2014 Double tubed stethoscopes vs single

[RNgypsy03]

There is an older thread on this site where many folks state that single tube stethoscopes are superior to double. As an ICU, ED, Trauma, and flight nurse for 25 years, here is my opinion.

When you are first learning heart sounds, lung, and bowel...you definitely want a double tube. Why? Your body has 2 ears for a reason. Much like a person loses depth perception when they only have 1 eye....the same thing happens when you use a single tube stethoscope. You see, the heart, lung, bowel, sound enters the diaphragm of the scope and travels up to your ear via sound waves. When you have a double tube...two separate sets of sound waves travel up the scope, 1 to each ear. the brain knows how to perceive this best, and the translates, better subtlety and dimension to the sound. It's important with your double tubed scope, that there are brackets to keep the two tubes from rubbing sound as they are transmitting.

A single tube stethoscope has one sound wave which travels up the single lumen, then splits, as the single sound then travels to each ear. Yes you hear it in both ears...but it's of a different quality. Your brain cannot discern subtleties in the sound because it lacks the "stereo" ability that you get with a double tube. This causes the nurse to miss things in his/her assessment.

To become really proficient at body sounds, I assessed ICU patients at minimum, every 4 hours, ratio 2-1.. Some vented, some not...FOR a solid year. I am easily better than some of the docs, and almost all of the residents. I've followed nurses, who never really learned their sounds..and it shows in their crappy assessments.

Once you become really good at sounds, then you can switch to a high end Littman, single or double tube...try to find the Littman that looks like a single tube, but is secretly a double tube! And opt for the shortest length you can find...the longer the scope, the more distortion. But even to this day....if I find some sounds I'm just not sure about, I grab my old double tubed $20 sprague outta my bag, so that I get it right! Good luck!

[CelticGoddess, BSN, RN]

I always had better luck with a single. It comes down to what works best for the individual. My husband, who worked as a paramedic for 20+ years, had better luck with a double. It's just what works best for the individual. And btw; I have heard things with my single that a doc has missed with his double.

[LadyFree28, BSN, LPN, RN]

I always had better luck with a single. It comes down to what works best for the individual. My husband, who worked as a paramedic for 20+ years, had better luck with a double. It's just what works best for the individual. And btw; I have heard things with my single that a doc has missed with his double.

This.

I found a single lumen to be superior; maybe because I paid for the right Littman.

[macawake, MSN]

I’ve used many different stethoscope brands and models but I’ve only owned Littmann Cardiology III and for me it’s the best stethoscope out there. I actually have three of them (I admit, splurge! ) because I love the wide range of colors available

They are dual lumen (albeit in one tube) so I guess my opinion somewhat supports the OP’s theory. However I don’t personally like stethoscopes with two external tubes.

[nurseprnRN, BSN, RN]

Since the sound is coming from a single diaphragm, there is (or can be) absolutely no "stereo" effect. It's the same as if you turn your stereo radio to "mono" at the amplifier. You hear the sound coming from both speakers just the same, because it's all delivered there from the amp as one (even though the tuner may be sending two separate tracks to the amp, the amp combines them to mono). You can't hear any difference between your two ears just because the sound is split after it leaves the diaphragm, either. It's the same sound, no difference at all.

Any difference you perceive between a single-tube and a double-tube is likely attributable to the quality of the individual instrument.