Any tips for two-person stethoscopes?

[Thoenix]

I have blood pressure down pat. I get accurate readings every time--as long as I'm using a single-person stethoscope. I cannot, for the life of me, hear anything on the two person stethoscopes. I'm being tested on this skill in a week with the two-person ones and there's just so much background noise getting in--even when I make someone use the other earpieces to block them--that I can't hear. I've got the earpieces facing forwards. I've settled and resettled the earpieces in. I've checked to make sure I've got the scope listening on the right side (diaphragm, not bell). I can hear on the cheap single-headed stethoscopes if I try really hard. I can hear on my Littman. I can hear on my classmate's MDF. I just can't hear anything through the double ones. My theory is that the shape of the hard plastic earpieces isn't settling right into my ear. I can't swap out the earpieces to softer ones.

Does anyone have tips to overcome this? A way to somehow get a better 'seal' with a hard plastic tip?

I know this skill, no problem. It's not nerves from being observed. I just can't hear anything through these scopes and I'm really worried that's going to send me for remediation even though I definitely know the skill.

[Hannah13Banana, ASN, RN]

Instead of focusing on the sound which can be very difficult to auscultate with all that interference, focus on the “bouncing” of the indicator on the sphygmomanometer. Obviously in the future you will be auscultating these sounds, but if you have no problems through your stethoscope, you’re golden, as in your work as a nurse you’ll never be using a double Steph again unless you become an educator!

Watch the indicator hand as it travels after you start releasing pressure, you’ll get your diastolic reading from the first “bounce”, and then it will “bounce” all the way down to your diastolic pressure, which will give you an almost double tic.

Hopefully this is helpful, good luck on your checkoff!

[Thoenix]

On 8/21/2019 at 7:55 AM, Hannah13Banana said:

Instead of focusing on the sound which can be very difficult to auscultate with all that interference, focus on the “bouncing” of the indicator on the sphygmomanometer. Obviously in the future you will be auscultating these sounds, but if you have no problems through your stethoscope, you’re golden, as in your work as a nurse you’ll never be using a double Steph again unless you become an educator!

Watch the indicator hand as it travels after you start releasing pressure, you’ll get your diastolic reading from the first “bounce”, and then it will “bounce” all the way down to your diastolic pressure, which will give you an almost double tic.

Hopefully this is helpful, good luck on your checkoff!

This is really helpful. I really hate the double scopes. Even the really cheap classroom single ones, I can hear fine. I'll watch for the bounce. I know I have the vitals down cold. I know my 'vitals dialogue' cold. I have this. Thanks for the good luck wish! This stupid scope is a thorn in my side!

[Hannah13Banana, ASN, RN]

Happy to help! Those double steths are terrible!

[Crash_Cart]

7 hours ago, Hannah13Banana said:

Happy to help! Those double steths are terrible!

lol you should try out a laennec stethoscope sometime.

Brief history of the stethoscope: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1570491/

?

[Leader25, ASN, BSN, RN]

On 8/15/2019 at 12:19 PM, Thoenix said:

My theory is that the shape of the hard plastic earpieces isn't settling right into my ear. I can't swap out the earpieces to softer ones.

Does anyone have tips to overcome this? A way to somehow get a better 'seal' with a hard plastic tip?

Had same in school,I always swapped out the tips and all was ok,figure out a way.

[Hannah13Banana, ASN, RN]

On 8/22/2019 at 1:38 AM, Crash_Cart said:

lol you should try out a laennec stethoscope sometime.

Brief history of the stethoscope: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1570491/

?

Hahahahaha, I’ll pass! It’s already hard enough to hear anything when the patient’s family members won’t stop yammering in about the flavor and temp of the coffee!