New EMT needs advice

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EMTWillow11

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Hello, I'm a new EMT and I'm having trouble obtaining accurate BP's in the rig because I can't hear anything. I have a standard 3M Littmann stethoscope ... some of my co-workers have mentioned there are 'EMS specific' ears that most medics have, but I didn't want to be too much of a newb and ask ... Does anyone have any suggestions for a better 'EMS' steth?

Thank you so much :)
 
EMTWillow11 said:
Hello, I'm a new EMT and I'm having trouble obtaining accurate BP's in the rig because I can't hear anything. I have a standard 3M Littmann stethoscope ... some of my co-workers have mentioned there are 'EMS specific' ears that most medics have, but I didn't want to be too much of a newb and ask ... Does anyone have any suggestions for a better 'EMS' steth?

Thank you so much :)
Click to expand...

There's no "EMS scope". If I were you I'd learn on a cheap scope first... Not jump straight to some expensive cardiology scope. And you have a littmann...it's already a super scope. If you have a littmann scope and can't hear korotkoff sounds then your doing something wrong.... It's you, not the scope. As a new emt you have a limited amount of sounds you know how to hear. Basically for breath sounds and BP. Practice practice practice. Take BPs of parents, friends ect. Also practice using efferent amounts of pressure on the stethoscope head. You may be using too much pressure, thus cutting out all sound.

Good luck!
 
EMTWillow11 said:
Hello, I'm a new EMT and I'm having trouble obtaining accurate BP's in the rig because I can't hear anything. I have a standard 3M Littmann stethoscope ... some of my co-workers have mentioned there are 'EMS specific' ears that most medics have, but I didn't want to be too much of a newb and ask ... Does anyone have any suggestions for a better 'EMS' steth?

Thank you so much :)
Click to expand...

If it's not because you're pushing too hard it might be due to background noise? You need to clarify.

If you're rolling down the street, trying to take a b/p, lift your feet off the floor, or put them on the tip toes. The ground noise from the ambulance can also interfere with taking a b/p.

Sort of like when you're trying to take a b/p and the hoses keep hitting/rubbing each other.
 
Use search. We kicked this one around for about a year or so.

Everyone has their own home brew method for making it easier to hear BP"s, including stopping the vehicle.

Some quick and dirty ones:

1. Make sure your earpices fit your ears. I used the soft mushroom ones and replaced them often.
2. Take lots of BP's. The sounds will become ingrained so you can recognize them despite interference.
3. "SILENCIO!". If you can't hear due to chatter or other extraneous talk, ask people to be quiet for a minute.
4. Feet off the floor and the litter rail.
5. Put down the IPod. Hearing loss and tinnitus only make it harder.

PS: hope your scope's tubes are long enough to let you stay back off certain patients.:cool:
 
Practice. Practice practice practice.


All else fails, you could spring a couple hundred dollars for an electronic one...
 
Actually, Linuss and I are opening an online Mobile BP Auscultation class...

$25 a pop. Who wants to be in the inaugural class?:cool:
(Just kidding).
(This week).
 
The biggest thing is to do it over and over and over and over again. I've been away from fieldwork for years. I still know what the korotkoff sounds are... and I'm certain that I could hop on an ambulance and take a manual BP while moving. Once you know what to listen for, you'll be able to hear them despite all the other interference that can sound a lot like the normal BP sounds.

Your Littman is easily good enough to do the job. I've had several over the years. I might get a little grumpy if I have to use a cheap, disposable steth... but I can still use it well enough to get the job done.

Trust me, after doing this a few thousand times on the road, you'll get the hang of it too. ;)
 
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If your Littmann has two bells, make sure the one you're trying to listen through is properly set at the end of the tube. Sounds silly, but I've seen it before.
 
Another simple mistake which has occurred many times over...make sure the ear pieces are pointing forward when placed in your ears.

I have seen many people insert them backwards and then complain about the stethoscope...a basic AnP course might have prevented this. :)
 
Thank you all for the good advice. I have tried several of the suggestions and some days are better than others, so it must just be me. I usually take my vitals when were stopped (when I can). I have lifted my feet to my toes and have asked the talking to stop.

I very well could be putting too much pressure on my bell, I guess it's instinct if you cant' hear something to press harder. I will try to take off some pressure. And maybe buy a different ear piece (the rubber parts on the end) as those are the part that doesn't seem to fit well into my ears. I have thought that maybe I was wearing them backwards, but I've tried both ways :)

Thanks again for all the help, practice may be the problem... although, I take probably 10-12 vitals a day, not counting overtime pt's LOL... Thanks again all :)
 
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