Electronic stethoscope?

Nurses General Nursing

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I have had instances lately where I wasn't able to hear heart sounds. Both pts were rather large. I wonder if any of you use electronic steths and like them that much better than regular ones? Any recommendations? I'm using a Master Cardio now. Thanks in advance.

Specializes in NICU.

Check out www.amphl.org the Association of Medical Professionals with Hearing Losses. Their members come from all medical disciplines including nursing and their web site is full of great advice, forums, links to manufacturers, etc.

I too suffer some hearing loss and am starting nursing school in the fall. Having done medical instrument electronic work for many years, I can share some of my experience.

Not all, but most hearing loss is caused by age and/or exposure to loud noise. This type of hearing loss is characterized mainly by pretty severe loss in the higher frequency range. The speech consonant sounds like "s", "f", "t", "P", etc. have a large high frequency component so hearing loss in the high frequencies makes these sounds difficult to differentiate. What this means for such individuals is that they seem to be able to hear pretty well but they (we) often have difficulty understanding some speech.

The good news for people with this type of hearing loss is that we generally have pretty good hearing at the low frequency end of the audio spectrum and this is the part of the spectrum where heart, lung and GI sounds occur. Virtually all of these sounds are at or below the frequency of 100 Hz; so a 70 db loss (which is not uncommon) at 6,000 Hz or higher has minimal effect on the sounds you need to hear via a stethoscope.

Even people with good normal hearing, however, can benefit from an electronically amplified stethoscope because of their ability to minimize the annoying interferences which often occur in the hospital environment.

Unfortunately if you wear hearing aids like I do, even these electronic stethoscopes are problematic since you need to remove your hearing aids to use them.

But good news is just around the corner. Cardionics expects to be releasing a new version of their electronic stethoscope within a "month or two" which includes the bluetooth wireless radio link technology. This will enable those who wear properly equipped hearing aids to have the stethoscope broadcast sounds directly to your hearing aids thus avoiding the need to remove them every time you need to use the scope. Small FM receivers which attach directly to behind the ear hearing aids is all that's needed to use this system. Some hearing aids even come with FM receivers built into them.

I believe Cardionics can be found at cardionics.com

The amphl web site contains some compelling stories of people who succeeded at getting into nursing and medicine many years ago when there was enormous opposition to doing so. One nurse tells of being rejected by several nursing schools and finally getting a call from a school hundreds of miles from her home where an opening had occurred. She travelled there for an interview while a box containing everything she owned sat in the hallway. When the director of the school asked her how she would survive her surgical rotation where everyone's lips are covered by masks she answered "I don't know but I'll figure something out." Somehow she managed to convince the director to admit her to the school. When it came time for her surgical rotation her preceptor placed her with surgeons who used the long-established tradition of hand signals during surgery.

Where there is a will there is a way!

Specializes in None (as yet).
Check out www.amphl.org the Association of Medical Professionals with Hearing Losses. Their members come from all medical disciplines including nursing and their web site is full of great advice, forums, links to manufacturers, etc.

I too suffer some hearing loss and am starting nursing school in the fall. Having done medical instrument electronic work for many years, I can share some of my experience.

Not all, but most hearing loss is caused by age and/or exposure to loud noise. This type of hearing loss is characterized mainly by pretty severe loss in the higher frequency range. The speech consonant sounds like "s", "f", "t", "P", etc. have a large high frequency component so hearing loss in the high frequencies makes these sounds difficult to differentiate. What this means for such individuals is that they seem to be able to hear pretty well but they (we) often have difficulty understanding some speech.

The good news for people with this type of hearing loss is that we generally have pretty good hearing at the low frequency end of the audio spectrum and this is the part of the spectrum where heart, lung and GI sounds occur. Virtually all of these sounds are at or below the frequency of 100 Hz; so a 70 db loss (which is not uncommon) at 6,000 Hz or higher has minimal effect on the sounds you need to hear via a stethoscope.

Even people with good normal hearing, however, can benefit from an electronically amplified stethoscope because of their ability to minimize the annoying interferences which often occur in the hospital environment.

Unfortunately if you wear hearing aids like I do, even these electronic stethoscopes are problematic since you need to remove your hearing aids to use them.

But good news is just around the corner. Cardionics expects to be releasing a new version of their electronic stethoscope within a "month or two" which includes the bluetooth wireless radio link technology. This will enable those who wear properly equipped hearing aids to have the stethoscope broadcast sounds directly to your hearing aids thus avoiding the need to remove them every time you need to use the scope. Small FM receivers which attach directly to behind the ear hearing aids is all that's needed to use this system. Some hearing aids even come with FM receivers built into them.

I believe Cardionics can be found at cardionics.com

The amphl web site contains some compelling stories of people who succeeded at getting into nursing and medicine many years ago when there was enormous opposition to doing so. One nurse tells of being rejected by several nursing schools and finally getting a call from a school hundreds of miles from her home where an opening had occurred. She travelled there for an interview while a box containing everything she owned sat in the hallway. When the director of the school asked her how she would survive her surgical rotation where everyone's lips are covered by masks she answered "I don't know but I'll figure something out." Somehow she managed to convince the director to admit her to the school. When it came time for her surgical rotation her preceptor placed her with surgeons who used the long-established tradition of hand signals during surgery.

Where there is a will there is a way!

Amen ...this is preety Amazing i like how you broke down the whole concept...So you enrollin for fall too. I just sent out some application to CUNY for Fall too...I have my ten fingers crossed with my toes and I aint Afraid....I'm ready to do this...I'ts not because of the money, not to proove any thing to any one ,Its because this is my Calling.....Thank you.....Together we will conqueor.Please stay in touch

I mentioned i have a Cardonics. It does work wonderful and you dont have to take your hearing aids out.

Specializes in NICU.

Perhaps I should pass along a bit of my experience w hearing aids as well. I had the good fortune to try out several different types and brands of hearing aids before choosing my Siemens BTE (behind the ear) hearing aids.

I first tried some of the hearing aids which fit completely in the ear or the ear canal because I thought they would be more comfortable and convenient to use. What I eventually discovered is that a hearing aid which fits behind the ear will almost always outperform those which fit inside the ear or ear canal and having the device positioned behind the ear is not at all uncomfortable, in fact, I found the hard plastic device which fills up the ear or ear canal much more uncomfortable and far inferior in performance to the behind the ear device. With a BTE device the part which fits inside the ear, the "earmold", is usually soft and very comfortable.

The other problem with the device which fits inside the ear is that it obstructs whatever natural hearing you have. In the case of most of us who have pretty good hearing at the low frequencies, loosing this part of the spectrum which we can hear without help is very disturbing because, no matter how much you pay for the hearing aid it will not come even close to reproducing those sounds which you can hear unaided; this makes for very "unnatural" sound which I found impossible to tolerate. For those who have a high degree of loss at all frequencies this is not a problem but it is for the rest of us.

Since earmolds are available for BTE type hearing aids which do not completely occlude the ear or the ear canal, it is possible with these hearing aids to continue to enjoy most of the sounds which you are able to hear unaided and I found this to be enormously important.

Another advantage of placing the hearing aid behind the ear is that the microphone of the device is located much farther away from the point where sound is fed into the ear canal. This means greater amplification can be achieved without producing the annoyance of oscillation and squealing which occurs when sound being fed into the ear manages to be detected by the microphone.

But here's the most import difference of all. If you can't afford to pay $6,000 to $9,000 for hearing aids, you can get most of the benefits of the high end devices by buying a less expensive hearing aid which fits behind your ear. The least expensive BTE device will often be almost as satisfactory as the most expensive ITE (in the ear) hearing aid.

Be aware that this advice may not apply if your loss is congenital or the result of trauma or pathology but it does apply to most of us who suffer age or noise-induced hearing loss primarily in the high frequencies.

Good luck!

Specializes in NICU.
I mentioned i have a Cardonics. It does work wonderful and you dont have to take your hearing aids out.

Sorry, I neglected to mention that. With the current Cardionics scopes you can connect it to a lightweight pair of headphones and place them directly over most hearing aids. I'm told that in some situations it can be difficult to accomplish this without producing feedback but that doesn't seem to be a problem for you.

I also neglected to mention that the Cardionics comes with conventional earpieces which enables the device to be worn like a normal stethoscope if you don't use hearing aids. Or you can even use the "normal" earpieces to wear the stethoscope hanging from your neck and still leave it connected to headphones over your hearing aids.

Another neat feature of the Cardionics is that it can be connected to a PDA which can record the sounds. There is also PDA software which enables the PDA to display the sounds in graphic form like an electrocardiograph.

Some of the other electronic stethoscopes also have the ability to record sounds.

Cheers

Specializes in 27 yrs in long term care, 5 yrs office.

Hi, I too am new here, and newly hearing impaired, glad to hear there is an electronic steth scope, i am currently using a loaner hearing aid and to do b/p's i have to keep removing it, which is bothersome, and making the ear sore, my manager conceded to get a digital b/p cuff, but the sales rep offered bad references on them, i have a loaner $1100 monitor, but the one the manager bought was for $55., i need to have it checked freq with someone doing a manual to compare accuaracy. do you have any feed back on these. fortunately b/p's are going to be my major hurdle as its an office setting (non cardiac) I talked to my docs about how they feel about the digital b/p, they are ok if it is maintaining a fairly accurate reading.

looking forward to any replies.

Specializes in ED, ICU, PSYCH, PP, CEN.

I have a phillips I got from allheart.com about 4 years ago. I love it and it never leaves my neck. You do have to be more gentle with them than a regular scope. I shorted out my first one due to rough use. They were kind enough to give me a new one free.

Regarding the message about contacting the state's department of vocational rehabilitation: Does every state have one of these? I can't seem to find this office for the state of Pennsylvania. Any ideas on what else to look for?

Specializes in 27 yrs in long term care, 5 yrs office.

The easiest way to find the Pa vocational rehab is to go to www.parc.org

it will give you a list of states to choose from and the pa one will take you right to voc rehab section.

good luck

Specializes in 27 yrs in long term care, 5 yrs office.

Just a correction to the web site for pa voc rehab, i recheck this site and it is a different site than i originally had, try www.dli.state.pa.us, at keyword type ovr, and it should take you to there voc rehab page.

sorry for previous address

Specializes in ICU, telemetry, LTAC.

Question about the BTE hearing aids: Is it something that you can still stick an electronic steth in your ear without removing the hearing aids?

My experience was that I had some hearing loss before nursing school, but never paid attention to it, and discounted the amount of lipreading that I did. (Hey this comes in handy with trach patients who want to mouth words!) Right before school I bought a steth and about had a fit, 'cause of course I heard diddly and squat, with a few lung sounds. So I went to get a hearing aid or two, wound up with one because they were godawful expensive, and was nauseous for several days on end with the darn thing. It was either ITE or ITC - I don't remember which- and due to the shape of my ear canal, they put the speaker in the "best" place. LOL! That produced the most amazing feedback when I stuck a steth up there. IF I got the thing angled right I could hear heart sounds but that usually resulted in me accidentally flipping the stupid thing out of my ear. So I took the darn thing back and got my refund.

My first electronic scope was a phillips and I still have it, but it didn't do so well on obese people. It did just well enough to allow me to pass my checkoffs for vital signs and auscultation, and pass school. My scope that I now use is a Littmann 4000, it cost nearly $500 including shipping, and it works well. I change batteries every few months, no problems so far. I do worry about shorting it out though; there's a permanent bend in the tubing where it's always around my neck, and a kink right above the battery case thing from where I shove it in my purse.

Currently I do have problems at work, but mostly with speech. There are some docs I have to work hard to understand, and a couple that I just prefer not to talk to on the phone, since I won't know what on earth they said unless I can see their lips move! I hear all alarms, beeping things, etc. I am trying to put off getting a hearing aid as long as possible! I work with a nurse who takes hers out to use an ultrascope. Occasionally we find 'em laying on the floor, etc. So we look out for her hearing aids, but I do NOT want to purchase something that expensive that I have to take off and possibly lose!

Hence the question about BTE aids and scopes. Also, I wear glasses; do BTE's get in the way of glasses? (Good grief, I'm getting old.)

Specializes in NICU.

Indy,

No, my BTE's are not a problem w glasses. It would be nicer wo glasses but there's really no problem wearing both.

There are a couple of ways to use BTE hearing aids and stethoscopes at the same time.

One method is shown and described on the amphl web site. I've never tried it and it looks problematic and clumsey to me; it involves modifying the earmold portion of the BTE hearing aid by drilling an additional air passage in it. You then screw the plastic tips off the earpieces of the stethoscope (standard or electronic) and fit the bare metal ends of the stethoscope over the passages drilled through the earmolds. I think the earmolds can be ordered with the extra channel in them. There would be some advantage here in that you could use the more conventional style stethoscope but it looks pretty questionable to me even though there are people who swear by it.

The other way to go with BTE aids which I described earlier in this thread involves getting "audio boots" for the BTE's which will accept a thin wire cable which connects to the Cardionics scope w a small plug or buying an additional "FM boot" for the BTE aids which will broadcast directly to the soon to be released bluetooth-enabled Cardionics scope. That's the way I'm going to do it. I hope to be Cardionics' first customer for the new wireless version of their scope any time now. This way there are no wires between your BTE hearing aids and anything else. The cardionics scope does come with conventional earpieces which enable it to be carried around the neck just like a regular scope but you never have to put the thing in your ears (but you can, if you want to remove your hearing aids and use it the conventional way) if you go the wireless route, just use the earpieces to hang it on your neck. Or, of course, you can remove the earpiece assembly entirely and just carry the box with the electronics and the transducer tube in your pocket. This is a more expensive solution but it will be well worth my money.

Another variation on the Cardionics that others have mentioned here is simpler and a good bit less expensive. You can plug any lightweight earphones, ala Walkman, etc. into the Cardionics and just place the earphones over your ears while wearing BTE aids. In some cases this could produce a lot of annoying feedback but users on this forum don't seem to report such problems. Success no doubt depends on the characteristics of your particular BTE aids as well as your own type of hearing loss.

The wireless solution sounds best to me. I'll gladly pay a few hundred $$ extra for the FM boots, etc. to be free of wires, headphones, etc..

I think you'll find BTE aids superior in every way to the in-the-ear model you tried. I tried in the ear/canal aids years ago because I thought they would be more comfortable than having to wear something outside and behind the ear but I was WRONG. There is PLENTY of room behind your ear and the earmold which connect your ear to the BTE is FAR MORE COMFORTABLE than the ITE hearing aid. Modern BTE devices are much much smaller than the things you used to see years ago. Siemens even has a rather tiny BTE model which can used for peds. I tried a set of those. They were excellent and a lot less expensive than the what I ended up with but I decided to go for the slightly larger adult model because of a long array of enhanced features, automatic feedback cancellation, etc..

If your budget makes it necessary for you to settle for a low-end set of BTE's they will still be FAR SUPERIOR to the most expensive set of ITE aids money can buy. I know this may be hard to accept but, believe me, I've done it both ways and would NEVER go for an in the ear device again.

Hope this helps. Welcome to PM, email or phone me if you'd like more info on my experiences.

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