Can't hear beats on my Classic II S. E.

mcknis · Jan 19, 2011

Congratulations on being in nursing school. It is very difficult as you know to get in, but enjoy it! As for the stethoscope, a few things to try before rushing out to go buy another one. Make sure the ear pieces are sitting properly in your ears. May be difficult to understand, but pull out the manual that came with it to get a better understanding of this. When you put the earpieces in, they should be angled towards the direction you are looking. On the Littmann, they are already pre-angled, do not try to adjust them. Take the head, (diaphragm and bell) or the piece you hear with, in your hand. With the earpieces in, the proper way, lightly stroke or tap the diaphragm (plastic piece with the "L" on it), and you should be able to hear sounds. If not, rotate the head until you feel a "click." You will not break the head by rotating it, it is supposed to do this. The bell (curved shape) works on hearing low frequency sounds, and the diaphragm works on hearing high frequency sounds. Finally the diaphragm on all Littmann's is pressure sensitive, meaning the more pressure, or less pressure, you will hear different sounds.

This may in fact be the issue, but perhaps not. Learning how to check a BP is difficult at first, but after many, many times, it does get easier. I, for one, do not care for the Littmann Classic II because everything I heard sounded muffled and diminished. I do however use a more expensive Littmann in my daily practice, but it is not necessary. Only reason I use something different is for the mere fact I received it as a gift. Many stethoscopes out there and many will say, it is not about what you put in your ears, simply what is between them.

Good luck!

genifoss · Jan 20, 2011

just another tip for improved hearing of heart beats when taking a blood pressure. i, like you, had a problem in nursing school hearing beats when learning to take blood pressures. my nursing instructor advised me to expose the patient's arm as much as possible by rolling up the sleeve. by rolling up the sleeve it makes it easier to hear the brachial pulse. you should not roll up the sleeve if the shirt is heavy or tight because it may disrupt the blood flow. if you are not able to roll the sleeve, ask the patient to take their arm out of the sleeve, if possible. next, it is very important to palpate the brachial pulse. ask patient to expose arm (left arm, unless contraindicated) on a flat surface with the arm facing upward. when the arm is facing upward it is easier to get to palpate the brachial pulse. locate the brachial pulse with your middle and index fingers. the brachial pulse is felt on the brachial artery and is located on the inside of the patients elbow. practice locating your own pulse for practice. be careful of the amount of pressure you apply. too much may block blood flow and too little pressure will not allow you to feel the pulse. weight and vessel disease may affect the ability for you to palpate the pulse also. just practice on family members and friends until you are comfortable finding it. next place the diaphragm over the brachial pulse, and go from there.

i know it will get easier for you as you gain experience, but i also understand you frustration. hope this helps!

Jenwillie122 · Jan 21, 2011

Thank you both so very much. I practiced a lot over the weekend on omy husband and he has a good strong beat so I was better able to hear what I was supposed to. That practice helped a ton this last week. I also found that palpating the brachial pulse first was extremely helpful in determining the proper location and made placing the stethoscope properly super easy. Additionally I put the hard ear pieces on instead of the soft ones and while they are less comfortable, to me the sound quality was better.

Thanks again, I am sure I will be turning to this site a lot over the next several years!

Jennifer

aluna09 · Jan 30, 2013

I just finished my first week of nursing school and so far I am loving it. I am concerned, however, that I may have purchased the wrong stethoscope for me. When taking BP's last week, I was having trouble hearing the beats. I know that learning to take BP's is difficult to master, but if I need to upgrade my stethoscope so I can hear better, I would like to do it now so I don't get left behind. Does anyone have any feedback or suggestions for me? Thank you!

would you recommend me to get a new stethoscope? or just use the littmann cardiology II S.E ?

AMR21, BSN, RN · Feb 2, 2013

I also had some issues hearing things at first. I upgraded to a cardio iii thinking a better scope would help. It did, but just a bit. After playing with all the different parts that came w the scope, I realized I just needed smaller earpieces. Littman makes soft and hard AND small and large. Once I got the small ones I could hear bc the scope was finally in my ears. No trouble since, unless I borrow someone's scope w regular size earpieces. (I also noticed the same w iPhone earbuds...must have small ear canals)

ktliz · Feb 4, 2013

I also had some issues hearing things at first. I upgraded to a cardio iii thinking a better scope would help. It did, but just a bit. After playing with all the different parts that came w the scope, I realized I just needed smaller earpieces. Littman makes soft and hard AND small and large. Once I got the small ones I could hear bc the scope was finally in my ears. No trouble since, unless I borrow someone's scope w regular size earpieces. (I also noticed the same w iPhone earbuds...must have small ear canals)

This!! Small earpieces made all the difference for me. The fact that the OP hears better with the hard earpieces makes me think this may be the case.