Medical Student question to Mr Economedical.

What Stethoscope should I buy?

In Short. The one you like!

The long answer is just that, long.

Students should not buy single sided stethoscopes unless you have cleared with your lecturers that its OK to use in your particular course of study. Single sided scopes are the ones that are called Master in the Littmann range and have no bell side to them.

New medical students will be learning which side focuses on which frequency of sounds in order to listen to a particular part of the body, focused sounds coming from the heart are usually heard on the traditional diaphragm side of the scope, or flat side. Lung sounds, a less focused area, are listened to with the bell side, which you use buy rotating the stethoscope head and using the side that looks like a funnel.

In your examinations and review processes lecturers will be looking at which side of the scope you are using to ensure that your doing it right, single sided stethoscopes don't allow for this and therefore it is harder to correct the wrong technique.

Single sided Littmann stethoscopes have what they call a tunable diaphragm, this has two sealing points, lightly holding the head against your patient provides standard bell sound frequencies. When you apply firmer pressure the tunable diaphragm reseals against an inner rim that limits the frequencies pick up by the scope to those of a traditional diaphragm.

The advantages of tunable diaphragms are many, for one its very easy to slide a flat stethoscope under clothing as it hasn't got the bell edge to catch on the clothes. In the case of a Cardiology III Littmann have been able to place a paediatric diaphragm on the traditional bell to make a two in one scope for adults and kids. So for EMS workers, Master series scopes that are flat are great in trauma cases, whereas in the world of the GP a Cardiology III means not having to have two scopes for different aged patients.

The next option is Classic or Cardiology, this certainly can boil down to price as its a little over twice the price for a cardiology model. The difference between the two can usually be heard even by untrained people. The sounds of a Cardiology scope are usually clearer and appear to be louder. This is a bit of a aural trick as the sound level is the same, its the head and tubing that make the difference. The external environmental sounds are blocked better by the Cardiology heads which are heavier and have thicker metal, they also have a double lumen tubing which is basically a thick tube with two holes running up to your ears. Classic scopes still have a very good sound rating as Littmann has spent years perfecting the function of their devices.

My advice usually to a student is to grab a Classic IISE in your favourite colour, its cheap enough to not break the bank yet good enough to help you learn the basic of auscultation. This is the number one selling model of scope by Economedical.

If your certain your heading down the Cardiology route then certainly pick up the Cardiology III now and replace the paediatric diaphragm on the bell side with the provided non chill rim to turn it back into a standard scope so as to not get in the bad books with your lecturers. When your ready to go it alone simply refit the paediatric diaphragm.

Once your clear of school and you know which discipline you will follow then you can make a better choice for your new stethoscope. The decision then will be based on what's best for your work, this could be any of the scopes listed, ambulance officers can be rough on their scopes so they stick with the Classic IISE, if you break one its not that much to replace it!

If you have any questions please leave a comment so we can share the answers with everyone else or email me thomas@economedical.com.au