Stethoscope!!!

[Guest MDmmmsure]

Hi everyone.....

 

I know I won't be starting medical school until the fall...when all the equipment rep's will be coming around, etc.....however, I have glanced over a few forums pertaining to which stethoscope to buy/which one is better, etc..... I'm curious....apparently the Rappaport-Sprague Acoustic Stethoscope is quite good, however, I have heard that production of this stethoscope (made by Philips I believe) is being discontinued..... I was looking forward to trying this model out.....anyone know why it's being discontinued?

 

Joe

[Guest fizzicyst]

On the stethoscope subject... anyone ever tried any of the electronic ones? They seem pretty cool and in some cases not that much more expensive... especially considering the extra features. Any thoughts?

[Guest Elaine I]

I have approximately 30% hearing deficits in both ears, and work in an often-noisy environment (as a paramedic - noisy scenes and moving vehicles). I've had the opportunity to try two different electronic stethoscopes - the HP and the Littman 4000.

 

I didn't like the HP at all. I found that it amplified too much ambient noise, and made the sounds I was hearing completely indistinguishable. It might be fine in more controlled environments, but not in noisy ones. The stethoscope did not have a battery low indicator, and just died all of a sudden, leaving me without a way to auscultate on a call.

 

I really liked the amplification of the Littman 4000. It did an excellent job of filtering any/all of the ambient noise, and was suitable for all environments. There was a battery low indicator. However, there were two problems with this scope. First, it allowed for breath sound recording, which substantially increased the cost. Second, due to the recording devise on the tubing, it sat around my neck off centre, and was constantly falling off. I was afraid that I would loose the scope.

 

Had the Littman 4000 been available without the recording devise, I definately would have got it. (Cost wasn't as much an issue for me, as my employer agreed to purchase a better scope to aid me in noisy environment due to my hearing deficit.) However, since it wasn't (at that time), I settled on the Littman Master Cardiology. I opted for it over the III, as it was slightly lighter, and after wearing a stethoscope around my neck for 12 hours at a time, the bit of weight made a difference. In addition, we don't deal with that many pediatrics, so having the smaller side wasn't as important.

 

Elaine

[Guest moo]

Cardio Littman III all the way. Forget about all the other electronic gadgetry. No one in the real world has those (unless you've got hearing deficits like Elaine). Ninety percent of the people in my class has the Cardio Littman III. You can hear 2/6 murmurs nicely, and with a little imagination 1/6 murmurs can be heard as well. It's sturdy, withstood the test of time, and fits in a med student's budget. In fact, most of my attendings still carry the Littman III.

[Guest quebecboy]

Absolutely! 95% of the people in my class (including me) and residents have the Littman Cardio III. It's a great buy!

 

Quebecboy

[Guest 0T6]

There's a fairly comprehensive review about steths and all that on this SDN forum:

 

forums.studentdoctor.net/...p?t=189673

[Guest UWOMED2005]

For most of us (but I can't comment on hearing issues) the Cardio III is MORE than enough. If you go into cardiology or cardiac surgery, buying a fancy stethscope won't be a big deal then.

 

Many of the docs I worked with even used a Cardio II or Cardio I. . . I liked the Cardio III and don't regret the extr $35, but it wasn't even necessary to get a Cardio III.

 

It's interesting that the minimum stethoscopes the equipment reps will sell you is the Cardio III. Hmm - wonder why they'd only bring out the best equipment to impressionable first year med students?

 

BTW - they will try to sell you EVERYTHING and convince you you need it. All you really need is the stethoscope. . . even the otoscope/ophthalmoscope can be often used at the clin methods buildings or hospitals. . . I've barely used mine. And if you need it for practice you can buy it then and not carry the cost on your LOC!

 

My ot/oph has become a highly overpriced flashlight. . .

[Guest happyshortie]

Hmm...Can someone explain to me what's the difference between the Littmann Master Cardiology & the Cardiology III stethoscope? I got the first one as a present from a doc that I shadowed. I'm not sure if I should get what you guys recommended too.

 

thanks in advance,

 

:b

[Guest clinicalchief]

Wow thats a neat gift.

 

The master card. has one tunable diaphragm (adult) while the cardio III has two (adult and peds; although the uselfulness of the 'smaller' diaphragm is a matter of opinion).

 

Check out this thread for more details:

 

p084.ezboard.com/fpremed1...D=63.topic

 

cc

Incoming Med 1, Memorial U

[Guest cheech10]

The nice thing about the cardio III is that you can remove the pediatric diaphragm and turn it into a traditional bell, which I find infinitely better than the tunable diaphragm.

 

That said I would love to find an old Rappaport-Sprague one day.

[Guest satsumargirl]

Hi I thought I would post this site since it looks like it has great deals for students....anyone order from here?

 

https://www.canadianmedstudents.com/products.php

 

I can get cardio III directly from 3M for $161 but it looks like it is even less on this site!

 

According to this site the cardio III is regular $253

 

Does anyone know if the reps that come to the schools beat this price?

[Guest fluidity2]

You had better check on the 3M price. Our class was going to order directly from the 3M website but duty and shipping from the US was not included and it ended up being way more than $161. The reps ended up getting us a price of ~$180 that included a CD to listen to heart sounds.

[Guest Lactic Folly]

That reminds me.. fluidity, are you U of A 2008? Whatever happened to that heart sounds CD?

[Guest clinicalchief]

Check eBay for the cardio III. I got mine brand new for $193 CDN, taxes/shipping/duties included.

 

cc

[Guest cutieyellow]

My cardio III was 149 + tax from the reps. So i think that 193 from ebay was slightly overpriced. Plus if you buy it from the reps, mine doubled the guarantee (it now has 10 yrs warranty) and no questions asked on any default (oh you've cut the tubing b/c you don't know what you were thinking when you bought a burgundy steth? no problem we'll replace it)...

 

Oh, not to mention the two free CD-roms. Heart sounds and...heart...murmurs ? I don't remember.

 

CY

[Guest UWOMED2005]

In my honest opinion, the difference (for a medical student) between the Cardio III and Cardiomaster is price. I don't think any med student could get that good at auscultation that they'd noticed a huge difference.

 

I think I paid $149 + tax as well in 2001 from the reps for my Cardio III.

 

Some of the students whose parents were doctors actually had orders for their parents - apparently the prices offered at the med student sales are a steal.

[Guest UTMed07]

I wouldn't rush out and buy anything at this stage. Odds are your school has an equipment sale-- that's how it is at U of T. They tell you what you ought to buy... you can try out the equipment... and you can double check with upper years what they bought and what they think is useful. The sale is well advertised and some time in October-- so I would worry about it now. Get in the deposit... then relax and enjoy the summer.

[Guest Isoceles]

"no questions asked on any default (oh you've cut the tubing b/c you don't know what you were thinking when you bought a burgundy steth? no problem we'll replace it)..."

 

ha ha ha ha ha! :rollin ...awesome

Thanks CY, that gave me a good laugh this morning!

[Guest cutieyellow]

Hihihi Isoceles

 

That's EXACTLY what they told us too as an example of the

"no question" warranty I thought it was funny.

 

And i do have a burgundy steth... And up to now, haven't had to cut the tube :rollin

 

CY

[Guest Elaine I]

A couple other differences between the Cardiology III and the Master Cardiology...

 

The Cardiology III has both a diaphragm and a bell side, while the Master only has one side. As a result, the shape of the Master is easier to slide down someone's back, especially if they have a decreased LOC, are very obese, etc. It is also lighter, which I found makes a difference when carrying it around your neck for extended periods of time.

 

For chest auscultation, I find that both of the above scopes are more than adequate in very noisy environments, even with a significant hearing loss. As far as heart sounds, I don't claim to know as I've never tried to hear murmurs, etc.!

 

Elaine

[Guest cheech10]

As far as heart sounds, I don't claim to know as I've never tried to hear murmurs, etc.!

Unfortunately, this is the key point about stethoscopes as breath sounds are readible audible on even the cheapest of scopes. I find that the bell tends to make most heart sounds more discernable as it filters the high-pitched breath sounds (obviously does not work well for high-pitched murmurs such as AR). This is why I feel that a proper bell is better than a "tunable diaphragm", although everyone has their own preferences.

[Guest UWOMED2005]

This is why I feel that a proper bell is better than a "tunable diaphragm", although everyone has their own preferences.

 

Yeah - it was great to see how some classmates forgot to take off their "peds diaphragms". . . very few of us actually used the bell

 

In general, MOST docs I've worked with haven't used much of their bells. . . unless they were cardiologists!

 

And it is a bit funny how the "Cardiomaster" is the one without the true bell (and more expensive.)

[Guest drews97]

Hey all,

 

In all seriousness, you don't need much equipment to be a med student. A decent stethoscope is a must (like everyone has been saying, virtually everyone in my class, Queen's 2007, has the Cardiology III) but other than that you really don't need anything else!! The med school tried to convince us that we HAD to have a diagnostic kit (opthalmoscope, etc) and a blood pressure cuff, but other than the first week that I got them I have NEVER used them!!!! They are bulky and awkward to carry and unless you plan on practicing gnarly remote medicine virtually everywhere you go will have at least these basic pieces of equipment. Resist the urge to buy medical stuff (I know, it's hard), save the $700 and save it for that trip you'll want to take after 1st/2nd year!!

[Guest cracked30]

On the topic of how good a medical student can get...

 

I saw a medical student make a fool of a consultant by diagnosing a RBBB by auscultation.

 

Dr Sahsi knows of whom I speak.

[Guest strider2004]

RBBB by auscultation? I'd be hard pressed to hang my hat on the the width of a physiologic split. Are you sure it wasn't LBBB?