How valid are stethoscopic auscultations when the patient is still wearing his clothing? Malcolm — the most accurate sounds come from listening directly on the skin. Certain clothing, like sweaters and silk are nearly impossible to listen through, even for low frequency sounds, like heart tones.
For a physical exam on a patient without complaints, listening through one layer say a soft cotton shirt is usually not a problem for an experienced clinician. Hi Paul, Thanks for your comments. She seemed to be nervous in using her stethoscope, putting it to the upper left lung once and then upper right once and saying that she could hear nothing abnormal. Great article on stethoscopes.
Thanks particularly for the section about how to actually use a stethoscope for a handful of common reasons, very helpful! Thanks, Richard.
Thanks Paul. I purchased a Littmann cardiology III. First thing I did was have it monogrammed. When to use the bell vs. This was very helpful. Just got a Littman as a gift. Stethoscopes are easy to store. I suggest you but it in a ziplock back and keep it somewhere away from heat and sunlight. Or hanging from a coathook in a closet is usually fine too. You must be logged in to post a comment.
Edinburgh: Blackwell Science; Swash M. Edinburgh: WB Saunders; Coviello Jessica S. Auscultation skills — breath and heart sounds. Pennsylvania: Springhouse Corporation; Jeferies A, Turkley A. London: Mosby; Ogilvie C, Evans CC. London: Butterworth Heinemann; Bourke SJ. Lecture notes on respiratory medicine. Welsby PD. An illustrated colour text — clinical history taking and examination. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure.
Arch Intern Med ; — Chalmers J, et al. J Hypertens ; 17 — Hypertension ; 42 — European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens ; 21 — Handler J. The importance of accurate blood pressure measurement. Perm J ; 13 — Measuring blood pressure accurately: new and persistent challenges.
JAMA ; — Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet ; — Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.
Circulation ; — Effect of respiration, talking and small body movements on blood pressure measurement. J Hum Hypertens ; 26 — Physiological causes of variability in blood pressure measurement.
Sources of variation in the determination of distal blood pressure measured using the strain gauge technique. Clin Physiol ; 18 — Mauro AM.
Effects of bell versus diaphragm on indirect blood pressure measurement. Heart Lung ; 17 — Prineas RJ, Jacobs D. Quality of Korotkoff sounds: bell vs. Prev Med ; 12 — Bell or diaphragm in the measurement of blood pressure?
J Hypertens ; 23 — Effect of back support and stethoscope head on seated blood pressure determinations. Am J Hypertens ; 3 — The effects of tubing bore on stethoscope efficiency. Am Heart J ; 42 — Stethoscope acoustics. Avoid leaving your scope in extreme heat or cold for extended periods of time, or exposing them to solvents or oils that might damage the tubing and chestpiece. Why does the tubing on my stethoscope become stiff and rigid after a period of years?
The majority of tubing used on Littmann stethoscopes is made of PVC polyvinylchloride , which becomes hard when exposed for long periods of time to the lipids found in human skin. Keep your stethoscope away from extreme heat, cold, solvents and oils. It is a best practice to use a disposable wipe when cleaning the stethoscope to remove organic material. The stethoscope has two different heads to receive sound, the bell and the diaphragm. The bell is used to detect low-frequency sounds; the diaphragm, high-frequency sounds.
When using a double-sided Littmann stethoscope, you need to open or index the side you want to use—bell or diaphragm—by rotating the chestpiece. If the diaphragm is open, the bell will be closed, preventing sound from coming in through the bell, and vice versa. Take a deep breath. We use our stethoscope to listen to your lungs in different places on your chest and back, checking for things like infection or fluid in the lungs, or wheezing, which is caused by an abnormal tightness the tubes that bring air into the lungs called bronchi.
When listening to your lungs, your doctor compares one side with the other and compares the front of your chest with the back of your chest. Airflow sounds differently when airways are blocked, narrowed, or filled with fluid. Using a stethoscope, your doctor can listen to your lungs for signs of congestion. The stethoscope also picks up abnormal heart sounds that may suggest heart failure. The doctor may examine the veins in your neck and check for fluid buildup in your abdomen and legs. To find out you may have atrial fibrillation.
You may also have trouble breathing and feel tired and dizzy. If you handle patients of all ages and sizes, the Duo Stethoscope would be ideal so you have one adaptable tool that can always get the job done. The Duo Stethoscope is great for primary care physicians, professionals in family care and emergency care, and veterinarians. If you often treat large patients or large animals, an Extended Stethoscope would help you reach the necessary places while still giving your patients space.
If you have hearing issues , the Single Stethoscope or the Classic Stethoscope could be for you. Advancements in science and medicine have given us a better understanding of the body now more than ever. It has endured as a symbol of medical practice and medical practitioners everywhere.
Getting the best stethoscope to suit your needs can help you become the best medical professional for your patients. The right stethoscope is what both you and your patients deserve.
A stethoscope is an investment to last for years and years to come. With this guide, we hope that it will now be easier for you to make that choice. Please subscribe to our email list and we will supply you with important tips and promotions. We will not provide your email to third party sites and will not flood your inbox ourselves.
Accessories Charms Clips Stethoscope Tubing. Chestpiece The chestpiece, also known as the head, is the part of the stethoscope responsible for conducting sound.
Diaphragm The diaphragm is the circular end of the chestpiece. Bell The bell is another circular end of the chestpiece. Stem The stem is the part that connects the chestpiece to the stethoscope tubing.
Tubing The tubing is responsible for transferring and relaying the frequencies or sounds picked up by the chestpiece.
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