![]() ![]() Usually the ear pieces are angled forwards. The ear tips should be comfortable and fit tightly enough to exclude extraneous noise. They have the drawback that pathological muffling of heart and lung sounds may be disguised by amplification.Ī stethoscope should be the user's 'property' and used for every patient so the characteristics of the instrument are known. These allow less easily audible sounds to be amplified and detected. Electronic stethoscopes amplify the audible signal and allow recording of the phonocardiogram to computer. Some may be 'dual', having a separate bell and diaphragm or combined in one face, with the listening surface varied by the pressure applied. ![]() These vary from infant, through paediatric, to full size. The author uses single tube stethoscopes in a variety of bell/diaphragm sizes depending on patient size. Electrocardiography, echocardiography, bronchoscopy, radiography and clinical pathology do not negate the importance of information obtained from effective examination and auscultation, at relatively minimal cost.Ī good stethoscope is mandatory for accurate auscultation, as is a good sense of hearing! Different types and models of stethoscope are available, traditional and electronic. If you need to, shut the whole truck down so you don’t have to listen over the engine rumble.įor hard to hear breath sounds, listen in the axillary region and press the patient’s arm down over the stethoscope to block ambient noise.Recent advances in cardiopulmonary diagnostics make it easy to overlook the importance of physical examination. Sometimes simply lifting your heels is sufficient. Place your feet on the stretcher instead of the floor so fewer vibrations will pass through your boots. When taking a patient’s blood pressure, don’t rest the patient’s arm on the stretcher rail vibrations will travel through the person and add to the artifact. Place the stethoscope directly on the patient’s skin, exposing the patient’s skin when necessary to auscultate a blood pressure, lung sounds or heart sounds. You can buy the best stethoscope in the world, but if you use it over clothing, you are blocking sound from ever reaching it. Sound loses quality when it travels through the patient’s clothing. Instead, secure it in place your fingers or cradle it between finger and thumb at the base with the cord draped over the back of your hand. Once you have the stethoscope in place, do not place your thumb on top to hold it - it can add artifact. You can find it by palpating the medial aspect of the antecubital fossa. When taking a patient’s blood pressure, make certain the stethoscope is directly over the brachial artery. Usually, the flat side of the attachment - or the side with the hole - indicates which side is active. Check your owner’s manual to learn how to determine which side is activated. ![]() If you are using a double-sided scope, the head will turn on a pivot that will allow the sound to travel from the operating side to the cord or tube. Turn the stethoscope’s head to the correct side. This way the earpieces are aligned with your ear canals. They should be angled slightly so that they point toward your nose. Also, make sure the cord is intact oils from your neck can damage the material over time. Check to make sure that the diaphragm isn’t cracked and the rings aren’t loose. If you suddenly can’t hear through your scope, make certain the head is turned the correct way. Also bear in mind that stethoscopes are a potential vector disease transmission - disinfect it after every patient. If you keep your stethoscope in your pants pocket, make sure that lint and dirt hasn’t clogged the earpieces. Ear wax blockages are one of the most common causes of hearing loss. Shorter tubes, in theory, will have better volume, but longer tubes are nice when the patient starts coughing. If you have young ears, a cheap scope may be good enough, but if you have less-than-perfect hearing or need a full range of sounds for diagnostics, then you will need a good scope.ĭouble-lumen, Sprague scopes, can cause artifact when the tubes rub against each other. Disposable and cheap stethoscopes are often recommended for students, but many of these stethoscopes have poor sound profiles. Make sure you have the right tool for the job. Here are 10 things to consider when choosing and using your stethoscope. A stethoscope, along with capnography, is essential for confirming placement of an endotracheal tube or a supraglottic airway. A stethoscope is also a crucial diagnostic tool for assessing any patient in respiratory compromise and the patient’s response to treatments. No other tool is more closely associated with the practice of medicine than the stethoscope, but choosing the right one and using it well is not an easy task.
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