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Stethoscope recommendations

Discussion in 'ALS Discussion' started by Houstonemt, Aug 7, 2018.

  1. Houstonemt

    Houstonemt Forum Ride Along

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    Hey, I'm starting paramedic classes this fall and our instructor highly recomends a cardiology stethoscope. I recieved some financial assistance for the classes and uniform so I have a little extra to spend on a good stehoscope. Any recomendations?
     
  2. NPO

    NPO Forum Deputy Chief

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    Any good brand stethoscope will be good. I have a Cardiology III. Newer models are available.

    If you're going to a community college you can sometimes get them on the bookstore and then you can use financial assistance to buy them.
     
    Last edited: Aug 7, 2018
  3. StCEMT

    StCEMT Forum Deputy Chief

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    I have the Cardiology IV. You definitely get a quality piece with it. If you have extra play money, by all means get it. If you don't, the Classic II is also a solid stethoscope for a good price.
     
  4. hometownmedic5

    hometownmedic5 Forum Asst. Chief

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    Stethoscopes are the biggest, most common lie we tell eachother. With the possible exception of critical care level staffers, nobody in ems NEEDS a cardiology stethoscope, plain and simple. We lie to eachother and to ourselves, but its just that. A lie. I’m deaf in one ear and do my job with the fisher price POS provided by my employer. Auscultating blood pressures and adventitious breath sounds do not require a cardiology scope.

    They are a status symbol in ems, nothing more. If you have the money to burn and want one, fine, but its a lie to tell you you need one; a lie that has been perpetuated by us, to us, for decades. I bought into it years ago. The funny thing was, it didn’t improve my practice any. I own two Littmann master cardiology scopes. One is in my work back pack, where its been for about three years since the last time I used it. The other is buried in a closet somewhere since I decided the silver master cardio wasn’t quite tactical enough and I needed the black model. That’s over four hundred dollars in scopes that haven’t been touched in years.

    Buy one if you want, but its only fair that you know you don’t NEED it and thats its little more than EMS flair.
     
    Chimpie and Peak like this.
  5. Peak

    Peak ED/Prehospital Registered Nurse

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    Now that I'm mostly in the hosptial I use a harvey dlx with a peds diaphragm and a bell. Back when I was in the fire service I used a ADC 603 and it worked just fine, and since at the time they were 20-25 bucks I didn't really care if they got stolen or broken; and over the noise on scene or in the bus I don't find there to that much benefit to a cards scope.

    If you can I would try out a handful of other scopes and see what you like. For example the ADCs actually fit my ears better than Littmanns, and as a bonus are much cheaper.
     
  6. DrParasite

    DrParasite The fire extinguisher is not just for show

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    You know, if you have two that you aren't using, you can always sell them on ebay, or give them away to me, and I will make sure they are put to a good use.... it's better than just gathering dust.....

    While I agree that not everyone need a $3000 cardiologist scope, I think having a decent scope is much better than the cheap fisher price POS or sprauge $6 dollar one. My personal preference is a littmann master classic II (available for under $100 on amazon, and it comes in all black), but mine was stolen, so i replaced it with a cardiology III (which doesn't get as much use now since i'm not full time on the ambulance anymore).

    I have also owned some littmann knockoffs (which worked surprisingly well), and have heard good things about ADC, but will respectfully disagree with @hometownmedic5, stating I hear clearer with a decent scope, especially when on the side of the highway when trucks flying by at 80 mph, or trying to listen to lunch sounds in a noisy environment.
     
    DesertMedic66 likes this.
  7. NPO

    NPO Forum Deputy Chief

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    Having a good stethoscope isn't about hearing that lung sound no one else could, or being able to roll into an ER exclaiming that the patients murmor is more significant so you suspect endocarditis...

    It's about having a quality tool, pride in your work, and a tool that will last.

    Sure the cheapo ones your employer provides do work, but the ear pieces are uncomfortable, and they are cheap and break...somewhat frequently I might add.

    To put it another way, a professional mechanic could go to Harbor Freight for all of his tools, but they would be cheaper, not last as long and not reflect positivity on how much he cares.

    $200 is a modest investment in a stethoscope you can keep for years. I got mine 6 or 7 years ago as a gift. It was refurbished by Littman a few years ago for free and has never failed.

    I'm not advocating going and getting a Bluetooth recording stethoscope, but get something that's yours, nice quality and will last. MVIMG_20180620_212607.jpeg
     
  8. hometownmedic5

    hometownmedic5 Forum Asst. Chief

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    The take home point seems to have been missed, so I’ll repeat it. You dont >>>***NEED***<<< a cardiology stethoscope in EMS. There is a lot of room to maneuver between the cheapest and the cardiology models(and room beyond as well), but the point remains the same.

    A 25 dollar ADC will do everything you need to do in EMS and be of quality construction enough to, while not be considered an heirloom, at least outlast most EMT’s careers, so anything above that is want. I totally and completely understand want. I have a safe full of guns I wanted, an entertainment center full of electronics I wanted, a truck I wanted. Got it. But the point I’m trying to make is we need to stop telling kids fresh out of school(or even before) that they need to spend a weeks pay in some cases on flair. It’s BS and I think we all know it. Some of us are still lying to ourselves and thats ok. Everybody comes around eventually.

    My employer provides the 9 dollar dual head scope from Moore medical. I can appreciate breath sounds, and auscultate BPs, even in an ambulance bouncing down unpaved country roads, with one ear. I feel no great sense of shame, my work gets done, I cant suffer financially if it breaks or gets lost or stolen and if it breaks, I go to the supply room and get another one. We buy them a case at a time.

    As with anything else, you get to do you. I don’t think less of a person because of the stethoscope they use(boy, wouldn’t it be nice if that worked both ways). What I hate though is the lies we tell the new kids, forcing them to spend money they don't have on crap they don’t need only to wait a few years and do the same thing to the next crop. I remember being a broke basic, having to decide whether I was going to spend my last ten dollars to buy gas to get to work and be hungry all day or call out sick, buy a meal and ultimately lose the days pay. I think we need to spend more time mentoring the new guys on how to actually do the job and not filling their heads with nonsense like stethoscopes and raptors and duty belts and so on. But hey, thats just me.
     
  9. Akulahawk

    Akulahawk EMT-P/ED RN Community Leader

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    What I usually recommend is basically any stethoscope that you can find between about $35 and $70. Most steths in that range will work for anything you'll need for field work (and actually most clinical work too). The #1 biggest thing you can do is train your ears. Once you know what you're listening for, it pretty much won't matter how good (or horrible) the steth is, you'll be able to get the info you need under most conditions. The few times you won't be able to hear will be in those situations where the local noise level is so high that you'll barely be able to hear anything let alone hear sounds through a stethoscope.

    If you're absolutely stuck on a Cardiology model, look for a Cardiology III from Littmann. These were discontinued and the "new" model is the Cardiology IV... therefore you might be able to find a Cardiology III for less than $100. I had a Littmann Classic II SE for many years as my primary steth. I have a Littmann Lite (looks like a Classic II SE except it's aluminum instead of stainless steel and very light because of it) and I have a Cardiology III that I've had since about 2002. Yes, 16 years. I'm making mucho money as an RN now but I'm not going out to replace my steths with the latest/greatest steth or even an electronic steth... Because I do have well-trained ears, I can do just fine with the $4 single head steth or the $12 dual head steth my ED has available.

    Work on improving the "software" as that will help you maximize what you can get from the "hardware."
     
  10. Remi

    Remi Forum Deputy Chief Premium Member

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    I think a lot of folks use the term "cardiology stethoscope" when recommending a scope not because they really think anyone *NEEDS* a cardiology scope who is new to EMS, but just because in many circles, "cardiology scope" is kind of a generic term for a stethoscope that doesn't suck.The Littmann Cardiology series is what many people are familiar with and what to them represents "a good quality stethoscope". So what I think they really mean to say isn't, "go take an advance on your first weeks paycheck to buy a Littmann 3200 electronic stethoscope, otherwise you'll never make it in EMS", but rather, "invest in a good quality stethoscope". And while that's probably not necessary, it also isn't necessarily terrible advice. I'd say the same thing about investing in good boots and a few other personal items.

    As far as the need vs. want thing and people spending money they don't really have on things they don't really need, well, isn't that just the American way?
     
    Last edited: Aug 9, 2018
    NPO likes this.
  11. RocketMedic

    RocketMedic Fancy Book Learnin'

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