Stethoscopes: I want one.

May 27, 2012 9:17 PM

I want a stethoscope, but I know nothing about them. Please teach me about the differences between stethoscopes and direct me toward some good ones.

I've only used stethoscopes to take blood pressure during my CNA training, and the ones I used were a motley, beat-up assortment belonging to my community college. I did notice that there were significant differences in the sounds of different scopes, and some of them were maddeningly hard to use.

I'm about to start nursing school and I'd love to have a decent stethoscope to fool around with. You know, auscultate my boyfriend and that sort of thing. But I'm overwhelmed by the variety of options and don't know what to look for. I don't have loads of money, so cheaper is better. I would, however, be willing to shell out a little more for something that will last and be useful in the long term. Should I look for something with a warranty? What's a good online vendor to buy from?

I've also heard that learning on too nice of a stethoscope can be disabling, because it's hard to use crappy ones once you're used to the higher sound quality. Is this something I actually need to be worried about? My gut instinct is that it is not, but I'm willing to defer to the judgement of folks who actually know something about this.

posted by bookish to shopping (13 answers total)

Don't try to learn on a crappy scope. It's just so much harder to hear out of a bad one, and if you can't hear it on a crappy stethoscope, the learning objective just isn't met. I have a cruddy scope that I got for free, and it's mostly useless. I keep it so that if I leave my good one at home, I have something to wear around my neck until I can run out to my car.

You don't have to go out and buy a Littman Cardio III or a Welch-Allyn Harvey Elite - that's probably way more than you really need. But spend a little bit of money. A Littman Classic II SE is a nice one, not their highest-end, and still gets a decent sound. And get a nametag for it so that if it walks off (as these things tend to), it has a somewhat higher chance of making it back to you.
posted by honeybee413 at 9:35 PM on May 27, 2012 [3 favorites]

Just graduated from nursing school two weeks ago! YAY! I used the Littman Classic II SE that honeybee413 mentioned. Got mine from medisave.net and had it engraved to prevent the chance of it getting legs! They used to engrave for free but now I think it's around 5 bucks to engrave.

As far as learning on a nicer stethoscope, I think the opposite is true from what you mentioned. Once you can hear things well on a better scope, it's easier to hear what you need to hear on a crappy scope because you have an idea of what you're listening for - at least that was the case for me. Hope that makes sense!

Good luck in school! It's stressful at times, but it will fly by!
posted by fresh-rn at 10:02 PM on May 27, 2012 [1 favorite]

A while back I was trying to find reviews of which one to get, and even though I can't find the site I finally read through (they compared a bunch of different scopes from all over the world, if memory serves) I still have the "compromise" scope in my Amazon wish list, and it's an Omron Sprague Rappaport. It does fit your "cheap" criteria.

I have no professional use for it, but only thought it'd be neat to hear what's going on inside. I'm sure those of more professional hippocratic persuasion might have more appropriate advice; I'd be curious to know how it compares.

As a side note, those things don't ship outside of the US. If anyone would care to help a quad-curious person out, PM me.
posted by monocultured at 1:42 AM on May 28, 2012

I don't have any specific recommendations on brand, but I agree with fresh-rn that it's easier to learn with a good stethoscope so you can actually hear what you're supposed to be hearing. Plus when you have a crappy one, and you're new, you're always wondering "Are his lung sounds diminished, or is it just my crappy stethoscope? Or am I putting it in the wrong place?" There's a reason the super-expensive ones are named for cardiology; they're overkill for most nurses. But don't go super duper cheap, either.
posted by vytae at 4:14 AM on May 28, 2012

My wife has been using stethoscopes for the past sixteen years, and she swears by the Littman Classic II SE. It says a great deal about their durability that she's only had three in those sixteen years, and one of them got lost/stolen, so yeah, name tag. A cheap and durable way to get a tag for it is to use those make-your-own-pet-tag machines down at your local mega-petmart.
posted by Rock Steady at 4:21 AM on May 28, 2012

Littmann Cardiology III is what is commonly suggested (and almost universally used) by medical students in Australia, but the Cardiology II is a perfectly good option at a lower price. I'd second the advice to have it engraved/marked.
posted by quercus23 at 5:05 AM on May 28, 2012

Almost everyone at my medical school has a Littman Classic II SE.

Whichever you choose - most places you get them from you can get it engraved with your name, and get this! If you ever want to take it into hospital to use, you'll find that everyone has similar stethoscopes, and if yours gets into a general pile you'll never see it again if it's not marked in some way.
posted by Coobeastie at 6:15 AM on May 28, 2012

Seconding the Littman Classic II SE.
posted by MonkeyToes at 6:42 AM on May 28, 2012

I have the Littmann Lightweight II S.E. Stethoscope, which is similar to the Classic but lighter and cheaper without veering into the too cheap/too much extra noise territory. I've just finished my first year of nursing school, and it's served me well!
posted by RainyJay at 6:55 AM on May 28, 2012

3rd year med student here:

IMHO, 3M/LIttmann is something of the iPod of stethoscopes: a superior product at a significant price premium, and with an almost complete lock on the market. That said, you really can't go wrong with the Classic II SE; it's a solid scope at a decent price, and no one will give you funny looks.

That said, most if not all Littmann scopes these days have tunable diaphragms, which are something of an acquired taste. From what I've heard (no pun intended!), experienced users can get extra mileage with controlling frequency, but the average joe/jane whitecoat finds the sound mushier than with a traditional diaphragm. I can't speak to it mysef, since I have an ancient hand-me-down classic II with a fixed diaphragm.

Non littmann scopes are also worth considering. I have a KL-770 from Kila Labs, which is a Cardio II clone at about half the price, and as far as I can tell is comparable in sound quality. Terrific customer service too -- it's a one man operation. It's my primary scope right now, with my classic II as backup.

A few other considerations:
* Cardio style scopes are relatively bulky and heavy compared to classic-style scopes.
* I've seen a surprising number of cardiologists and pulmonologists using cheapo sprague-rappaport style scopes (and I don't think they're using the no-longer-made-$2000-on-ebay HP sprague-rappaport scopes). Take that as you will.
* Get a bright, striking color, which should reduce the risk of it walking off
* Listening to a cat purr with a stethoscope is the best thing
posted by demons in the base at 8:12 AM on May 28, 2012 [1 favorite]

Listening to a cat purr with a stethoscope is the best thing

Unless you are actually trying to listen to their heart or lungs or something, and then you just want them to shut the eff up for a minute! My wife is a vet tech, and some cats purr when they are nervous. It can be like trying to listen to the heartbeat of someone riding a Harley Davidson.
posted by Rock Steady at 6:02 PM on May 28, 2012

I had the Classic II SE through nursing school and only upgraded to a Cardiology II a few months ago. The Classic was fine and lasted me eight years with only some minor cracking on the tubing where I hang it around my neck. However, I do have to say that the Cardiology II is a pretty significant step up as far as sound quality. I think it's the tubing - its much more insulated. I'm in critical care/cardiology, so I do find the sound quality increase to be valuable for the price, but YMMV depending on your work setting, as the classic is just fine for most anything.

I was actually planning on springing the big bucks for a cardiology III, but a friend had a spare Cardiology II hanging around that she gave to me, so I saved myself the money and just use that now.
posted by takoukla at 10:15 AM on May 29, 2012

Thanks for all the thoughtful answers. I'm not going to mark a best answer since I think they were all helpful, but I'm leaning towards acquiring a Littman Classic II SE, since there seems to be a consensus that it's a good product at a respectable price. I also see a lot of them at the hospital where I work, so the advice about personalization is much appreciated!

And a special thanks to demon in the box for letting me know about the tunable diaphragm vs fixed diaphragm thing, which I knew nothing of. That's why I come to AskMe for advice before heading into uncharted waters.
posted by bookish at 8:40 AM on June 28, 2012