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Learn how to Choose your Stethoscope
The Last Guide You Will Ever Need When Buying a Stethoscope
Table of Contents
A brief History of Stethoscopes
The 18th century was a prudish time! Body sounds were mainly analyzed using percussion methods or direct auscultation…meaning putting the ear in contact with the skin. When asked to diagnose a heart condition in a young female patient, the devout Catholic French doctor René Laennec found the direct auscultation inappropriate. He looked for a chaste alternative and used a rolled piece of paper. He was amazed by the benefits of this simple invention and perfected it later on by using hollow pieces of wood instead of paper. The stethoscope, named after the Greek words στήθος[stethos] (chest) and σκοπός[skopos] (examination), was born.
The then monoaural stethoscopes got perfected in the subsequent years by Arthur Leared, an Irish physician, who devised a binaural stethoscope in 1851, while George Philip Cammann improved the design and convenience of the stethoscope.
It took more than one century for real innovation to bring stethoscopes to their nearly final iteration. Then, in the early 1960s, David Littmann, a Harvard Medical School professor, developed a new stethoscope lighter than prior versions and had better acoustics.
In recent years, stethoscopes have become digital and connected. They also evolved into fashionable medical devices while preserving their excellent diagnostic benefits.
Anatomy of a stethoscope
Ear Piece: A basic stethoscope will include two silicone or rubber earpieces. The quality of the sound heard by the wearer is determined by finding the proper fit. Depending on the brand and quality of the stethoscope, multiple sized earpieces may be included to guarantee proper fit.
Tubing: Stethoscopes are available in several sizes, often ranging from 22 to 31 inches (55-80 cm); the most frequent length is 27 inches (70 cm). Don’t be concerned that lengthier stethoscopes will produce poorer sound quality. The National Institutes of Health’s research contradicts this widely held belief.
Chest Piece: The diaphragm and the bell are two critical components of a stethoscope’s chest piece. The diaphragm is flat and takes up high-frequency noises produced by the heart, lungs, or bowels. It’s also helpful in taking blood pressure readings using a sphygmomanometer. In reality, some simple stethoscopes feature a single-sided chest component with a diaphragm. The bell is located on the smaller, curved side of the chest piece in dual-sided models. It is particularly good at detecting low-frequency noises, such as heart murmurs or bruits, as well as high-frequency sounds in young patients.
Understanding Acoustic Stethoscopes
The acoustic principle of a traditional stethoscope (also known as an “acoustic” stethoscope) is based on the reflection of sound waves within the stethoscope’s tube. The chest component, located at one end of the stethoscope, has one or more membranes that operate to catch sound from the patient’s chest and transfer it via the tube.
The binaural component is located at the other end of the stethoscope. Its purpose is to split the sound and convey it to our ears in the best possible way. The ear tips or olives at the extremities of the binaural piece serve to “close” the conduits of the binaural piece to our ears, preventing sound loss.
Acoustic stethoscopes are classified into two types:
1. Single-Head Stethoscopes — These are known for producing clear, high-frequency sound. They let you focus on either high or low-frequency sounds. This stethoscope is usually used for general examination, such as listening to a patient’s breath sounds.
2. Dual-Head Stethoscopes — These tend to be more versatile than single-head stethoscopes. As the name implies, they have two heads: the diaphragm and the bell. The diaphragm is the bigger flat component of the stethoscope that is excellent for catching high-frequency noises. On the other hand, the bell is a tiny cup-like portion head that is good at catching low-frequency noises.
While acoustic stethoscopes are still the reference, they have one disadvantage: the sound volume collected is modest. Furthermore, the sounds heard should be described as they can not be recorded. On the other hand, Digital, also known as electronic stethoscopes, offers premium sound analysis performances and comes with numerous benefits for noise-canceling, analysis, storage, and sharing a digital audiogram.
Understanding Electronic Stethoscopes
In electronic stethoscopes, acoustic sound waves are converted into electrical signals. The amplified sounds are analyzed using a variety of algorithms to assist practitioners in detecting and interpreting clinical abnormalities. The data can also be transferred to a smartphone or tablet through Bluetooth technology for further analysis or a second viewpoint.
Digital stethoscopes are more costly than traditional stethoscopes. It’s tough to compare the ease of use they provide, particularly the sound quality produced with ambient noise reduction technologies.
They can also be quite beneficial to medical students. They make it possible to hear the patient’s noises more clearly. Some of them have an attached app that allows them to record and store the clinical examination for later reference or seek a second opinion.
There are various choices accessible for medical professionals who are deafening. An amplified electronic stethoscope, as mentioned above, will raise the level of the sounds to make them more audible. You may use this stethoscope normally if you don’t use hearing aids. If you wear hearing aids, you can experiment with special adaptors known as stethomate tips, which allow you to use the stethoscope while wearing your hearing aids.
If using a standard stethoscope with your hearing aids is too unpleasant, you can use a digital stethoscope with headphones. As long as you pick a large enough set of headphones (over-ear and on-ear types), they should fit comfortably over your hearing aids. Depending on the model of your hearing aids and digital stethoscope, you may be able to purchase a transmitter that wirelessly transmits the stethoscope’s sounds to your hearing aids.
What needs to be considered when choosing a stethoscope
Buying a stethoscope not only will have an impact on your bank account but also on your medical practice. We summarized some of the key components to consider when choosing an instrument. Cheap stethoscopes are cheap for a reason. They usually lack the necessary acoustic performances needed to identify a condition.
The first decision to make will be to choose between a traditional or a Littmann stethoscope. Traditional stethoscope chest parts often include two sides with differing diameters: the bell, which has a smaller diameter, and the diaphragm, which has a greater diameter. The bell is used to collect lower frequencies, and the diaphragm is used to capture higher frequencies in these stethoscopes.
Littmann stethoscopes, on the other hand, work in a somewhat different way: they feature dual frequency membranes. This innovation allows them to pick up low and high frequencies from both sides of the chest piece. To record low and high frequencies, there is no need to alternate between the bell and the diaphragm.
Changing between low and high frequencies with a Littmann stethoscope is as easy as putting less or greater pressure to the patient’s skin, either with the bell (the smaller diameter) or the diaphragm (the larger diameter):
- Low-frequency noises are heard when light pressure is applied to the patient (bell mode).
- High-frequency noises are detected when strong pressure is applied to the patient (diaphragm or membrane mode).
One can wonder why Littmann stethoscope still have a double-sided chest piece when either side may produce a bell or a diaphragm depending on the pressure applied?The tiny size of the chest piece of a Littmann stethoscope was meant to be utilized in pediatric and newborn conditions, as well as to listen to carotid or pulse auscultations, among other applications. The larger-diameter side of the chest component was intended for standard adult auscultations.
Acoustic performances are the number one consideration when deciding on a stethoscope.
Do you need an electronic or acoustic device? Electronic stethoscopes are suitable for persons who work in busy situations. Finally, search for a precise diaphragm.
Sound clarity is paramount and should be in line with your practice.
Besides the lucky few with boundless means, price is sadly a concern for most transactions. Unfortunately, stethoscopes are not the most inexpensive tools. Therefore, it is critical to consider pricing before making a purchase decision.
Buyers should prioritize quality over the aesthetic appeal. If a few possibilities for aesthetically appealing quality instruments are available, the customer should select the greatest suit for their budget.
The tubing should be strong and sturdy to amplify sound while reducing outside noise. For best sound transmission, the stem should be constructed of the same sturdy material as the chestpiece.
Snap the eartips of the stethoscope you are considering with your fingers. They should be smooth enough to fit comfortably into your ears without annoying. Now attempt to take one of the eartubes off. For optimal acoustic performance and safety, the ear tips truly snap tight.
A good stethoscope should be symmetrical in appearance, with all components neatly linked. Holding the stethoscope by the headset allows you to see if there are any flaws in the stethoscope’s components. You may inspect the tubing for bends and kinks, as well as if the ear tubes are symmetrical. Choose a stethoscope that has no flaws in its whole cross-section.
As a cornerstone in your medical toolbox, you’ll need a stethoscope that you can wear for lengthy shifts without making your patients squirm. For example, the headset should be adjustable. In addition, when you buy a stethoscope, it should come with at least three distinct sizes of eartips.
Try each one to see which one is the most comfortable and will block out the most outside sounds. Finally, seek tubing long enough to provide you and your patient with enough room to be comfortable and safe.
For the most part, a decent stethoscope should be light and pleasant to wear when in use. The ear tip should be designed to mainly produce a good seal around your ears while causing no discomfort at all. The use of a stethoscope that is heavy, uncomfortable to the wearer, and challenging to operate should be avoided at all times.
You’ll need to consider what level of acoustic fidelity and performance you’ll want from your stethoscope.
If your professional practice requires accurate auscultations, high-performance models available have been engineered to meet those needs.
For general practice or students, your stethoscope’s degree of acoustic performance does not need to be as great as in the preceding section’s specialty. These stethoscopes will enable you to do general cardiac auscultations, arterial blood pressure readings, respiratory and abdominal auscultations, and so on. However, these stethoscopes might be challenging to use while performing auscultations, distinguishing subtle sounds.
The determining factor for pediatric and veterinary stethoscopes is the size of the diaphragm and the bell. With small animals and infants, we need to use membranes that have smaller diameters to isolate the sounds effectively.
We encourage you to test different stethoscopes by listening to your own heartbeats. Make sure to try many different devices and choose the one that relays or generates the finest noises. If a stethoscope brand has received a lot of attention, it does not always mean that it is the best. It is always best to test things out for yourself to never make a wrong decision.
Although this may seem obvious, research reveals that 80 percent of stethoscopes are infected with hazardous microorganisms. Therefore, it would help if you chose a stethoscope that is simple to clean.
According to experts, you should wipe clean all of it with one or more alcohol pads. Alcohol gels should not be used since they include lotions that might promote sediment accumulation. Replacing components as needed will also help your stethoscope stay clean and last longer.
Finally, the design and general look may also be essential to consider. In recent years, stethoscopes gained colors and customization. Even if the stethoscope will always be a medical device, it doesn’t mean that adding a touch of style should not be considered. Companies such as MDF now offer a vast selection of tubing patterns and even elegant chestpiece that will make stethoscopes genuinely unique. Far from the standard black tubing instruments, adding a dash of colors will not only reassure and entertain the patients, but it may also be a great way not to lose your instrument.
The last point to consider relates to maintenance and warranty. Even if stethoscopes are now affordable, you need to think long-term. Buying from a reputable maker is the best way to ensure that your device will be serviced properly.
Follow these steps for a wise choice
To ensure the proper choice, follow these three easy steps:
- First, define what usage and environment you will mainly use the device. This will help define the acoustic quality you should aim for and set a price bracket.
- Check the various models’ brands in this price bracket. In doubt, also go for reputable brands that offer replacement parts and maintenance. Do not forget to check on the warranty as well.
- These first two steps should limit the choice to just a couple of models. It will then be time to consider the design and look of your new stethoscope. Do not forget to consider the weight and comfort. You do not want to carry a brick around your neck or in your pocket all day long.
There is no replacement for checking out different stethoscopes while buying a stethoscope. Inquire with coworkers whether you may listen via their stethoscopes. (Of course, make sure to clean the eartips before and after usage.)
Last update on 2022-12-12 / Affiliate links / Images from Amazon Product Advertising API
To wrap up
Choosing a stethoscope is often the first step that symbolizes getting into in healthcare world and should be considered carefully. It summarizes what we think are wise choices that will meet the needs and budget of most. Purchasing from a reliable online site or retailer is strongly advised.
Do not think that the latest digital stethoscope will make you a better doctor. In reality, many doctors do not require a high-performance stethoscope, but they choose one nevertheless. Choose a device that will meet your current needs and add a little more as your practice may evolve with time. After all, a good stethoscope has an average lifespan of more than 15 years and can assist you in making more accurate diagnoses. As a result, while a bit more expensive, selecting dependable, high-performance equipment might be a solid long-term investment.
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