Pediatric Stethoscopes

[adventure_rn, MSN, NP]

Hi, all! I'm making the jump from NICU to Peds Cardiac ICU, and hoping for some advice. In the NICU, I've only ever used patient-specific Littmann Classic II Infant scopes provided by the unit. In the process of looking for my own stethoscope, I've been surprised, and a bit overwhelmed, by all of the options out there.

I've perused the Scrubs/Uniforms/Gear forums, but I'm hoping to get more peds-specific traffic on this forum. What have you used, and have you been happy with your purchase? Given the vast range of patient ages, do you find that intermediate-sized 'Pediatric Stethoscopes' are too large for some patients and too small for others?

Going into a cardiac specialty, one stethoscope that has caught my eye is the Littmann Cardiology IV, which has both a peds and an adult tunable diaphragm; however, I'm not sure if that would be overkill.

[chare]

First, you should verify with the new unit that your personal stethoscope would be acceptable; they might have patient specific stethoscopes just as your current unit does. If you can purchase your own stethoscope, I would suggest purchasing a pediatric sized scope, rather than an adult size. While the unit might see pediatric patients of all age ranges, I think you will find the majority of them are per school age, or younger.

Good luck as you transition to the cardiac ICU.

[NotReady4PrimeTime, RN]

I've spent the past 15+ years working on a peds cardiac ICU... where we use those $5 basic stethoscopes with the red plastic tubes. That's what our hospital provides. The only people who use the more sophisticated stethoscopes are the ones with the Jag in the garage.

[adventure_rn, MSN, NP]

Good to know. When I shadowed I saw a number of nurses wearing what appeared to be personal stethoscopes around their necks, but I'm definitely going to reach out to the manager to see what she recommends. About 1/3 of the kids were in Iso when I visited, which makes me think that several are using disposable stethoscopes regardless. I'm so used to Littmanns, it would probably drive me nuts to use a cheapo; every so often we get an off-brand (but still non-disposable) infant stethoscope in rotation on my unit, and even then I find the difference in sound quality pretty annoying.

Interestingly enough, the NICU at this hospital is the only one I've seen which doesn't provide patient-specific scopes at each bedside; I'm curious to see what the PCICU policy looks like.

[Double-Helix, BSN, RN]

You can't go wrong with a pediatric Littmann Classic II. Good quality and half with price of the cardiology stethoscope you mentioned. I think you'll find that the extra $100 doesn't really provide you with that much acoustic improvement. If you were hard of hearing, it might be worth considering, but remember that you still have to know what you're hearing. A more expensive stethoscope may make the sounds a bit louder, but unless you can differentiate an S2 murmur from an S3 murmur, a gallop from a click, a mitral regurg from an aortic stenosis, etc. increased volume isn't going to be much help.

[KelRN215, BSN, RN]

I've been a pediatric nurse for 11 years and have never had any sort of special pediatric stethoscope. I still use a stethoscope I got for free from my home health job 6 years ago. That said, I don't work in an ICU.

[NotReady4PrimeTime, RN]

Our cheapo stethoscopes aren't disposable, but they are patient-specific. Once the kiddo is discharged, they're taken apart, thoroughly cleaned and put back together.

You're going to be looking after children with open sternums, with only the skin sutured (sometimes not even that!) and a sheet of Ioban over top. Mediastinitis is a HORRIBLE complication so I'm pretty confident that your new unit will have patient-specific stethoscopes.