Littman Cardiology III tube size 22 or 27?

Katnip, RN · Jun 28, 2004

Shorter tubing usually allows you to hear better. BUT if it's too short you really don't want to get that up close and personal with a patient. :)

You might want to take some string and see how close you get to someone just to get an idea of the distance.

Marie_LPN, RN, LPN, RN · Jun 28, 2004

I like the 27 inch tubing. I don't want my face too close to the pt. during flu season. I don't notice a difference in the sound quality, but that's just me.

Jailhouse RN · Jun 28, 2004

You can always trim the tubing. Get the longer one and trim it to where you are comfortable. It is true that shorter resonates best.

Todd SPN · Jun 29, 2004

I have a 22. It's great if a person is laying down and you are on their left side listening to the heart. But, if you need to move it around for lung sounds or even when doing BPs you will find it is too short. Not only was I uncomfortable, I wondered what the pt thought.

mhull · Jun 29, 2004

I have a 22 inch Cardiology 111 and love it. Although I agree you are sometimes to close.

DustinRN · Jun 29, 2004

Try this article from the Littmann website.

Short vs Long Tubing

Quite often health care workers raise questions regarding tubing length based on early publications claiming shorter tubing length provides better acoustic response. Some instructors have recommended their students buy the shortest tubing possible. In an attempt to clarify the information surrounding tubing length, Littmann stethoscopes has tested their product line to offer the following information about tubing length.

To explain our test results, it will be helpful to compare the tubing of the stethoscope to a garden hose. For example, an increase in the length of a garden hose will decrease the pressure at the end of the hose as a result of frictional and other internal forces. The same effect occurs when the tubing length of a stethoscope is increased. However, in the case of stethoscope tubing, change in length is relatively small; this decrease in acoustic pressure is not detectable by the human ear.

Additionally, as tubing length increases, resonant frequency decreases. Considering this fact, an increase in tubing length provides a better response to the lower frequency sounds (an advantage in auscultation). Many heart sounds fall below 150 Hz and are considered low frequency. Because it has been shown that the human ear is least sensitive to low frequency sounds, improved low frequency response is an advantage.

Taking these two factors into account, there is no detectable difference in acoustical performance between Littmann stethoscopes with shorter tubing vs. those with longer tubing. In fact, there may be some enhancements to low frequency sounds.

When purchasing a stethoscope, the health care practitioner needs to consider their own needs and practices. Longer tubing might be more appropriate for people wearing the stethoscope around their neck as it drapes better. The practitioner's height and arm length should also be a factor to determine optimal tubing length. Many practitioners would like a little more distance from sicker patients while auscultating. Longer tubing also reduces the amount needed to bend over the supine patient which can stress the practitioner's lower back.

Toby's mum · Jun 29, 2004

Thank you all so very much for your thoughts, research and comments on this matter. I really appreciate your help. Based on the general census, I am going to get the longer 27'' tubing and go from there.

Thanks so much for your terrific and prompt response. That's one of the reasons why I love allnurses. Kind regards, Stephanie :)