litman for trucks

[cafr]

Hello Nurses,

sorry if this has been posted before.

I am not a nurse but one day I would like to be an RN. Long, long ways from now, though. right now I am an EMT in Austin, Texas.

A litman cardio III scope was purchased for me back before I knew much about scopes. After using it on an ambulance, I have determined it is a bit TOO good for my needs. I can hear all the movement of the truck right through the pt. and I don't get to hear the lungs or heart sounds.

what do you folks recommend for a nosy environment? I'd prefer a 'high end' scope, if possible...like a Litman but I don't know what series or anything to get.

Any input would be kind of you.

[suzanne4, RN]

Working as a flight nurse and riding in ambulances transporting patients, the only thing that I ever used was a pediatric scope. And don't go for an expensive one either. You can pick one up for about $20 even at the uniform shops. If you do get a good one, they pick up so much sound, you won't hear your patient. The extra noises from the street and rig, or a smaller airplane will just mask the sounds that you want and need to hear. To this day, even when working an adult ICU, I still use my pediatric scope and I can differentiate any of the sounds that I need and quite clearly. That means split heart tones, gallops, murmurs, etc. Just because it costs more or is high-end doesn't mean that you will get any better sound.

Good luck with your schooling.......

[cafr]

RN, BS, MBA...

yeah, I'll trust you. :)

So you don't even recommend a low end litman?

"Just because it costs more or is high-end doesn't mean that you will get any better sound."

I agree this is true on a truck but then why do doctors sport the cardio ones? Is it just fasion like Polo is the the lay person?

thanks again,

Sean

[suzanne4, RN]

First of all they are status symbols.....................second, perhaps if you were a cardiologist or working full-time in a CCU, then you should consider one. But in the field, you are concerned with listening for breath sounds and if they sound clear or wet. As for heart tones, you are concerned for knowing that they have a pulse. In an emergency situation, your treatments are going to be the same no matter what. That is why many of the BP cuffs in rigs now are based on you listening for sounds from the actual cuff, and not trying to palpate a pulse.

Plus the expensive stethoscopes get stolen all of the time, even at the hospital. Years ago, I removed the tubing and replaced it with oxygen tubing, worked great and I could pick mine out in a hurry if anyone picked it up. If you get a new one, go for the ugliest color, then you have a chance of it staying around.

[cafr]

I thought they were a status symbol. Most things seem to be in EMS and in health care...hell in life in general they are.

Good point about the basics for scopes on a truck but RNs aren't generally concerned with the lung sounds unless they suspect something.

How would be scope get stolen if it is on me?

thanks for your time,

cafr (a/k/a sean)

[NRSKarenRN, BSN, RN]

Ive been using the same stethesope for 20 years-- a $15.00 dual head I purchased from Hopkins medical. Caring for vent dependent patients and all the techo buzzes in the hospital to homecare and families roaring, I can hear BP/heart/lung sound clearly. only changed ear pieces and diaphragm x3 when cracked.

[suzanne4, RN]

Sean: Even though your scope is always with you, wihout fail you will take it off to clean and forget to put it back around your neck or in your pocket. Or you are taking care of an isolation aptient and you don't take your scope into the room. You sit down to chart and remove it from your pocket, etc. They have a tendency to walk away.

Nurses are responsible for breath sounds. Unless you listen you won't know what is going on in your patient. Patients are supposed to get an assessment every shift and that includes listening to breath sounds, more often if deemed necessary.

[cafr]

Thanks for your help. I'll see how a $20 set of ears compares.

thanks.

[ER hippie]

Here's my two cents, for what its worth... In the ER I use my Littmann, on the ambulance I use the good old 20 dollar sprague style I bought when I didn't know there was a difference. In my experience, you are exactly right, the Littman is just too sensitive to use in the ambulance. Hope this helps you out!:)

[cafr]

thanks for your help. I shall find one.

[Medic946RN]

When I started out in EMS I had low end Littmann that was issued to my class in paramedic school. It worked fine but only lasted a year or two from the constant abuse EMS gives everything. I had a bunch of cheapies over the years but finally got a Littmann Master Classic II. It had the single head dual diaphragm deal and worked just great. I used it for ten years w/o a problem. When I became an ER nurse I got myself a Littmann Cardiology III, love that for the ED, but I always fall back on my Master Classic II when I work the medic car or the PHRN truck.

http://www.reddingmedical.com seems to have the cheapest prices on Littmanns. Good luck!