[snewsarah]

Hi,

I'm current obtaining my CNA and then moving right on to get my AAS in nursing. At this point, I'm having a heck of a time taking blood pressures because I simply cannot hear the pulse! It so frustrating and I've been practicing a lot and I don't feel it's getting better. So I'm thinking about buying a really good stethoscope. My question is: what kind of stethoscope is a really good one? I know a cardiac stethoscope is probably the best, right? But what brand, etc? What are things I need to look for in one?

And please - any tips and advice on improving my ability to hear the pulse would be appreciated. Thanks!

[TrendyNursingStudent]

well are you not hearing anything or just not hearing the changes in the pulse? are you looking for the pulse point and placing the scope directly over that befor pumping the cuff? are you letting the air out to fast?

heres my tips. if you arent doing these things a higher grade scope i dont think wil help....

1) find the pulse first and place the scope directly over the pulse.
2) Put the scope in your ears correctly. I put mine in backward the first ouple times LOL
3) pump to atleast 130
4) let the air out slowly and take your time when listening.
5) you should ( depending on how high you pumped) hear nothing then a loud beat.... followed by a change in the loudness of the beat.

hope that helped!

[underpaidrn]

Originally Posted by snewsarah

Hi,

I'm current obtaining my CNA and then moving right on to get my AAS in nursing. At this point, I'm having a heck of a time taking blood pressures because I simply cannot hear the pulse! It so frustrating and I've been practicing a lot and I don't feel it's getting better. So I'm thinking about buying a really good stethoscope. My question is: what kind of stethoscope is a really good one? I know a cardiac stethoscope is probably the best, right? But what brand, etc? What are things I need to look for in one?

And please - any tips and advice on improving my ability to hear the pulse would be appreciated. Thanks!

Number one - have you had your hearing checked? Is this something new for you?
Number two - they do make an electronic stethoscope for persons who are hearing impaired and they do work very well.

I personally use a Littman's Master Cardiology and have very short tubing on it. The longer the tubing, the less sounds you will hear. I could hear a gnat pass gas with mine!

Hope this helps you and good luck with everything.

[suzy253]

Do you have them in your ears correctly & not reversed?

[diamondmeadows]

Hi Sarah,

I have found that I can't really use stethoscopes that have hard plastic earpieces. My stethoscope has soft PVC earpieces, and the sounds are very loud and clear, but with hard plastic ones I can barely hear a tiny tap or nothing at all. I only know of one or two other students in my class who have this issue, so I don't know how likely it is that this is your problem, but I wanted to throw it out there just in case. If you are using a steth with hard earpieces, maybe you could try borrowing a steth with soft earpieces to see if it makes a difference. I don't know if it means that there is something wrong with me or what.

I use an Adscope 603. It has worked great for me so far and was reasonably priced.

Good luck!

[pdjax]

Have you been taught the direction the ear pieces should go? This sounds silly but i didnt know there was a certain direction for them to go until i got my littman. i noticed the ear pieces were curved so i tried both directions and realized i had been doing it wrong. Our instructors never mentioned it and i have seen other students doing the same thing. I tell them what I have discovered and they are always amazed at how much better the sound quality is. Funny how things work better when you use them correctly huh?

[Carla25]

I purchased a Littman Master Cardiology and I love it, you can hear everything

[MeghanRN]

Diamondmeadows: If there is something wrong with you not being able to hear from hard tips, they there is something wrong with me too!

Sarah:

Try Diamondmeadows advice. I Can only hear out of soft tip stethoscopes. In fact, if I use the hard tips, it hurts my ears so much that my own ears start pulsating after about 15 seconds.

I bought a littmann stethoscope for about $50 - its lightweight (huge plus b/c you cannot carry a heavy one around your neck for 12 hours) It works great, and its soft tipped.

[Rage]

Originally Posted by TrendyNursingStudent

well are you not hearing anything or just not hearing the changes in the pulse? are you looking for the pulse point and placing the scope directly over that befor pumping the cuff? are you letting the air out to fast?

heres my tips. if you arent doing these things a higher grade scope i dont think wil help....

1) find the pulse first and place the scope directly over the pulse.
2) Put the scope in your ears correctly. I put mine in backward the first ouple times LOL
3) pump to atleast 130
4) let the air out slowly and take your time when listening.
5) you should ( depending on how high you pumped) hear nothing then a loud beat.... followed by a change in the loudness of the beat.

hope that helped!

Good advice but you better pump to 200..........120 is considered normal, hypertension of 170/100 wouldn't be detected at 130.........

My first Med/Surg patient was a 21 year old that was in acute renal failure, he was morbidly obese. I had a standard littman and couldn't hear a heart beat (prolly 8 inch fat layer)........the instructor let me borrow her Master cardiology and the heart sounded like a shoe in a dryer. It was loud. Needless to say I went and got one.

In Psych we went and did some work with the homeless, a patient with an acute asthma attack came by the clinic. While listening to his lower right lobe I could hear his heart beat.
So while assessing his lungs I could also listen for skipped or transient beats...............the master cardiology (special edition all black with laser signature).....yeah baby.

Just noticed many people said to check to see if you have the ear tips in correctly but no one said how to do it.

Correct ear tip placement: If you put your finger in your ear you will notice the canal is angled from the back to front. Place the ear piece of the stethoscope around your neck with the diaphragm against your chest, reach up with both hands and turn the metal extension piece of each sound tube slightly forward towards your face. Pulling the stethoscope off and looking at them from the ear pieces down the sound tube, you will see them with a slight up angle on each ear tip. Try them on, and continue adjusting in this manner until they feel comfortable in your ears and have a good seal. Then when you put them on make sure the diaphragm is against your chest and the tips will always be at the correct angle.

[CAPGnu]

has anyone heard that well with a master cardiology scope as a ultascope?