Don't particularly care about cliche... I don't even bother bringing it on a psych calls and I don't operate under the assumption that everyone wants to attack me.
Have I worn the steth around my neck? Absolutely. When you use it and the bag isn't in reach to put it away, the neck is the perfect natural temporary storage place. While I can understand the convenience of having it around your neck all the time while on a call, I personally do not like having something dangling around my neck. After reading my post, I can see it was worded in a fashion that made it sound like "if you wear it around your neck, you're doing it wrong". That was not my intention at all, so let me clarify that.
On day one of my orientation at AMR 5 years ago, our regional safety person mentioned the whole "don't wear it around your neck because it allows someone to grab onto you". It's something that I personally took to heart, and along with my personal preference of not wearing it around my neck in general, it proved to be a very minor reason for me. Did I approach each person as someone who was going to hurt me? Absolutely not, but I liked to be at least minimally cautious, since I didn't make enough to put myself into a bad situation.
Just so I understand how your operate.... inside the house, or outside of the truck, during your initial patient assessment, which often guides you later interventions or determining sick vs not sick, you use the cheap scope that you on the cot; it's only once you get into the truck do you use your nicer scope to assess your patient with a quality medical device, after you have already started down the treatment path with the cheapie scope....
Please tell me I am wrong.....
The stethoscopes we were provided were better (albeit only a little bit) than the plastic disposable ones you just posted. Perhaps instead of costing $2 they costed $10. Were they flimsy? Yes. Did they work? Yes, reasonably.
Determining if someone is sick takes multiple factors into account and my lack of ability to listen to one's lung sounds doesn't prevent me from making that determination. If they're pale, cool, diaphoretic, and tripoding with accessory muscle use, do I NEED to listen to their lungs right then and there to determine this person is sick? No, but it would be nice to get a whole picture. As a BLS provider in the LA County system, does the fact I am able to check lung sounds immediately at patient side really affect my immediate action plan? If they show signs of moderate to severe respiratory distress (and are
Sick), my concerns are vitals, O2, moving to the cot, and beginning to load them up in anticipation of either rapidly transporting BLS if we are very close to the ED or waiting for ALS to show up. Whether or not I hear rhonchi in their living room isn't going to change my immediate plan of action at the BLS level.
Our stethoscopes were more than capable of doing on scene work (BP and basic lung sounds). Admittedly, if I was first on scene, which was often the case only about 25% of the time, I would take my personal stethoscope in with me, but I often forgot to grab it off the webbing.