Buying guide for Best stethoscopes
The stethoscope is a basic and essential tool in a variety of medical fields. Not all stethoscopes are the same, however, and may measure physiological functions differently. Whether you’re choosing your first stethoscope or are upgrading your current tool, we will help you take all factors into account when making this decision.
The primary difference between stethoscopes is the chest piece. Bell and diaphragm chest pieces are the most common and can measure vibration at two different frequencies. Single-head tunable diaphragms can be adjusted to pick up a range of frequencies. Dual-head tunable diaphragms have two heads that can be adjusted to pick up different frequencies. The number and length of tubes as well as the construction of the head will vary and can affect both accuracy and patient comfort.
Buying guide for How stethoscopes work
At their most basic, stethoscopes work by picking up the vibrations caused by a variety physiological functions via the chestpiece, then transmitting them to our ears through the airtight tubing and headset.
In the case of traditional dual-head stethoscopes, this can be achieved by using either the wide, drum-like surface of the diaphragm (which collects vibrations directly from high-frequency sounds) or the smaller concave bell (which picks up vibrations on the skin caused by low-frequency sounds). These vibrations are then funneled through the narrow tubing directly to our ears, resulting in effective amplification.
Common chestpiece types
While stethoscopes themselves certainly aren't all that complicated, the various elements that go into making a good stethoscope can be difficult to identify when you're unsure of what you're looking for.
Single-head tunable diaphragm
This type of chestpiece is most commonly used by cardiologists and features a one-sided, tunable diaphragm that allows for auscultation of both high and low frequencies by simply adjusting pressure. While not quite as versatile as a dual-head chestpiece, the single-head tunable diaphragm usually offers improved clarity and amplification, especially when used to listen to heart sounds.
Did you know?
In most cases, a single tube (or bi-lumen encased in a single tube) allows for clearer auscultation than a double tube.
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Bell and diaphragm - traditional dual-head chestpiece
Arguably the most popular type of stethoscope, the traditional dual-head stethoscope features a wide, flat diaphragm (for higher frequency sounds) on one side and a smaller concave bell (for lower frequencies) on the other.
In order to alternate between the two, the chestpiece will need to be turned by the user.
"While traditional dual-head stethoscopes have a separate bell and diaphragm, many newer models conveniently feature a combined bell and diaphragm in a single head and only require a change in pressure to alternate between the two."
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Dual-head tunable diaphragms
In some dual-head models, both sides are fitted with tunable diaphragms, creating a highly versatile tool that can be used for both adults and children, with the application of varying degrees of pressure allowing for low- or high-frequency auscultation on either side.
In most cases, the smaller diaphragm is removable for traditional open-bell use as well.
Expert Tip
Always clean the stethoscope with alcohol wipes before and after using
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Chest piece construction
While the chestpiece design is largely a matter of preference or, in some cases, intended application, most agree that the quality of its overall construction is non-negotiable.
Materials such as titanium or stainless steel with a smooth, well-finished interior and exterior generally provide superior performance. But, be warned: the same high-density materials that offer improved clarity may also add considerable weight.
In terms of patient comfort, most chestpieces come with a non-chill rim that not only helps to form a seal but also goes a long way toward ensuring your patient’s consultation is a pleasant, gasp-free experience.
Tubing construction, length, and style
Construction
When it comes to tubing, thick and durable construction is a must.
Thin, flimsy tubes will easily pick up external sounds and are more likely to produce distortion or lose signal. Both PVC and latex rubber are commonly used materials.
However, many physicians opt for PVC as it not only reduces the risk of skin irritation but also offers better durability.
Expert Tip
If you need to hear heart sounds, use the bell side and apply more pressure.
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Length
While shorter tubes do tend to produce marginally better acoustics, they can also be uncomfortable.
A shorter tube may force you to bend over frequently, causing unnecessary strain on your back. And for some practitioners, examining patients in such close proximity can be uncomfortable.
"Applying too much pressure to the diaphragm is a common beginner mistake. The ideal pressure should only cause a slight depression of the skin. With the correct pressure, sound should be noticeably louder and clearer."
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Style
You’ll need to decide whether you’d prefer double tubes, a single tube, or a bi-lumen single tube.
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A stethoscope with double tubes features two separate tubes, just as the name suggests. Each tube is independently connected to each earpiece. While this design works for some, the tubes can be prone to rubbing against one another, causing considerable interference.
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A stethoscope with a single tube has a tube that runs from the chestpiece and splits into two at the earpieces. For some, the “split” quality of a single sound source is insufficient. Others actually prefer it.
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A stethoscope with bi-lumen single tubes features two tubes molded into one casing to prevent rubbing. This design is considered by many to yield optimal overall sound quality.
Pediatric Stethoscope
These stethoscopes allow you to hear higher-frequency sounds and have smaller diaphragms. A neonatal stethoscope will have an even smaller diaphragm than a pediatric stethoscope, which allows you to better hear with preemies and infants.
Other vital stethoscope parts
Headset
Ensuring that the binaurals (ear tubes) are constructed from the same high-quality materials as the chestpiece is crucial for accurate sound transmission.
Size, adjustability, and angle are also important considerations, as an uncomfortable headset will only serve as a distraction.
Expert Tip
You can also use the stethoscope to measure blood pressure with a manual blood pressure cuff.
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Eartips
Not to be overlooked, suitable eartips aren't simply a matter of comfort. They are also vital to getting an accurate reading.
A snug fit will create a seal that effectively blocks out ambient noise.
Ill-fitting eartips, on the other hand, will cause pain and could make hearing heart sounds nearly impossible in noisier environments.
Did you know?
Ensuring that you have the ear tips placed on the correct ear is essential. You may not hear any sounds at all if they are on the wrong ears.
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A note about stethoscope durability
The stethoscope is a tool that is certainly put through its paces in terms of handling and use. A well-made stethoscope could last for years, if not decades.
Many quality stethoscopes also feature replaceable parts which go a long way toward extending the life of the instrument.
However, if you need a stethoscope for light or infrequent use, selecting a heavy-duty model probably isn't necessary.
Expert Tip
I suggest getting a dedicated name tag attachment. Stethoscopes are easily misplaced, and since they all look alike, they are easily lost forever.
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Stethoscope weight
Unfortunately, the same materials that provide the best acoustics and durability also add extra weight to a stethoscope.
While most consider the added weight of stainless steel or titanium a worthwhile tradeoff for superior performance, others find these materials too cumbersome to comfortably carry around all day.
Fortunately, there are plenty of quality lightweight stethoscopes available. Unless you're a specialist or using your stethoscope for critical assessments, one of these could make a perfectly good alternative.
Stethoscope prices
Stethoscope prices can vary drastically, with budget models starting out around $15 and specialist stethoscopes making their debut at the $200 mark.
$15 to $40
Budget stethoscopes are entry-level tools that offer decent performance for those in training. Although a budget stethoscope might be “good,” a medical professional with a focus on accuracy probably wouldn’t want to use one.
$40 to $100
Professional-grade stethoscopes fall under the broad scope of mid-tier stethoscopes. Instruments in this price range generally offer a combination of quality, versatility, and affordability.
$100 to $250+
Specialist stethoscopes are the best available and make no sacrifices in terms of quality, performance, or price.
FAQ
Q. How do I clean my stethoscope?
A. Cleaning your stethoscope is easier than you might think, although certain parts do require special care.
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Eartips: For quick cleaning, a cotton swab dipped in a 70% isopropyl alcohol solution is perfect for gently reaching into smaller crevices. For more thorough cleaning, the ear tips may need to be removed.
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Headset (Binaurals): These are quickly and easily cleaned by thoroughly wiping each ear tube with alcohol prep pads or a cotton ball soaked in a 70% isopropyl alcohol solution.
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Tubing: A stethoscope’s tubing requires special attention, as harsh chemicals and alcohol-based cleaning agents can cause them to become sticky. A paper towel or clean cloth soaked in warm, soapy water is your best bet. After wiping the tubing down with a soapy solution, a paper towel can be used for drying.
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Chestpiece: As the chestpiece comes into contact with contaminants more often than the rest of the stethoscope, this area requires the most frequent cleaning. For wiping surface areas, a prep pad or cotton ball soaked in 70% isopropyl alcohol solution may be used. Harder-to-reach areas can be cleaned with a cotton swab dipped in rubbing alcohol.
Note: While the aforementioned methods of cleaning are suitable for most stethoscopes, it's always a good idea to refer to the manufacturer’s care instructions to understand how to best clean your stethoscope.
Q. I’m having problems hearing with my stethoscope. Am I doing something wrong?
A. A number of factors can contribute to acoustic problems.
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Incorrect headset alignment is a common culprit and one that is easily corrected. Holding your stethoscope in front of you, ensure that the ear tips are pointing forward and away from you before inserting them. If the ear tips are in the wrong ears, you probably won’t hear anything!
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Badly fitting eartips can severely affect sound quality. Finding the correct size is essential for optimal results.
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Obstructions in the form of lint (when carried in pockets) or dirt buildup can be eliminated with proper cleaning and maintenance.
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Loose seals around the chestpiece and tubing, as well as cracks in the tubing, will hamper your stethoscope’s ability to properly transmit sounds.
Q. My stethoscope is damaged. Do I need to get a new one, or can it be fixed?
A. Many quality stethoscope manufacturers offer replacement parts. However, budget stethoscopes are usually cheaper and easier to replace entirely. Check with the manufacturer to find out more about replacement parts.
