seeking stethoscope advice

  1. I am a first semester nursing student, but I am posting my question on this forum because I need the benefit of experience. I have discovered that I am somewhat hearing impaired. (Actually, it was something I already knew, just not to what extent; I suppose it has a lot to do with being 47 years old & having spent the last 27 years of my life working on & around jet engines & rivet guns & so forth, & being foolishly blaise about hearing protection, but....)

    Okay, anyway, I started out w/ a cheap generic stethoscope, found that auscultation (especially of BP) was difficult for me; I then upgraded to a Master Classic II & found things to be much more audible--but, I can't hear everything on every patient. Does anyone know anything about the electronic cardiologist stethoscopes? (Specifically, I am referring to the Littman model 3000.) Would it be so sensitive that it would be impossible to use effectively in the average clinical nursing situation?

    Allheart.com has them for $200 plus shipping, & I know that's a lot, but the way I am viewing it is, that if they told me I needed a 200$ textbook I'd buy it.

    I think am doing everything I'm supposed to be doing; I first palpate & find the brachial artery, it is just that on certain patients, the systolic end just sounds so faint I can't be sure where it started, & lung sounds aren't always that audible to me all the time either. (On some patients, everything comes in clear as a bell.)

    Regardless, any & all advice will be appreciated. I am old enough to appreciate the voices of experience.

    Thanx/Matt
    Last edit by matt59 on Oct 29, '06
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  2. 9 Comments

  3. by   TazziRN
    Before you spend that kind of money, ask a fellow student or your instructor to help you out: both of you get BP's on the same pt, same arm, and compare. Same with lung sounds. If there is a significant difference, see if you can get an amplified scope, something that a lot of hearing impaired nurses get. Not necessarily a cardiology scope.
  4. by   matt59
    Thank you for the quick reply, Tazzie; I've already kind of done the comparison test ... on some people it's presto-bang, audible as a churchbell on a January morning in Montana. On other people, I really have problems. On my critical compency for BP, I muffed it real bad my first shot at it, but then on my next go around (with a different guinea pig), I got lickety-split, first time.

    Do you happen to know of an amplified scope on the market that hearing impaired nurses are using? As far as the cost of the 3000 goes, I can't say I'm absolutely dying to pop for it, but than again, if that's what it takes, I guess it's a small price to pay.

    Thanx again/Matt
  5. by   RN007
    Matt59,

    There was a similar thread on the forum a few weeks ago. If I weren't studying furiously for a respiratory exam, I'd find it for you, but alas, I need to keep my priorities in line. If you have the time, search 'stethoscopes' here and I bet you'll find where someone endorsed the electronic steth. We are blessed to be about the same age and I empathize. I sprung for the Master Cardiology so I could hear. I must say, I love it. Good luck!

    aka Linda
  6. by   matt59
    RN Double Oh Seven (AKA Linda), thank you for the reference to the thread. The Tink Labs sounds like it is worth trying. I hear the Kortkoff sounds clearly in between systolic & diastolic, it is just that with some patients, they sound so muffled & soft at the beginning & where they end, many times I am not really sure.

    I can experiment on my family to my heart's content, but I'm thinking one can only get away with so many trys on a patient in clinicals. Fortunately, on the people I've had trouble with, I got someone to bail me out. There is probably a limited amount of times I can do that, as well.

    Okay, I hope the studying goes well. That's all I seem to do anymore; I used to indulge in about every vice known to man, & I've given just about all of them up. I registered here last summer, & very seldom get a chance even to check in. I'm happy to have it as a resource when I really need it.

    Thanx again/matt
    Last edit by matt59 on Oct 29, '06
  7. by   gpsytgr
    Good evenin Matt. Just a quick FYI.... You cant get better than the Littman.I too am heard of hearing but mine is hereditary. I have had the pleasure of using the 3000 but dont own one. Definatly worth the money. Good luck and God Bless. Talk to you again sometime
    Missy
  8. by   matt59
    Quote from gpsytgr
    Good evenin Matt. Just a quick FYI.... You cant get better than the Littman.I too am heard of hearing but mine is hereditary. I have had the pleasure of using the 3000 but dont own one. Definatly worth the money. Good luck and God Bless. Talk to you again sometime
    Missy
    Thanks for the reply, gpsytgr (AKA Missy), just out of curiosity, what kind of stethoscope are you presently using to compensate for your hearing impairment?

    And, I take it that you did not find that the 3000 over amplified & you heard too much?

    Thanx for the advice/Matt
  9. by   Indy
    With the electronic Littmann you will have to practice quite a bit more to figure out what you're hearing. For instance, with the manual blood pressure you may think you're hearing a higher diastolic because it amplifies the background heartbeat... practice, wait, you'll notice you hear a heartbeat, then the THUMP of the blood pressure begins. Sometimes if someone has a bounding pulse it's more difficult for me due to that extra noise than if they're thready or half dead.

    With lung sounds: yes you can hear more but you have to learn to pick out what is what. TV speakers on the bed? Turn it off or down so you can't hear the TV through the steth, amplified. Put it on the skin if at all possible, as the movement of fabric will sound like crackles at first. Listen to coworkers, family, etc. who have good lungs, through their shirts, to figure out what it sounds like over moving fabric. You can train your ear to filter out the static and extra noise.

    I can't hear anything but a really strong systolic blood pressure through a non-amplified scope. The amplified ones are wonderful but you do have to take the time, like everybody else does, to figure out what you're hearing. When you know you heard something, and you know what it is, it does increase your confidence. Good luck!

    Edit: I have the Littmann 4000. It cost about twice what the 3000 does, but they didn't make the 3000 when I bought mine. I wish they had! I like that it uses AAA batteries, as we stock these at my hospital. Batteries last about 3-4 months, and I do mostly manual's on my patients, so the thing does get quite a bit of use.
    Last edit by Indy on Oct 30, '06
  10. by   CraigB-RN
    I use a phillips. i to spent to many years as a flight nurse and before that as a paramedic before we knew you needed to use hearing protection.

    All electronic scopes have a little learning curve becuase the sounds are different. You also get what you pay for. The philips is a cheaper scope and it picks up lots of extraneous sounds. The more expensive scopes have filters and don't pick up as much outside sounds.
  11. by   matt59
    Indy & Craig, thanks for your replies & advice.
    Matt

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