Stethoscope hacking.

jameswf

jameswf

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So from what I gather stethoscopes like to grow legs and walk off, get soiled beyond proper sanitation or otherwise expierience other events that makes investing a lot of money in one a silly idea. So how can you hack up a cheap one to make it work better.

Some advice from my teacher:

- Replace the diaphram with xray film. (done)
- Replace the tubes with suction tubing. (cant due to single tube design)
- Get Gel ear pieces (cant find cheap but got some rubber ones)

Any hacks you do to yours? Ethnic engineering etc...
 
Buy a littman and keep it under your bed, no one will know you have it so it won't get stolen. :D
 
I just make do with the cheap ones. I don't make a lot of clinical decisions prehospitally off of heart sounds, so if I can't hear them, it's not a big deal.

I can usually always hear lung and bowel sounds very easily, even with the hearing damage I have sustained over the years of siren exposure.
 
I have a couple of "frankenscopes". I have Littmann tubing with a Kila Labs bell and my Vet length ADC with Littmann ear pieces.
 
Disregard the jibberish
 
jameswf said:
So from what I gather stethoscopes like to grow legs and walk off, get soiled beyond proper sanitation or otherwise expierience other events that makes investing a lot of money in one a silly idea. So how can you hack up a cheap one to make it work better.

Some advice from my teacher:

- Replace the diaphram with xray film. (done)
- Replace the tubes with suction tubing. (cant due to single tube design)
- Get Gel ear pieces (cant find cheap but got some rubber ones)

Any hacks you do to yours? Ethnic engineering etc...
Click to expand...

I offer my loyal assurance, If I ever saw a provider walking around with suction tubing with a cut piece of xray film hanging off of it as something other than an emergency repair, at best they would lose significant professional credibility in my veiw.

If it were in my power, they certainly would not appear before a patient as such.

In the matter of professional pride, you don't need the most expensive equipment or even high priced equipment, but it does have to be in good repair and demonstrate pride in what you do.

Otherwise, it is not your equipment that is a hack, it is you.

EMS is a healthcare field.

Professional miinded people take care of their equipment. They clean it. They replace it when it becomes too worn.

Boots get dirty and scuffed. Why not just wrap some plastic bags around your feet and save some money?

Pants and shirts become stained, frayed, and faded, why not just wear a leather apron?

You do not need to spend a lot of money. But you do need to represent yourself, your voacation, and your agency with professionalism.
 
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Go to allheart.com and buy a Littmann, they're on sale now. I just bought a Classic II for 70 bucks, the Lightweight is $45 and they will engrave your name on it if you want to prevent it walking off.
 
Vene has a very good point. Some of the old timers in EMS (and folks who want to pretend to be old timers) seem to think the more worn out and beaten up their equipment/uniform is the more credibility they'll have. While I'm not advocating that every medic needs to look like a well polished penny I do think that wearing boots well past their polishable days or repeatedly piecing together a stethoscope from odds and ends is not something that we should be doing.

Using X-ray film to repair a scope is great if you're behind enemy lines in Iraq or deep in the outback and there are no alternatives but it looks kind of silly outside of that context. You might look like you're trying to hard.
 
As usual Vene hits it on the head.
 
[YOUTUBE]http://www.youtube.com/watch?v=l1wjpZDVa24[/YOUTUBE]
 
7635_zps83518333.jpg
 
I have had my littman lightweight II for over two years now, best $35 I have ever spent. if you dont put it down it wont walk away...

If I had a partner who had a stethoscope with suction tubing and x-ray film I would politely ask him to either put it in his locker or in his car, because it is coming nowhere near a real ambulance. take pride in what you do, look like a professional, and if you dont know ASK.
 
jameswf said:
Some advice from my teacher:

- Replace the diaphram with xray film. (done)
- Replace the tubes with suction tubing. (cant due to single tube design)
Click to expand...
uhh what? why? it's a piece of equipment, one that you own. treat it well, and replace it if it gets broken. the diaphram breaks? go on ebay, and get a new one. replace the tubes with suction tubing? do you want to get laughed out of the ambulance?
jameswf said:
- Get Gel ear pieces (cant find cheap but got some rubber ones), or at least get some littmann ear buds to put on your cheap scope for comfort purposes.

Any hacks you do to yours? Ethnic engineering etc...
Click to expand...
ok, the gel ear pieces aren't a bad idea.

here is Dr. P's advice:

1) its your scope. treat it well. it's your scope. always know where it is.

2) its your scope, clean your scope when it gets dirty. decon the diaphram, as well as the tubing with alcohol prep wipes, and if you lend it to someone else, clean the ear buds.

3) it's your scope, don't leave the truck at the end of your shift without knowing where it is. if you can't find it at the end of the shift, keep looking. if after tearing the truck apart looking for it, admit that you lost it, it's your fault, and purchase a new one, accepting the cost as the cost of a learning experience.

I have owned two scopes, an all black edition littmann master classic (that developed legs because I didn't follow rule #3), and a blue littman master classic (that is kept in my EMS gear bag. I loved them.

I also have two generic littmann cardiology ebay knockoffs, one that was given as a gift to a friend of mine, and one that is my backup scope in case I ever need it. I don't use them, but my friend likes hers.
 
socalmedic said:
I have had my littman lightweight II for over two years now, best $35 I have ever spent. if you dont put it down it wont walk away...
Click to expand...

I've got posession of 2 Littmans myself- a S.E. and a limited all-back master classic. And amazingly even on the times that I have set it down (or, as more likely, dropped it), all my coworkers have let me know or grabbed it for me. Seems I may actually work in a place where people have integrity.

....That and they like to make fun of me for being the only one to carry their own stethoscope rather than use the P.O.S. one on the vanbulance :P
 
sirengirl said:
I've got posession of 2 Littmans myself- a S.E. and a limited all-back master classic. And amazingly even on the times that I have set it down (or, as more likely, dropped it), all my coworkers have let me know or grabbed it for me. Seems I may actually work in a place where people have integrity.

....That and they like to make fun of me for being the only one to carry their own stethoscope rather than use the P.O.S. one on the vanbulance :P
Click to expand...

Yea, the people I work with are for the most part great people, I've misplaced my Littmann a time or two and had it returned to me the next day or hidden away in the truck for safe keeping.

As for my Sports Medicine job, the attitude seems to be what's yours is mine and mine yours. I come into work and someone is using my steth, someone else has my nice shears, another person has my personal kit (it looked the nicest so I borrowed it! :angry:). I think it's more ignorance than anything else though, most of our staff has no idea what's nice and what isn't.
 
I get annoyed any time I see a medic with a $5 stethoscope that I know they have just for show. Worse is the rare occasion you see a doctor with one.

If I see someone with one of these on their neck, I usually assume they don't check lung/heart sounds.
can-stock-photo_csp4619234.jpg


A stethoscope is the sole assessment tool you need to do your job that comes out of your own pocket. Is $50-100 seriously that much for something you will use EVERY day you are at work?
 
I can't tell you how many times I have heard EMS people brag about the $250 Danner boots they just bought or the $75 pair of EMS pants with a gazillion pockets, yet you want to jerry rig a stethoscope?

You won't be making clinical decisions in the field likely, but it is a VITAL piece of equipment. It is probably one of the only pieces of equipment that has a impact on patient care (at least for us basics). I mean look at medication. As a basic I can assist with Nitro, BP has to be above 100 to give it. If you have a crappy stethoscope and can't hear the Korokoff sounds how are you going to obtain an accurate BP.

You don't need a fancy stethoscope but invest in a good one. Littman's can be had for around $50 which is what I have. Some ADC scopes are around 20 or 30 bucks.
 
leoemt said:
You won't be making clinical decisions in the field likely
Click to expand...

How do you expect to treat patients then?

Anyways, couldn't agree more with what Vene said. My Littmann is the best $120 I ever spent, it's probably one of the best tools I have. Granted, I can hear lung sounds well enough with the crappy stethoscopes provided by my company, but they kill my ears, and quite honestly, they gross me out.

I could never take a provider seriously if I saw them with the kind of stethoscope described above. It's unprofessional, an it only serves to make you look like a hack to your patient, and to fellow healthcare staff. It's not horribly difficult to keep track of your stethoscopes, granted there are times when things get hectic and it may get misplaced temporarily, but that seems rather rare. Buy a decent scope, get your name engraved on it, and take care of your things so you can take care of others.
 
fast65 said:
How do you expect to treat patients then?
Click to expand...

The only thing I expect a Basic to actually listen for is lung sounds. How many paramedics, let alone basics, can actually distinguish various heart tones? Furthermore what impact will it have on your actual treatment? Maybe realizing muffled tones in relation to a tamponade but I can't really think of much else.

I wish I still had the article but they did a study with medical students, residents, and various MD specialties on recognition of heart sounds and it was overwhelmingly poor. It is one of those skills that takes a lot of practice and experience.
 
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