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question about stethoscopes

Posted

Hi,

I hope this isn't a dumb question, but I was wondering if someone can tell me what sounds the bell is supposed to pick up on the stethoscope. Reason being: I ordered a Littman Master Classic II stethoscope not realizing it came with a diaphragm but no bell. Now my nursing school is saying that we must have a stethoscope with a diaphragm and a bell unless the one I have can pick up the same sounds that the bell picks up. Any info is much appreciated! Thanks!

Mike R, ADN, BSN, RN

Specializes in Emergency.

The bells pick up the lower pitched sounds like the heart valves. You can hear them on the diaphragm side, but they are more distinct with the bell.

Though the Master Classic II is tunable so you can hear the different sounds just by applying more or less pressure; so you should be ok.

OB-nurse2013, BSN, RN

Specializes in Labor and Delivery. Has 3 years experience.

My school made us have one with both. My friend had the master and its supposed to be able to do both but they wouldn't allow her to use it for our skills check-off's. The bell is used to hear high frquency sounds such as bruits.

KristeyK

Specializes in Private Practice- wellness center.

I had to use my friend's master classic II for a check-off, just use a little more pressure and you'll hear what you're supposed to. :D

bhanson

Specializes in Cardiac. Has 2 years experience.

Why do I dislike tunable diaphragms so much? In short, because they muffle sounds, and because most people don't know how to use them properly. In order to use a tunable diaphragm as a diaphragm (which is what you'll want to do most of the time), you have to press firmly and evenly on the chestpiece. Uneven pressure will result in muffled sounds. Firm, even pressure is the only way to clearly hear higher-pitched sounds. This is best accomplished on a flat surface. However, most patients' bodies are not flat, making it virtually impossible to maintain firm, even pressure as you move your stethoscope around. Unfortunately, if you only apply light pressure (which is what most people do most of the time), all you'll hear are boomy, muffled sounds. Contrary to 3M's advertising, it's nothing like what you'll hear using a traditional bell, where the low-pitched sounds are crisp and distinct. To further confuse things, correct use of a traditional bell demands light pressure, as firm pressure essentially turns the skin into a diaphragm. In short, tunable diaphragms are a recipe for disaster when you're trying to learn how to listen, and (IMHO) are partly to blame for the poor auscultation skills of modern doctors.

http://forums.studentdoctor.net/showpost.php?p=3289972

FWIW I use a Littman Classic II SE so I don't have to deal with the tunable diaphragm issues.

AgentBeast, BSN, RN

Specializes in Cardiology and ER Nursing. Has 7 years experience.

My school made us have one with both. My friend had the master and its supposed to be able to do both but they wouldn't allow her to use it for our skills check-off's. The bell is used to hear high frquency sounds such as bruits.

The bell is used for low frequency sounds, not high. Bruits are a low frequency sound.

AgentBeast, BSN, RN

Specializes in Cardiology and ER Nursing. Has 7 years experience.

I had to use my friend's master classic II for a check-off, just use a little more pressure and you'll hear what you're supposed to. :D

Very very light pressure for the "Bell" more pressure and you'll get the diaphragm.

OB-nurse2013, BSN, RN

Specializes in Labor and Delivery. Has 3 years experience.

The bell is used for low frequency sounds, not high. Bruits are a low frequency sound.

You told me..Sorry I used the wrong terminology..I know what they are used for and what bruits sound like, was just trying to be helpful because many of my friends bought the master classic or cardiology and were not able to use them in class and we were never told not to buy them so I felt bad for the people that happened to.

The bells pick up the lower pitched sounds

the bell gives out a lower pitch sound vs the diaprahm with higher