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Got to this forum thru googling "HP stethoscope tubing" because I'm looking for tubing for my old HP S/R stethoscope, which is still available thru eBay. I'm a practicing pulm/crit care MD >25 yrs in practice, so I have lived thru all the stethoscopes here. Purchased a Littman electronic stethoscope because I missed a carotid bruit on a pt who ended up having a CVA, and discovered that I had high end hearing loss (yea, I listened to too much loud rock in the '70s). However, having tried various 'scopes, I wanted to add my 2 cents.
Having tried the basic "you just graduated" Littmann, the various flavors of Littman including their electronic, then the electronic one with ambient noise reduction (which is far better than the original - model # on the ANR is 4100) and having lived thru the era of the Harvey 3-bell as well, here is my order of preference:
1) HP S/R - mfg by Phillips - this scope is far and away the best scope that I have ever used. The quality of tones is superb. I still use this scope and have replaced the tubing at least 10 times. I have purchased the aluminum bell, and have used it for a number of years mainly because I kept dropping the scope and my bell kept breaking. The tones delivered from the large, machined alumnium bell are excellent, and although I have dropped the scope on the bell several times, and the bell does have a slight ding, it really is worth the price. By all means, buy this scope if you can get it. Remember that the $350 spent today will factor over your career, and my scope was purchased in 1982, so the "rent" on this scope for me has been $12.50 per year. I personally would pay $1000 for this scope today. From the maintenance standpoint, you'll want to use a pipe cleaner or some other means (I have run water thru the metal earpieces and airblown them dry) to remove the fine dust that does collect in it over time and reduces acoustic quality, but I have only had to do this about 4 times since I purchased the scope.
This scope is so superior to the electronics, and even to the Littmann Cardiology series, that you won't regret spending the extra money.
RE: the tubing length. The original HP Sprague-Rappaport stethoscope came with short tubing, and docs have done many things to modify this. I have seen the tubing metal-clipped together, longer tubes purchased, surgical tubing substituted for the original HP tubing, etc. My opinion is that the shorter tubing offers superior sound quality, and you should use the original tubing if you can get it. Reason for this is that HP did an amazing amount of research in developing this stethoscope, and looked for materials that were acoustically matched, including the rubber in the tubing. The only problem with the tubing is that it lasts about 3 yrs before the rubber starts to degrade and become sticky, especially where it rubs on your collar at the earpieces, and at the place where it attaches to the bell. Replacing the tubing is a piece of cake, anyone can do it, no special instructions required.
Disadvantages of the scope: somewhat less "wearability" around the neck than the Littmanns. The large machined aluminum bell which you have to purchase extra from the dude in Colorado doesn't fit well into a sports coat pocket. But you WILL look badass with this scope, and you can use it as a swinging mace club and do some serious damage so someone's head if anyone wants to get violent with you. (I have not personally tried this!)
2) Littmann Cardiology III scope I think is a distant 2nd to the HP. The advantage is that the scope easily drapes around your neck, and fits into your white coat pocket better. Acoustically, the tones are not as beautiful as the HP, but the sound quality is good.
3) the Harvey - 3-head scope with the corrugated diaphragm - This is an impressive scope. It was orignially manufactured with longer tubing and had a metal clip to clip the tubing together. I think the sound quality is a B+ if the HP is an A+. The longer tubing puts nice space between you and the pt with TB.
4) The other Littmann scopes are about the same to my ears in terms of quality after this.
5) In my opinion, the "tunable head" should be eliminated. This concept has never worked for me, and I do not recommend any one-head scope to medical students. You need to learn to understand and appreciate how to use a stethoscope bell.
Thanks for reading this long post!
Having tried the basic "you just graduated" Littmann, the various flavors of Littman including their electronic, then the electronic one with ambient noise reduction (which is far better than the original - model # on the ANR is 4100) and having lived thru the era of the Harvey 3-bell as well, here is my order of preference:
1) HP S/R - mfg by Phillips - this scope is far and away the best scope that I have ever used. The quality of tones is superb. I still use this scope and have replaced the tubing at least 10 times. I have purchased the aluminum bell, and have used it for a number of years mainly because I kept dropping the scope and my bell kept breaking. The tones delivered from the large, machined alumnium bell are excellent, and although I have dropped the scope on the bell several times, and the bell does have a slight ding, it really is worth the price. By all means, buy this scope if you can get it. Remember that the $350 spent today will factor over your career, and my scope was purchased in 1982, so the "rent" on this scope for me has been $12.50 per year. I personally would pay $1000 for this scope today. From the maintenance standpoint, you'll want to use a pipe cleaner or some other means (I have run water thru the metal earpieces and airblown them dry) to remove the fine dust that does collect in it over time and reduces acoustic quality, but I have only had to do this about 4 times since I purchased the scope.
This scope is so superior to the electronics, and even to the Littmann Cardiology series, that you won't regret spending the extra money.
RE: the tubing length. The original HP Sprague-Rappaport stethoscope came with short tubing, and docs have done many things to modify this. I have seen the tubing metal-clipped together, longer tubes purchased, surgical tubing substituted for the original HP tubing, etc. My opinion is that the shorter tubing offers superior sound quality, and you should use the original tubing if you can get it. Reason for this is that HP did an amazing amount of research in developing this stethoscope, and looked for materials that were acoustically matched, including the rubber in the tubing. The only problem with the tubing is that it lasts about 3 yrs before the rubber starts to degrade and become sticky, especially where it rubs on your collar at the earpieces, and at the place where it attaches to the bell. Replacing the tubing is a piece of cake, anyone can do it, no special instructions required.
Disadvantages of the scope: somewhat less "wearability" around the neck than the Littmanns. The large machined aluminum bell which you have to purchase extra from the dude in Colorado doesn't fit well into a sports coat pocket. But you WILL look badass with this scope, and you can use it as a swinging mace club and do some serious damage so someone's head if anyone wants to get violent with you. (I have not personally tried this!)
2) Littmann Cardiology III scope I think is a distant 2nd to the HP. The advantage is that the scope easily drapes around your neck, and fits into your white coat pocket better. Acoustically, the tones are not as beautiful as the HP, but the sound quality is good.
3) the Harvey - 3-head scope with the corrugated diaphragm - This is an impressive scope. It was orignially manufactured with longer tubing and had a metal clip to clip the tubing together. I think the sound quality is a B+ if the HP is an A+. The longer tubing puts nice space between you and the pt with TB.
4) The other Littmann scopes are about the same to my ears in terms of quality after this.
5) In my opinion, the "tunable head" should be eliminated. This concept has never worked for me, and I do not recommend any one-head scope to medical students. You need to learn to understand and appreciate how to use a stethoscope bell.
Thanks for reading this long post!
... any idea where I can get one?
yeah, we use way too many echos. Today alone on a service of 30 we ordered 5 echos.
