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anonymouspls

Stethoscope not picking up bowel sounds

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Hello,

This may seem strange but it appears my stethoscope is not picking up bowel sounds? It can pick up heart sounds just fine, but appears to have trouble with higher pitched noises? I showed it to my preceptor and he examined a patient with it and confirmed it's not picking up bowel sounds. Does anyone have any experience with this? I have a littmann classic III for reference. 

Can I ship it back to them and have them fix it, or should I buy another stethoscope? I just bought it in September. 

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Hi ! 

Usually medschools suggest you to buy the littman cardiology IV which has a better sound and can probably work for you. It's expensive though, around 250$ regular but can drop to 170/180$ at Black Friday. I don't know if you problem is related to the "classic" or the number "3". For this, you could call the company to ask about the differences and uses of each directly (if they have customer support).

Hope this helps and that someone with better experience can sort this out for you 

(it ain't much, but it's honest work :) )

 

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I mean people got through med school without the cardio 4 before, one doesn’t need it. I use the classic 3 and hear vowel sounds just fine, might just be a defect for your stethoscope. I hear murmurs fine, just gotta really pay attention. If money is an issue don’t feel like you gotta spend, especially if you aren’t going to become a cardiologist/internist hah. Plus apparently these things become lost during clerkship, can always wait til residency hah.

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Perhaps you should ask for an urgent surgery consult. (Just kidding)

If it seems defective, send it back to Littmann. Their warranty seems pretty solid: The rep who came to my school said they'd replace any broken or defective ones under warranty as long as we could bring any piece of it as proof that it's not lost.

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1 hour ago, Snowmen said:

Perhaps you should ask for an urgent surgery consult. (Just kidding)

If it seems defective, send it back to Littmann. Their warranty seems pretty solid: The rep who came to my school said they'd replace any broken or defective ones under warranty as long as we could bring any piece of it as proof that it's not lost.

yeah they would replace that easily enough - they have a reputation to protect and a profit margin to also protect (what do you think the per unit cost is for one of those afterall :)

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I remember reading that to do it probably (via Bates I believe) you have to listen for minutes just to do a valid examination  and listen is all four quadrants- NOBODY has that kind of time for just a limited exam. 

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There is a lot of historical rubbish taught as gospel in medicine. Bowel sounds is one such thing. 
 

Back before Med school I did a history of medicine project looking into the history of “bowel sounds”. I tracked all the references about bowel sounds back to their 19th century source. Cozy up kids, let me tell you a story. 
 

In the early 19th century a physician named Leannec in France invented the stethoscope. It was in part intended to prevent awkwardness when listening to female chests. It also happened to improve auscultation. As you can imagine Leannec hit a gold mine with this invention. Published a bunch of things on auscilating the chest and received praise and fame. 
 

Like all good academics, Laennec had a salty academic rival. He initially published a bunch of things basically saying the stethoscope was non-sense. This line of thinking clearly didn’t catch on. So if you can’t beat them in research, join them. This rival started publishing all these things about auscilating the abdomen. High pitch sounds mean this or that. Frequency of bowel sounds means this and that. It was all this guy’s opinion. Not actual evidence. 
 

As far as I could tell, all papers citing the usefulness of auscilating an abdomen have their source in this paper. Zero solid evidence. Just some 19th century academic trying to carve himself out a niche in the rough and tumble world of academic medicine. This 19th century opinion has been parroted in various forms for over 150 years. 
 

The last time my stethoscope went below the diaphragm was during Med school when it was a silly check box on an OSCE. ;) 
 

Some other day I will tell you about the “story” of FOBT in the acute care setting...

Edited by rogerroger

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I agree with the above. Bowel sounds are BS. The colon, small bowel and stomach all start moving at different times post ileus. Do the presence of bowel sounds means nothing about the lack of ileus. 

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