Stethoscopes and Sirens

[MadMack]

What scope do you guys use? I currently use a Littmann Classic II and I'm thinking about jumping up to one of the Master Cardiologist ones, anyone use that one or have recommendations? The Classic II does a good job of knocking out a lot of ambient noise and I've heard that Cardiologist does an even better job, plus it'll be even better during my work in the ER and doctor's office. Anyone got experience with them, or any input?

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[MedicFL]

A master cardiologist is over kill for EMS, there is no need for such sensitive scope on the truck. I use the classic 2 and I think it is fine..

 

[deleted6669]

ditto, classic 2 is great. I own 3. I also own a cardiology 2 scope which is really heavy and stays in the locker.
also consider the following: which would you rather lose? a 60 dollar scope or a 200 dollar scope(ouch)....

 

[jbar]

I like the cardio III, it should be about $120 onilne. I found I was able to hear much better once I upgraded from the classic. While plenty of people hear fine with the classic, it is also worth thinking about where you are headed. If you are eventually going MD/PA/RN you might as well get a good scope early so down the road you can hear heart murmers etc. I like to say that I'm too poor to pay to replace cheap gear.

 

[cavalier329]

in all of the emergencies ive responded to around NYC....the lightweight II S.E which I have is completely fine for an EMT-B. Never had any complaints. Plus if it gets lost I won't care much.

For anything higher in EMT training...im sure anything more than a classic II is overkill. But hey, to each is own. The medics ive worked with usually use classic II.

 

[TarHeelEMT]

I own two scopes.

I have the ADC adscope 603, which I preferred over the Littmann Classic II, because in my testing of the two, I actually thought it was more comfortable with better sound quality, despite being cheaper.

I also own a Littmann Cardiology III, which I bought for myself after getting into medical school. I've used both on the truck, and to be honest I just can't tell the difference out in the field. In a quiet room, the cardiology wins hands down, but it really is overkill for a prehospital provider.

 

[Druggernaut]

I bought a Welch Allyn Harvey Elite and really like it. It keeps out a lot of the ambient noise and allows you to hear very well. Usually when I let someone else use it, they tell me how much they like it afterwards.

It does have about the shortest tubing you'll find on a stethoscope, which might turn some off, and like other higher-end stethoscopes, it's heavy. Plenty of the ED doctors at my hospital have less expensive ones, so it's clearly overkill for EMS purposes. But since it's not as well known as the Littman stethoscopes, you might be able to find a new one on ebay for cheap (comparitively). After shipping, mine was around $110-$120.

 

[Blahblahologist]

There's ambient noise and then there's listening to lung sounds while riding down a cobblestone alley, with the AC blowing, the PT's cousin in the front seat on her cell phone, another unit being dispatched on the radio, and the PT moaning "It hurts," all after having been deafened on the way to the call by a partner with an air-horn fetish.

Which is just to say that even a top of the line stethoscope has limits to what it can screen out. The Cardiologist model is probably overkill in the field, though it sounds like you'd be using in more ideal locations as well, in which case it might do you more good.

 

[cavalier329]

There's ambient noise and then there's listening to lung sounds while riding down a cobblestone alley, with the AC blowing, the PT's cousin in the front seat on her cell phone, another unit being dispatched on the radio, and the PT moaning "It hurts," all after having been deafened on the way to the call by a partner with an air-horn fetish.

That was beautiful hahaha have we worked together before?? haha

 

[snulma1]

I've used a Master Cardiology for the past 6 yrs and love it! But I was doing critical care interfacility stuff as well as flight medicine. So I needed something that was going to knock out noise pretty well.

But here is the trick. I could have the top of the line scope but if I really don't know what i'm listening to/for, its useless. I learned using a crappy old ADC that was put together out of a box. And that lasted for 3 yrs. Then I went to a Classic II for 2 yrs, and when I got my previous job, I treated myself to a new shiny scope!

 

[MedicFL]

How were you using your stethoscope in flight? Did you take off your helmet? The bird I fly in is pretty loud, you cant hear crap in them..Plus with your helmet and with the comms, my scope doesn't fit inside. We have a scope that plugs into the comms box and puts the sound through your headset.. Just curious? The more sensitive a scope is the more ambient noise it is going to amplify.

 

[NiteOwl]

in all of the emergencies ive responded to around NYC....the lightweight II S.E which I have is completely fine for an EMT-B. Never had any complaints. Plus if it gets lost I won't care much.

For anything higher in EMT training...im sure anything more than a classic II is overkill. But hey, to each is own. The medics ive worked with usually use classic II.

I have the lightweight also. Its worked pretty well for me. I have to listen a bit more closely/carefully than I do in my other job as a med tech since it is noisier in the ambulance, but I can still hear okay with it.

 

[snulma1]

In all of the birds i've flown in (BK's, BO's, EC's, 412's, Dauphines, and even one sikorsky) I've never had a problem listening for lung sounds. I would pull my helmet off to listen to lung sounds if there was a vent issue enroute that couldn't be troubleshot by looking checking the vent and monitor connections. Granted, I'm able to appreciate cardiac anamolies, but lung sounds I can hear.

How were you using your stethoscope in flight? Did you take off your helmet? The bird I fly in is pretty loud, you cant hear crap in them..Plus with your helmet and with the comms, my scope doesn't fit inside. We have a scope that plugs into the comms box and puts the sound through your headset.. Just curious? The more sensitive a scope is the more ambient noise it is going to amplify.

 

[MacBook]

A master cardiologist is over kill for EMS, there is no need for such sensitive scope on the truck. I use the classic 2 and I think it is fine..

Well said. The classic 2 is fine for what we do. I'm not sure why you would want to invest in anything else Between MVCs to house calls there are more than enough opportunities to leave your blood steth. behind and man would that be a waste of money.
If you have difficulty hearing breath sounds or your BPs, ask your seasoned co-workers for the "tricks of the trade" that will help you get those sounds.

Good Luck

 

[MadMack]

Well said. The classic 2 is fine for what we do. I'm not sure why you would want to invest in anything else Between MVCs to house calls there are more than enough opportunities to leave your blood steth. behind and man would that be a waste of money.
If you have difficulty hearing breath sounds or your BPs, ask your seasoned co-workers for the "tricks of the trade" that will help you get those sounds.

Good Luck

Eh, the time I had serious problems getting a BP on the patient was a lights and sirens trauma alert and we were hauling ass to the trauma center. Couldn't differentiate the Korotkoff's sound from the rest of the ambient noise. Questions directed towards the rescue Lt. and a few flight medics all got "if you're lights and sirens on the road, palp it."

I'm bridging to RN sometime in August of 09' and I work as a tech in a doc's office right now and will be going to work as a paramedic in the ER once I finish this course, so the cardiologist would be getting used more in the clinical setting than the street.

I probably phrased the question poorly to start off with, I wanted to know how substantial of an acoustics difference there was between the Classic II and the Cardiologist.

 

[MacBook]

Eh, the time I had serious problems getting a BP on the patient was a lights and sirens trauma alert and we were hauling ass to the trauma center. Couldn't differentiate the Korotkoff's sound from the rest of the ambient noise. Questions directed towards the rescue Lt. and a few flight medics all got "if you're lights and sirens on the road, palp it."

I'm bridging to RN sometime in August of 09' and I work as a tech in a doc's office right now and will be going to work as a paramedic in the ER once I finish this course, so the cardiologist would be getting used more in the clinical setting than the street.

I probably phrased the question poorly to start off with, I wanted to know how substantial of an acoustics difference there was between the Classic II and the Cardiologist.

That's what manual BPs are.

 

[leviathan]

That's what manual BPs are.

You mean a palpated blood pressure? Pedantic man signing off...

 

[MadMack]

That's what manual BPs are.

Go read the last sentence of my first paragraph.