should i invest in a new steth?

Specialties CCU

Published

Hi,

I was thinking of buying the littmans master cardiology stethoscope. But its really expensive and wanted to know if it was worth it. I have a light weight littman and i think its not doing a great job! I also was thinking about taking a class on stethoscope assessment skills...do you think this is worth the time? or is it a skill you develop over time?

I think it will be worth every penney!!!

I now own my second littmann Cardiology III. the 1st one was for $250 at the store. 2nd one $150 online. I didn't know what I was missing with my $30 steth until I got my littmann. Buy it and you will not regret it. or just try it on.

Good luck!

Specializes in CVSICU.

I bought a Master cardiology and I really like it....neccessary? Not really.

Depends, started out in a private hospital SICU, I bought a littmann cardiology STC ($175), then went to work for a level 1 trauma center in the trauma ICU, and half our patients come in or end up getting acinetobactor, so now my $175 stethoscope sits in my backpack and I use a 10 cent disposable stethescope. But I do always have it on standby in case I really need to hear something.

If anyone can find a study that demonstrated improved patient outcomes based on price of their nurse's stethoscope I'd love to see it. I'm pretty well convinced that a $200 stethoscope is more often than not a fashion accessory.

Here is a study that suggests they don't make much a difference:

Am Heart J. 2006 Jul;152(1):85.e1-7.

Effect of teaching and type of stethoscope on cardiac auscultatory performance.

Iversen K, Søgaard Teisner A, Dalsgaard M, Greibe R, Timm HB, Skovgaard LT, Hróbjartsson A, Copenhagen O, Copenhagen S, Copenhagen K.

Clinic of Cardiology, Rigshospitalet, Copenhagen Ø, Denmark. [email protected]

BACKGROUND: Auscultation of the heart is a routine procedure. It is not known whether auscultatory skills can be improved by teaching or with the use of an advanced stethoscope. METHODS: This study was a randomized trial with a 2 x 2 factorial design. Seventy-two house officers were randomized to a simple or an advanced stethoscope and to a 4-hour course in auscultation or no course. The doctors auscultated 20 patients' hearts and categorized findings as normal or as one or more of 5 categories of heart diseases. Patients were selected such that 16 had a known heart disease as well as a corresponding murmur and 4 had no heart disease or murmur. Auscultatory performance was assessed as concordance with echocardiographic findings and interobserver variation. RESULTS: Doctors using the advanced stethoscope diagnosed 35% of the patients correctly, as compared with doctors using the simple stethoscope who did 33% of the patients (P = .27). Similarly, 34% of the patients were diagnosed correctly by doctors who had received teaching as compared with 33% of those who were by doctors who had received no teaching (P = .41). The kappa values were higher for doctors who had received teaching for aortic stenosis (0.43 vs 0.28, P = .004) and ventricular septum defect (0.07 vs 0.01, P = .003). There was no difference between groups for any other single murmur or for the detection of murmurs as such. CONCLUSION: Heart auscultation findings were in poor accordance with echocardiographic findings and had high interobserver variation. Neither outcome improved to any important extent with the subjects' use of an advanced stethoscope or attending of a course in heart auscultation.

Specializes in Going to Peds!.

I adore my Cardiology scope. It doesn't have to be a Littman cardiology scope to be good. I bought one that my schooll had on sale for $35 and it worked wonderfully until about a year after I was out of nursing school. Then, I accidentally tore the tubing. I didn't know I could buy new tubing, so I bought a new scope. This time a Littman. Truthfully, I liked the one from school better, but the Littman is almost as good and world's better than a single lumen scope.

Specializes in ICU/CCU.

I use a Littmann Classic II, and I think it works just fine. I own an electronic Littmann that I received as a gift, and it mostly sits in my locker. I have lent both of my stethoscopes to doctors and nurses at work on the unit, and it is fun to watch them listen for breath sounds only on the FRONT of the patient and OVER THE GOWN and then give me their assessments of how well each stethoscope works. I think that really fancy stethoscopes are mostly a waste of money and that you are better off working on improving your assessment technique.

I recently bought a book with audio cd called "Auscultation Skills--Breath and Heart Sounds," which is published by Lippincott. I feel like it was a good investment.

Specializes in CVICU.

I have a Littmann Cardiology III and I have a $16 steth that my mom gave me when she retired from ER nursing. I can hear absolutely no difference between the two. The only advantage is that the Littmann doesn't hurt my ears, and the cheap one has hard earpieces that slide too far into my ears.

Specializes in Critical Care.

I bought an electronic one last year and I love it. Before that had the Littman Cardiology III and loved that one. I do a lot of listening to valves and my new one makes that easier. But I think a key point to consider is if you have hearing issues. My friend bought a really expensive electronic Littman because she's having hearing problems affecting her assessments. The electronic one seems to be doing the trick for her. Just a thought

I have a littman master cardiology. It reallly does work better than a cheap one. But I don't think it really makes that much of a difference in practice (at least in the icu).

It did make a difference outside of work- when I heard a family member's heart murmur and it led to diagnosis of a congenital heart defect. So I think it was worth the $125.

Specializes in Dialysis.

The problem with the Littmans are inherent in the design. They are a tube inside of a tube and do not transmit sounds as well as seperate tubes. I don't think Phillips still makes the original Rappaport design but acoustically this is the best.

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