Inside Duke Medicine
Stethoscopes: Getting to the heart of the matter
posted December 5th, 2008
Think all stethoscopes are created equal?
Think a stethoscope is a stethoscope is a stethoscope?
To the typical patient, perhaps, it’s just that rubber-and-metal doohickey doctors use to listen to the heart and lungs.
But to the people who use stethoscopes for a living, the issue apparently isn’t so simple.
Doctors have preferences, brand loyalties, even confusion about which to choose. (Plus, stethoscopes come in different colors!)
Barbara Sheline, M.D., M.P.H., uses the Littman Classic II for both pediatric and adult patients.
“I have been totally satisfied,” Sheline told first-year medical students recently. “The price has been good in the past for a reliable instrument that will last for years.” Some stethoscopes cost well over $200.
The Littman Cardiology III is a bigger seller, she says. But she sees its interchangeable heads (for children and adults) as just something else to lose, and feels the Cardiology III is more than medical students need.
The inquiring minds at Inside Online would like to know what other stethoscopic-oriented folks think. Go to “comment” below to share your advice, preferences and stories from the front lines of stethoscopes. Don’t forget to mention your favorite color.
Comments
Hi -
Although I am not a doctor, I take great pride in having the late Dr. David Littman as my great great uncle. David Littman, a cardiologist and Harvard Med School professor, designed and patented the first Littman stethoscope. I have fond memories of my family’s visits to his suburban Boston home.
Thanks!
Darren
Duke Surgery Central Administration
I found this article quite interesting and it brings up an interesting question.
While I am working here at Duke as a financial analyst, in my prior life before moving to NC I spent my spare time as a volunteer EMT for 17 years. I used, and still have, a Littman Classic II. It stood up to the rough and tumble of the field and nothing worked better in a patient’s living room, on the side of the road at a motor vehicle accident, or in the back of a noisy ambulance racing down the rough rural roads of New Hampshire. The color? Light blue (it was a gift from my nurse mother).
Hunter green Littman Cardiology IISE was my first stethoscope in 1994. You can get by with less, but you don’t need more.
I, too, have always loved the Littman II. In my previous practice in the mountains of Maine it would not be unusual to encounter frosty 30-below temperatures this time of year. I always seemed to leave my scope in the car, and the soft rubber tubing couldn’t take the cold, becoming brittle and splitting frequently. On the other hand, you could easily tame it to curl up on the nape of your neck, and keep it warmed and ready for application. One of the best gifts I every got for my birthday was to have it cleaned and re-tubed. Lot of miles on mine!
Ditto for Littman Classic II (and Duke Blue)
a colleague has a Littmann 3000 Electronic Stethoscope and very cool to listen to differences in heart sounds with that and my “classic”...esp in areas with high ambient noise
I have recently tried the new Ultrascope and really like it, really good acoustics and reasonably priced - mine is bright orange !!
I bought my first stethoscope some thirty-eight years ago as a first-year Duke med student (a wonderful Lumiscope ($24 at that time)). Having had many stethoscopes in my nearly thirty years of cardiology practice, I could write the book on the subject but will mercifully give just a few ‘pearls’. All stethoscopes need a functioning diaphragm and bell. The tubing should not be longer than about 18 inches. The ear pieces need to be comfortable and the yoke not too tight. My current favorite model is the W. Proctor Harvey (Duke Medical School ‘43) Model (three-head version) from Tycos. It has black tubing. The most important component, however, is between the ear pieces.
For the longest time I just thought I had bad ears but I realize now that it was the scope (I’ve tried many!). For me the DRG (Doctor’s Research Group) scope has made all the difference. Apparently Bose is responsible for engineering the innards of this scope. Every time I hear someone say they’re not happy with their scope I lend them mine to try they are always blown away by the clarity of sound. The gel eartips are so comfortable (and colorful) and the changeable antimicrobial diaphragms are great for infection control. I love my scope!
Color: Black tubing with ever-changing colors on the diaphragms and ear tips.
I like my green Littman Master Cardiology. I have at least 10 years on my current scope.
Are there Littman cardiology III stethescopes offered at affordable prices? I would definitely find it useful in my future role.
I love the Littman Cardiology III which I purchased as a student here a few years ago. It’s solid. I’m very curious when it comes to stethescopes and listen to everyone’s when they keep them lying around. Like mentioned before, even though there are better, the Cardiology III is a solid instrument. I will never get rid of mine. If it only came in Carolina Blue…
I am nurse and have used several brands of stethoscopes. I agree that Littmann stethoscopes are good. But I personally don’t own one. I have an Adscope Cardiology one-sided stethoscope. Its amazing! I might add the price is awesome, too! $120! The same kind of stethoscope by Littmann cost $230. The only con to this kind of stethoscope is the heaviness on your neck after awhile due to the head of it being solid metal. I own a black stethoscope. (It has to match your scrubs:) I engraved in small letters my name on the metal of the stethoscope. I dare a doctor to take it
Remember, 98% of the time, it’s not the hearing, but the processing that matters. Consider what individual instruments are doing when you listen to music on the radio. What are the drums doing? What is the tuba doing? What are the strings doing? Your ability to isolate and identify an individual instrument isn’t a matter of what you’re hearing, but rather how you are choosing to process what you hear.
Generally, what distinguishes the residents from the students is use of the bell in addition to the diaphragm. What distinguishes the cardiology fellows from the residents is use of maneuvers (lateral decubitus, breath holds, squats, etc) to elicit findings.
Consequently, what model one carries matters less than the manufacturers would have you think. A lot of it boils down to individual preferences regarding fit and comfort.
Personally, I carry a Sprague-Rappaport, manufactured in 1990 by Hewlett-Packard. Over the years, I’ve gone through two sets of tubes, a binaural spring, a bell (yes, I managed to crack one), and a couple sets of eartips (the soft ones do wear down!). Unfortunately, the original Spragues are no longer being manufactured and spare parts are getting harder to find. The inexpensive copies are definitely inferior to the original.
Abandoning practicality for sentimentality, I’m also fond of the Leatham (with its heavy bell and folding binaural spring), the triple-head Harvey (Dad carried one), and the Sprague Bowles chestpiece that bears my teething marks.
-DFK-
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