Stethoscope Preference Question

bluegeegoo2, LPN · Feb 16, 2008

I like my Littmann. It's the cheaper model that is around $45 on "allheart.com". I have had several other brands, but this one is comfortable to wear and I can actually hear breath/bowel sounds better. I'm sure everybody has their favorite, and you'll find what works for you.

LyndseyER · Feb 16, 2008

I am getting ready to grad from school in May and I have used my Littman cardiology II se and it has been great. I have sinus problems all the time and even with my ears clogged I never have a problem. Well worth the$$ this is also the same steth I have brought twice over to Iraq as a medic and it is very sturdy and proved you can hear in anything. allhearts.com has some good deals:nurse:

NusingCareerMan · Feb 17, 2008

where can I buy a littman stethoscope; I start work in a week or do you just order them online?

bluegeegoo2, LPN · Feb 17, 2008

where can I buy a littman stethoscope; I start work in a week or do you just order them online?

I ordered from allheart.com and got it in about 3-4 days. I think they also have "express delivery". Good luck at your new job!

freelow · Feb 23, 2008

hi everyone, i am a l2 cards resident. many of you have many more years experience than me, but i find it interesting to read some of your posts. i have used just about every brand of stethoscope there is. here is what i can tell you:

expensive is not always better. i use a traditional sprague. these are probably the best steths out there and the most inexpensive. every pathologic heart sound can be heard with a sprague. if you can't hear a heart sound on a sprague, it is not important. i was tricked into buying a littman steth for 100+ dollars in medical school because of the schools affiliation with them. it wasn't until i entered my fellowship (5 years later) and heard 100's of heart sounds that i realized i had been going about this all-wrong.

tunable diaphragms are probably the worst steths. they require much more work than a traditional steth. try listening to a child with pericarditis on with a tunable diaphragm. it is a mess. it requires the patient to be very still and able to resist pressure on the chest. better yet, try listening to a carotid bruit with a tunable diagram. it’s just as bad because the neck isn’t a flat surface and pressing too hard can stimulate the baroreceptors. it's amazing how people tend to run to tunable diaphragms, and the sound quality is only 60% at best that of a sprague. the sound is muffled, it picks up just about every movement, and you have to play around to get the sound you would normally get on a sprague with a gentle press.

lastly, i would only recommend electronic steths to people who are going deaf or for very obese patients. again, if you have to amplify a sound then probably you don't know what you are doing or the sound you want to work up is not important.

if you have a steth and you can hear s1/2/3/4 and murmurs/clicks/rubs and pathologic breath sounds you are ok. there is no need to change to a more expensive steth if the one you have is performing. it always amazes me how medical students show up with electronic/ tunable/ 300+ dollar steths thinking they will dx some new heart sound. it's their job to detect when something is wrong. it's my job to detect and work-up what's been detected.

LyndseyER · Feb 23, 2008

i kinda have to disagree with the last post saying the sprauge is just as good. I have tried many stethoscopes and if you are in a noisy area or just starting to have to do pt assesments it is hard to hear on a cheaper stethoscope. I am in my peds rotation and I have used a littman cardiology II, a sprague and now I just purchased the cardiology III and there can be a party going on in the room and I can still hear resp and apical pulses. There was an extreme difference. So I guess it all depends how much you wanna hear. :twocents: But I cant hear a thing on a sprague unless its pretty quiet and an adult that is normal weight.

Miami NightNurse · Feb 23, 2008

I'm Hard of Hearing so I love my Littman 3000 electronic stethscope. I got it online with a 45 day trial and I was hooked. I think I payed $280 for it but it is well worth it. Here's the site: http://solutions.3m.com/wps/portal/3M/en_US/Littmann/stethoscope/electronic-auscultation/model-3000/

I also have a Welch Allyn Electronic Stethscope which is also great but heavy. So after 12 hours your neck hurts. However I do not recommend buying an expensive stethoscope until you've established a good habit of always keeping it around your neck. They will walk off.

freelow · Feb 23, 2008

i kinda have to disagree with the last post saying the sprauge is just as good. I have tried many stethoscopes and if you are in a noisy area or just starting to have to do pt assesments it is hard to hear on a cheaper stethoscope. I am in my peds rotation and I have used a littman cardiology II, a sprague and now I just purchased the cardiology III and there can be a party going on in the room and I can still hear resp and apical pulses. There was an extreme difference. So I guess it all depends how much you wanna hear. But I cant hear a thing on a sprague unless its pretty quiet and an adult that is normal weight.

Hi Lynnzee, what made you change steths 3 times? The first 2 you mention perform reasonably well with the sprague slightly out performing the littman. What exactly are you looking for? Apical pulses and breath sounds can be heard with just about any steth. The hardest sounds to hear are normally the diastolic and holosystolic murmurs. I can tell you a trained ear can hear all pathologic heart sounds on all the steths you mention.

If you are switching steths because of the surrounding noise problem. I would recommend only replacing the earpieces. If you are happy with the cards 3, fine. Clinically speaking the only significant difference between the 3 you mention is the price with the sprague being ~10 times cheaper.

LyndseyER · Feb 23, 2008

I couldn't hear anything with the sprague and I did try earpieces

other people in my class had the same problem. Plus its so bulky to put in my pocket. The IIse was fine till someone walked off with it so when a replacement was needed I fiq Id upgrade for a few bucks and get a black edition III maybe I could hear a little better on. I have patchless eustacian tubes so my ears are always full of fluid and its really hard for me to hear with a cheaper steathoscope. This new one I can hear through a coat. I don't care what anyone says on these posts it does make a diff between the 15$ and 100$ ones how you hear.

Indy, LPN, LVN · Feb 24, 2008

When people want to borrow mine, (Littmann 4000) I always warn them that it's gonna be too loud for them, they rarely listen. Without fail, the only ones who will use it twice are people who are actually a little hard of hearing. Others just tell me to come listen to something. It's funny, but me with an amplified steth is just about equivalent to a regular person with a regular ole steth that works. I'm not gonna pick up Radio China.

Ambition13, MSN, RN · Feb 24, 2008

I personally love the Littman stethescopes. I currently have 3 and one of them from when I was in nursing school 10 years ago - it's still working fine. For students, the Classic SE II models are perfect. The eartips seals out all of external noises perfectly. Spragues are ok, but they're big, bulky, heavy around your neck, and you can hear external noises when auscultating.