Diagnostic Kits, Stethoscopes, etc.

[cdreed]

I've been wondering... What's the comparison between 3M Littmann stethoscopes and those made by WelchAllyn? Is one better than the other?

I own both the Harvey DLX and the Littman Cardiology III. I prefer the Littman. It's much more comfortable, and the sound quality is superior.

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[Gauss]

I used to have a 3M light and now have the cardio. Honestly the light worked about as good, just took more manipulating and moving around to get good sounds. Its a gigantic waste of $$$ in my opinion so don't shell out a ton of $$ on one.

 

[Mumpu]

Yeah, WA's come with this weird thing that supposedly acts as a bell when lightly placed on the surface and as a diaphragm with more pressure. Sounds like a bunch of baloney to me. Use the regular diaphragm and the regular bell.

 

[Fernandus]

I m not sure about that, but i heard that one has a better quality and the other better amplification....

 

[Idiopathic]

Yeah, WA's come with this weird thing that supposedly acts as a bell when lightly placed on the surface and as a diaphragm with more pressure. Sounds like a bunch of baloney to me. Use the regular diaphragm and the regular bell.

Well that is the principle behind the Littman Master Cardiology scopes. They only have a diaphragm (no bell) that responds to light or heavy pressure differently.

 

[Jaded Soul]

Yeah, WA's come with this weird thing that supposedly acts as a bell when lightly placed on the surface and as a diaphragm with more pressure. Sounds like a bunch of baloney to me. Use the regular diaphragm and the regular bell.

Have you tried one? It might seem like baloney, but it actually works.

 

[b&ierstiefel]

Have you tried one? It might seem like baloney, but it actually works.

OK so which way is what? Light touch = bell or diaphragm? Pressure = bell or diaphragm?

I've heard it both ways...from RESIDENTS. Which is scary.

I will never use my stethoscope again; however, considering that I have a Littman Master stethoscope, I'm curious as to the right (and final) answer

 

[Willamette]

OK so which way is what? Light touch = bell or diaphragm? Pressure = bell or diaphragm?

I've heard it both ways...from RESIDENTS. Which is scary.

I will never use my stethoscope again; however, considering that I have a Littman Master stethoscope, I'm curious as to the right (and final) answer

Light Touch = Bell

Pressure = Diaphragm (Of the non-contraceptive variety)


This info is from the manual I received with my Cardiology III stethoscope.


And...it REALLY DOES WORK quite well.



Willamette

 

[EMTLizzy]

All stethoscope diaphragms are 99.9% effective in preventing your stethoscope from getting pregnant.

 

[Willamette]

All stethoscope diaphragms are 99.9% effective in preventing your stethoscope from getting pregnant.

Willamette

 

[Jaded Soul]

OK so which way is what? Light touch = bell or diaphragm? Pressure = bell or diaphragm?

I've heard it both ways...from RESIDENTS. Which is scary.

I will never use my stethoscope again; however, considering that I have a Littman Master stethoscope, I'm curious as to the right (and final) answer

Willamette answered your questions above. And just because some residents don't know how to use it, doesn't mean it doesn't work.

 

[phoenixsupra]

FYI you get better sound quality if you use the old fashioned hard earpieces rather than the new "comfort" ones. Both usually come with the scope but the comfort ones are on it.

 

[phoenixsupra]

There's not much difference between them. But if you want to not be able to tell yours apart from anyone else's then get a littman.

 

[Ministry]

I like the Littman as well. I had a cheaper steth, but I tried a littman and ended up buying it.

 

[Informer]

My last preceptor has a nifty pulse-oximeter he walks around with. Aside from Ebay, does anyone else know where I can get this? It's nice to have around the house or when I'm running . . . oh, it'd be great for patients too!

http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&category=11819&item=3845223407&rd=1

almost $300 for this doohickey! It's nearly $400 at online stores. anywhere know where i can find it cheaper?

 

[Seaglass]

A $300 pulse oximeter is only good for a paper weight. Heck, the medical grade ones are nearly useless half the time.

 

[tool]

Why would anyone walk around with a pluse ox???? To be honest I feel the only places for them are in the ER and ICU.

 

[doc05]

you want one for your home? wow what a stupid idea...

 

[Vince]

Do you have COPD?

 

[Informer]

you want one for your home? wow what a stupid idea...

No, I want one for my future practice. I figure I can use it too . . .

 

[Tenesma]

i have an idea:

if the patient is pink and breathing - then you know they have a good pulse-ox.

if the patient is blue and not breathing - then you know that they have a bad pulse-ox....

what else do you need a number for?

Pulse-ox wasn't actively used in most hospital till late 70s early 80s, how do you think they took care of those people?

 

[phoenixsupra]

That's a pretty cool idea. I use a heartrate monitor whenever I excersize. I'd be curious how my sats change like when I'm running up a steep hill. These are pretty interesting little experiments. You learn a lot about physiology that way. And you learn to associate an experience with the numbers which deepens understanding. Really, this kind of own time experimentation is what can make the difference between a good and great doctor. $300 is out of my price range but if you can afford it then go for it. I've long since gotten over my shock at the wealth of my fellow students. If you've got it, good for you.

 

[LovelyRita]

My last preceptor has a nifty pulse-oximeter he walks around with. Aside from Ebay, does anyone else know where I can get this? It's nice to have around the house or when I'm running . . . oh, it'd be great for patients too!

http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&category=11819&item=3845223407&rd=1

almost $300 for this doohickey! It's nearly $400 at online stores. anywhere know where i can find it cheaper?

omg

Now this is only in your best interest. Put the pulse-ox down and step slowly away. Now, turn around and pick up that object that says "life".

 

[phoenixsupra]

Come on, he want's to use it for his running. It's not a bad thing that he has some genuine interest in medicine, not just the "prestige" that comes with it. That seems like something rare in this field, unfortunately. I think it's cool that he wants to investigate these things for himself and not rely on the binge and purge memorization fest like most.

Sure, you need a life outside medicine. But you also need to bring some of your self, your life, your experience to medicine as well. And not be another zombie doctor clocking in for the daily dollar.

 

[LovelyRita]

Come on, he want's to use it for his running. It's not a bad thing that he has some genuine interest in medicine, not just the "prestige" that comes with it. That seems like something rare in this field, unfortunately. I think it's cool that he wants to investigate these things for himself and not rely on the binge and purge memorization fest like most.

Sure, you need a life outside medicine. But you also need to bring some of your self, your life, your experience to medicine as well. And not be another zombie doctor clocking in for the daily dollar.

Hey! I never said it was bad! I have a whole drawer full of hemoccult cards in my bathroom. They come in handy when I eat suicide-hot wings!

 

[Febrifuge]

A $300 pulse oximeter is only good for a paper weight. Heck, the medical grade ones are nearly useless half the time.

One day, waiting near the Trauma Bay for a patient to be brought in, the sensor intermittently read a sat of 65%. I don't think it was accurately reading the patient from a mile away.

(...and if it was, I want 12 more just like it.)

 

[edmadison]

One day, waiting near the Trauma Bay for a patient to be brought in, the sensor intermittently read a sat of 65%. I don't think it was accurately reading the patient from a mile away.

(...and if it was, I want 12 more just like it.)

No that is a device I would get. It sure would make monitoring the asthma kids easier.

Ed

 

[Tenesma]

what? why would your sats change while running up a steep hill unless you have cardiac dysfunction or a major developing intra-pulmonary shunt.... unless when you say "steep hill" you mean changing altitutde by 1000-2000 feet.... you guys gotta remember somthing from physiology classes, right?

 

[phoenixsupra]

Hey! I never said it was bad! I have a whole drawer full of hemoccult cards in my bathroom. They come in handy when I eat suicide-hot wings!

Ha ha. That's funny. A little gross.. but very funny.

I took home a load of lido and practiced doing nerve block on myself. That really was worthwhile. Made me better at doing it swiftly and as painlessly as possible. Was that a dorky thing to do? Hell yes. But it helped me on the wards.

 

[phoenixsupra]

what? why would your sats change while running up a steep hill unless you have cardiac dysfunction or a major developing intra-pulmonary shunt.... unless when you say "steep hill" you mean changing altitutde by 1000-2000 feet.... you guys gotta remember somthing from physiology classes, right?

Wrong. I remember close to nothing from physiology class. It was a weak point at my school. The questions were all "guess what i'm thinking" type and the director was a real jerk. In fact second semester is sort of just a blur for me. But I do know some physiology from studying for the boards

Anyway, have you ever actually run up a steep hill? I have one on my regular jog and it kills me every time. It wouldn't surprize me if my sat went down to about eighty five when im climbing it. Am I curious to see. Sure am. I bet holding your breath or underwater swimming would do it too.

 

[Febrifuge]

I took home a load of lido and practiced doing nerve block on myself. That really was worthwhile. Made me better at doing it swiftly and as painlessly as possible. Was that a dorky thing to do? Hell yes. But it helped me on the wards.

This strikes me as a little nutty, but I'll admit I am impressed with the initiative and the commitment. Also I'm glad you didn't accidentally give yourself permanent nerve damage.

Just curious: did you grab a bottle of Lido and a couple syringes from the cart and tell your attending you planned on doing this, or did you just smuggle the stuff in your coat?

 

[Febrifuge]

My last preceptor has a nifty pulse-oximeter he walks around with.

While I of course have the deepest respect for working physicians of all kinds... your last preceptor sounds like kind of a nerd.

 

[phoenixsupra]

This strikes me as a little nutty, but I'll admit I am impressed with the initiative and the commitment. Also I'm glad you didn't accidentally give yourself permanent nerve damage.

Just curious: did you grab a bottle of Lido and a couple syringes from the cart and tell your attending you planned on doing this, or did you just smuggle the stuff in your coat?

Yeah sure it's nutty. But I learned a lot that way. Did I tell my attending and ask permission? Whataya think? Hell no. That would be more than just nutty.

 

[Bermiedoc]

Hi. i need to buy a portable otoscope/opthalmoscope set and want to pay around $200. do you have any suggestions. is it "okay" if it isn't a welch allyn set? when i inquired at the book store they were wondering why i would want to buy anything else? well for one they start at $400. ire ally can't afford they but would anything "less" mean that it will fall apart in 1 week? thanks!

 

[VentdependenT]

Don't bother buying one as you will rarely use it. Otherwise get a used one or the cheapest one available. $400 is a lot of money to blow on that equipment. Most offices have them available as do er's and wards floors.

 

[ussdfiant]

One of my attendings has this cool flashlight that encircles the "hourglass" part of the scope between the bell and the diaphragm. He told me he got it from a drug rep and it looks really cool. Has anyone seen one/know where to buy one? I tried all the usual suspects (allheart, etc.) but to no avail.

 

[DrMom]

All of the ones I've seen have been pharm co freebies.

 

[jaeida8]

All of the ones I've seen have been pharm co freebies.

I got mine from a Zyrtec rep

 

[AMD]

i have a zyrtec one also...

i dont think they are good b/c when you're using your steth, it swivels around (although very minutely) and creates extraneous sounds within the ear pieces.

it's good for blinding your eyes though

 

[imtiaz]

that thing is so damn bright! some of my classmates have them and they're like halogen lamps or something.

 

[phoenixsupra]

Wow, I gotta have one of those. Do you think I could just call up the zyrtec rep and ask for one. Or does anyone have a spare? Would appreciate much.

 

[AznTrojan]

screw that.. just hook me up with some nice dinners.. and pass the bottle of XO to the right..

 

[phoenixsupra]

screw that.. just hook me up with some nice dinners.. and pass the bottle of XO to the right..

No no. I already get the dinners and the booze. I wan't the damn scopelight. I'm gonna try calling the rep. I'll let y'all know what they say.

 

[lotanna]

Ok I ned to have this for my clinical skills this semester, so its not even optional. I did a search here and someone mentioned a Riester diagnostic kit which is way cheaper than Welch-Allyn. I guess I can say generic vs name brand. Has anyone used a Riester, and is it different?
Its a whole $200 cheaper, and this would be awesome!!

 

[mackaikai]

Ok I ned to have this for my clinical skills this semester, so its not even optional. I did a search here and someone mentioned a Riester diagnostic kit which is way cheaper than Welch-Allyn. I guess I can say generic vs name brand. Has anyone used a Riester, and is it different?
Its a whole $200 cheaper, and this would be awesome!!

I think i am just going to buy a Riester diagnostic kit too...it's so much cheaper... (scopesplus.com)

 

[lotanna]

I think i am just going to buy a Riester diagnostic kit too...it's so much cheaper... (scopesplus.com)

yeah thats where i'm looking at. So tempted to do that $139 is great
I mean it does the same thing right?? its a 2.5V though, I know they have 3.5V ones , Riester does. Welch Allyn is going to cost $$ even at the cheapest places.

 

[Paws]

Well, I am all for cheap let me tell you

But, at a price. For instance, I bought the cheap Prestige blood pressure cuff and thought: ok, $35 good deal. But when I went to use it for physical diagnosis, I realized it had come from the company UNCALIBRATED and was therefore pretty useless to me. #$@!&

Since I thought it was sort of cr@p anyway and one of my classmates had an awesome welch-allyn cuff (sweet!!), I went and bought myself one. The quality is incredibly! and it has a lifetime warantee. So that's what I got for trying to save $$ ... I ended up spending even more.

I think quality is always cheap at the price, and would say: spend the $400 on the W-Allyn stuff because you will be very, very happy every time you use it and you can have it the rest of your life. Quality is a good investment.

 

[Smurfette]

There have been several threads in the past regarding the use of buying a kit at all. I know I bought one and have never used it except on my roommate when she had an earache. Huge waste of money for me during first year. Ask a M-3 or 4 at your school if you really even need to waste your money in the first place. Every clinic has them in the room (as did our practice rooms as a M-1 and 2), and I've never seen anyone carry an oto/ophthalmoscope around in their pocket on the wards (though I am sure someone on SDN will say the contrary...). Same thing for a BP cuff...they are everywhere as are the different size cuffs you will need...save your money unless you want one for your personal home use.
What you do need is a stethoscope, reflex hammer (although I usually use the edge of my steth to check reflexes) and maybe a tuning fork or filament. Ask older med students at your school if anything beyond these items is truly necessary (or ask if you can borrow theirs during the P.E. practice as there is a good chance they are not actively using them).

 

[ColoMD]

If you are going to buy a diagnostic kit, you really should get the Welch Allyn. Yes it is more expensive up front, but it will last you for your entire career. There is a reason why it's the biggest name out there--they've earned it.

 

[Winged Scapula]

Moving to Clinical Rotations...