The absolute begining.

akflightmedic

Forum Deputy Chief
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Been a paramedic since 1994. I have used every type of stethoscope on the market...$14 Sprague to $$$ Cardio.

Never has a scope made the difference in these two things:

1. The patient's clinical presentation
2. My assessment based on #1 above and history gathering

It HAS made a difference on occassion in these situations:

1. Better documentation on a critical transport (Usually ALS Interfacility)
2. In flight due to ambient noise
3. In a hospital setting mostly to detect subtle changes
4. My overall intensity of exam (learning new things to see, hear, do).

Again, not much changed in what I would do or did.

Save your $$$,
 

Medpacks

Forum Ride Along
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0
1
MDF stethoscopes are comparable to Littman but cheaper. I know several EMT's and a few Paramedic students who have them and recommend them. Amazon has them.
 

jgmedic

Fire Truck Driver
785
203
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I would agree to not spend a lot on a steth just yet. However, get a good watch. Over my first few years, I went through so many crappy watches. Invested in a G-Shock 8 years ago, and the only reason I got a new one is my fire academy wouldn't let me wear a blue watch.
 

rujero

Emergency Services RN, NREMT
47
20
8
...the only reason I got a new one is my fire academy wouldn't let me wear a blue watch.

Hahaha that's awesome! G-Shock watches have pretty solid bands. It's like you either have to go wicked cheap and accept the fact that it's going to get wet and die, or the band is going to snap frequently... or you invest in something waterproof, that lights up, and has a sturdy band.

EDIT: Also avoid metal link bands. Yes they are stronger, but if it slides down your wrist while you're doing compressions its going to dig into your skin and depending on the angle of your wrist the links could still break. Metal is stronger than skin my friend, and it will dig right into your wrist right up until it snaps off... and trust me, it hurts like a muther.

EDIT #2:
Timex Item # TW2P71300ZA
https://www.timex.com/weekender-chrono-oversize/TW2P71300ZA.html

Waterproof, lights up, band that wont deteriorate when wet, over-sized analog face, Timex quality. Can probably find it cheaper elsewhere.

-r
 
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akflightmedic

Forum Deputy Chief
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I do not wear watches...

My initial radial pulse check while interviewing the patient and establishing rapport instantly tells me too fast, too slow, or no concern. Soon after releasing their wrist after10-15 seconds (if that long), I have either a pulse oximeter or a monitor in place. Those devices will then confirm my initial count.

No watch means no breakage, no loss and no cross contamination. Do not have to worry about sweat under the band, discomfort during compressions or risk of it getting caught on anything.

Any other seasoned providers do the same?
 

rujero

Emergency Services RN, NREMT
47
20
8
II have either a pulse oximeter or a monitor in place. Those devices will then confirm my initial count.

The OP is a BLS student. A watch is going to be an important part of his assessment tool kit to determine heart rate but also respiratory rate... and it looks trendy and professional. GOTTA look trendy and professional! ;)

-r
 

akflightmedic

Forum Deputy Chief
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Yes, I am aware as I posted earlier and always read OPs and subsequent posts before commenting. Fairly certain I accomplished two things:

1. Give the student something to work towards
2. Ended my post with comment directed at other seasoned providers.

Reading comprehension will serve you and others well in this profession.
 

rujero

Emergency Services RN, NREMT
47
20
8
Yes, I am aware as I posted earlier and always read OPs and subsequent posts before commenting. Fairly certain I accomplished two things:

1. Give the student something to work towards
2. Ended my post with comment directed at other seasoned providers.

Reading comprehension will serve you and others well in this profession.

Well... that escalated quickly. I was just trying to be funny and keep it lighthearted man.

I did read your post and you have great points about the annoyances of a watch, such as having to clean it ect. As much as reading comprehension will serve us all well in our profession, so will humility my friend. Not everyone's looking "to work toward" what you do. The OP doesn't need a Para-magician bragging about his scope and how his internal metronome makes him too cool to wear a watch. He came here for advice on gear as he starts his journey through Basic school. We are all just trying to help him out.

-r
 

akflightmedic

Forum Deputy Chief
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I never bragged about my scope nor did I imply internal metronome godliness or too coolness.(see comment about comprehension).

As for "working towards what I do", you might find that/this is a common practice which comes with repetitive experience/exposure. But just to confirm, I asked others (humility).
 

Peak

ED/Prehospital Registered Nurse
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I do not wear watches...

My initial radial pulse check while interviewing the patient and establishing rapport instantly tells me too fast, too slow, or no concern. Soon after releasing their wrist after10-15 seconds (if that long), I have either a pulse oximeter or a monitor in place. Those devices will then confirm my initial count.

No watch means no breakage, no loss and no cross contamination. Do not have to worry about sweat under the band, discomfort during compressions or risk of it getting caught on anything.

Any other seasoned providers do the same?

I don't wear a watch, I find it personally uncomfortable and just don't like it. I do however keep a watch on my stethoscope wrapped around the bit where the tubing splits just before the binaurals.

I think having a watch is important even for seasoned providers. I frequently can look at the 3 lead or pulse ox and see that the displayed rate is not accurate due to artifact, especially on toddlers. I also use it when I have to count out drip rates and we don't have a pump.
 

Gurby

Forum Asst. Chief
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I use my watch more for the lap timer than anything else. I love knowing exactly how long ago something happened - CPR has been in progress for X minutes, we gave them a drug X minutes ago, I called the pizza delivery place X minutes ago, etc.
 

akflightmedic

Forum Deputy Chief
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Peak...I hear you, but clinically how significant is the HR being displayed and the one you are counting that important or vital to your next intervention? This is the point I was working towards.

Sorry to hear any place has infusions occurring without pumps...they are so inexpensive these days and are certainly better from many perspectives ((pt care, documentation, liability, error reduction,etc.).
 

akflightmedic

Forum Deputy Chief
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Gurby....from ALS perspective, thats why I use the intervention button on the LP 15. Love it, everything time stamped and a nifty print out at the end of the call. In my personal sphere I see this being underutilized by so many providers.
 

rujero

Emergency Services RN, NREMT
47
20
8
I never bragged about my scope nor did I imply internal metronome godliness or too coolness.(see comment about comprehension).

As for "working towards what I do", you might find that/this is a common practice which comes with repetitive experience/exposure. But just to confirm, I asked others (humility).

I'm going to just let it go at this point and keep a watch on my wrist. Agree to disagree I guess. Stay safe up there!
 

akflightmedic

Forum Deputy Chief
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Solid plan skippy.
 

Peak

ED/Prehospital Registered Nurse
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Peak...I hear you, but clinically how significant is the HR being displayed and the one you are counting that important or vital to your next intervention? This is the point I was working towards.

Sorry to hear any place has infusions occurring without pumps...they are so inexpensive these days and are certainly better from many perspectives ((pt care, documentation, liability, error reduction,etc.).

Generally it's important for discharge from the ED, so critical for my emotional well being. For patient care... less so I guess.

When I'm out in the field we are packing in everything ourselves, we take an ATV as far as we can go but then often are hiking in the rest of the way. Because of a balance of weight, space, ruggedness, and a handful of other factors we don't use pumps. We only use experienced medics and ED nurses so counting drips for a short bit before flight shows up isn't the end of the world.
 

NomadicMedic

I know a guy who knows a guy.
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I wear a watch, but I can’t remember the last time I used it to count a pulse. Like AK, I’m only concerned with knowing if a pulse is too fast, too slow or... ya know... actually present.

And as far as watches go, my Gshock has lasted for years. As an aside, when I went to Haiti, the 100% DDT that we used to keep the skeeters at bay ATE MY WATCH. Simply destroyed all of tbe plastic parts. So, be careful.
 

cruiseforever

Forum Asst. Chief
559
169
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I do not wear watches...

My initial radial pulse check while interviewing the patient and establishing rapport instantly tells me too fast, too slow, or no concern. Soon after releasing their wrist after10-15 seconds (if that long), I have either a pulse oximeter or a monitor in place. Those devices will then confirm my initial count.

No watch means no breakage, no loss and no cross contamination. Do not have to worry about sweat under the band, discomfort during compressions or risk of it getting caught on anything.

Any other seasoned providers do the same?

I wear a watch. As for work, I use it to count a pulse on a pt. that has a very irregular pulse rate or I am getting vitals without a monitor.
 

DrParasite

The fire extinguisher is not just for show
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I haven't worn a watch on my wrist in probably close to 5 years... maybe closer to 10.

I do have a watch with a velcro band wrapped around the neck of my scope, which is always on my person on the ambulance. and it was purchased for less than $15 from kmart or walmart or one of the cheap stores.
 
OP
OP
ChubbyMedic

ChubbyMedic

Forum Ride Along
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0
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So we got our gear today and the scope we got is the Prestige Medical Clinical Lite. Has anyone used this scope? If so do you have any comments, complaints, or concerns?
 
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