How to Choose a Good Stethoscope

A stethoscope is a device that amplifies sound and transfers it to the listener's ears. Health care workers use stethoscopes to hear the sounds of the body in a process called auscultation. A stethoscope has earpieces, tubing and a chestpiece. The chestpiece is two-sided. One side is called the diaphragm. It is large and flat and used to hear high- frequency sounds like respiratory sounds. The other side of the chestpiece is called the bell. It is a small and round and used to pick up low-frequency sounds like heart murmurs. To choose a good stethoscope, consider how the stethoscope will be used.

Difficulty: Moderately Easy

Instructions

1. 
    
   Acoustic stethoscope

   Pick a stethoscope according to how and where it will be used. A nurse may choose an general diagnostic scope. A technician who works in emergency situations may choose a scope with adult and pediatric functions.

2. 
    
   Bell and diaphragm

   Evaluate the stethoscope for sound sensitivity. A good stethoscope has a diaphragm and a bell. A stethoscope with tunable diaphragm is another good choice. It allows users to hear both high and low frequency sounds without having to rotate the device.

3. 
    
   Tubing

   Choose the practicality of tubing over its composition and length. A stethoscope may have a single- or dual-tube designs. It has short or long tubes. It is made of hard or pliable materials. All these factors affect the acoustics. Theoretically, the most efficient scopes have two tubes, a larger internal diameter, a shorter length and thicker walls to reduce noise. A good stethoscope accommodates the user's height, arm length and range of motion.

4. 
    
   Earpieces

   Get earpieces that fit. Earpiece are rubber seal, snap-tight or threaded. The rubber molding conforms to the ear, but it can reduce ausculatory sound. Hard earpieces fit well when they have a firm spring but can cause ear pain. It's up to you which type of earpiece you choose; just make sure the earpieces align with the ear canal.

5. 
    
   Chestpiece

   Choose a stethoscope with a good-size chest piece. Chest pieces range from 45mm to 50mm in diameter. Some are made of stainless steel and titanium, while others are made of aluminum and plastic. Both the width and weight of the chestpiece affects sound intensity. A large, heavy stethoscope has wider channels to transfer sound, but it can lose contact with the body and lose sounds in the process. A small, lighter scope is easier to handle but does not carry sound as efficiently.

6. 
    
   Check for leaks

   Check the stethoscope for cracks and leaks. Take a good look at the tubing for cracks. Also, blow into one earpiece while placing a finger over the other side. If you feel air escape, the stethoscope has a leak (see Tips and Resources).

Tips & Warnings

• It is possible to check for leaks at the end of ausculation. Whenever you apply the bell with firm pressure, you create a seal between the instrument and the skin. If you remove the bell from the skin quickly, then you should feel pressure in the ear. You will not get the same pressure if there are leaks in the seal of the stethoscope. Be prepared to try many different stethoscopes before finding a good fit. Stethoscopes attract germs and earwax. Remove the earpieces from the tube, and go over the instrument with an alcohol wipe.
• Storing a stethoscope in a pocket can change the angle of the ear tube. Polyvinyl tubing can stiffen over time when it is in direct contact with the skin. It is a good idea to wear a stethoscope over a collar.

Resources

• Stethoscope by Specialty at 3M
• Merginet
• The Med Supply Guide
• All About the Stethoscope

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