Apr 28, 2016)

The first thing I added to my BLS toolkit was a stethoscope. I live in a community of retirees who commonly have lung and blood pressure issues, so...kinda need that steth for keeping an eye (or should I say, ear?) on those things. 

Now, if we want to talk quality, that's a different story...my instructor for my EMT-B class said he almost stole a flight medic's cardiology stethoscope after using it roughly 50' from the chopper to check his patient's lung sounds, without any difficulty. (My guess is...it was platinum!)


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## joshrunkle35 (Apr 28, 2016)

I think stethoscopes are a great tool that are very under-utilized in EMS. 

However, I believe that they are also very valuable as a symbol. Patients view them like a white lab coat. Symbols can be just as important as tools.


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