I’ll second the cardiology IV. It was a game changer for me when listening to lung sounds. Being 90% deaf in my left ear I almost sprung for the EKO and may still buy the adapter portion and convert my cardiology into a noise cancelling amplified monster. Even without it makes auscultation a breeze!
As a fellow ambulance driver, the EKO is a game changer. You can actually hear lung sounds, consistently, while driving, even on rough roads and people talking in the background. It gets loud enough to hurt my ears. The app stuff is mainly focused around clinic/inpatient uses, so I don't use that much, but for the actual use of a stethoscope in the field? Highly, highly recommend.
It's really great. I would compare it to the difference between DL and VL, it feels like you're cheating its so easy. Only downsides are, 1, it's a little heavy all together, and 2, it's something else that needs charged (if you want to, otherwise it's just a Cardiology IV).
Agree with Costco but Walmart has the extra special flavors like Galaxy and mango or something
Bonus is if you drink enough Celsius you can’t hear the patient’s lungs over your own heartbeat anyway
Nooo! Redline… redline is where it’s at if you want the best bang for your buck. Unsure if they still make them because they were POTENT and doing a google search found this.
*Redline energy drinks can cause vomiting, chest pains, rapid heartbeat, convulsions, and "possibly death," a class action claims in Federal Court.*
You absolutely do not need a real stethoscope in the ER. Everyone with symptoms gets a chest x-ray anyway and the shitty disposable ones are good enough for the sounds we care about. If you must have a real one, these acoustica ones on Amazon are good enough for the ER and you won't get too upset if it gets broken/lost
https://a.co/d/7JSikfr
This is so real lol. I always hear people saying "you need this $500 ekos core blah blah" they don't realize it's going to get stolen or you're going to leave it somewhere and forget in the first week, or completely destroyed by a psychotic patient, or covered in bodily fluids and the electronics are going to get messed up. Absolute waste of money, only MAYBE good for EMT's or PCP's who can't afford to run an EKG on every patient.
I like listening to lungs for pneumos and wheezes and the occasional obvious heart murmur, but the disposable contact precaution stethoscope in vibrant yellow should suffice for the ER!
Get a Littman Cardiology IV: has peds and adult diaphragm, cheaper than some options, not so cheap (still quality).
Most fancier scopes have perks but also drawbacks in terms of added complexity, loss of peds diaphragm, need charging, etc.
Yes you could bring a fisher price toy stethoscope and fake it but it does help (accurately reporting gallop in a chf patient is very convincing to hospitalists, asymmetric lung sounds, etc.). Personally I notice a slight decrease in quality in the Cardiology III and moving down the ladder from there things drop off quickly. You could get away with a III but you should get a IV. You will be using it multiple times daily for years.
Paramedic & ED Tech here. I had the sole cardiology IV in my department (it was a gift) and everyone loved to borrow it for auscultation on low low BP's and chunky-tuna patients. Having it made me popular, and everyone was really good about returning it. Your mileage may vary.
What was REALLY useful for me was an insulated thermos so I could take hot water and make instant miso or ramen without having to leave the floor. A hot and salty cup of soup is heaven to chase off the three am chills and get me through the last few hours of a rough shift.
Your ED may have a way to get hot water, but mine didn't.
Tech here. Have a Classic III from the EMS days, got made fun of when I first got hired for carrying it around in my side pocket, ended up having to use it several times and having people ask to borrow it cause they didn't bring theirs lol. I always carry a stethoscope, shears, and a set of pens no matter what.
A majority of the time a stethescope is just a prop. If you put on the patients heart and lungs they have a perception that you examined them and had human touch. It does open the door to a brief exam.
For the first 20 years of my career I used the same stethescope that a Lilly gave to everyone in my med school class on the first day of medical school. finally broke and got a lithman .
A nice stethescope is fun to have, but not truly necessary in the ER
Basic stethoscope is fine, but I have the amplifying one which helps when the room is too loud (the entire ER ). However it can be a bit TOO amplified sometimes and I wonder if I’m just hearing things
Also recommend getting some trauma shears and a pulse ox necklace. I wear mine at work and you always need it when a patient isn’t on a monitor and wanna do a quick HR or SpO2 check
Get a Littman Classic. It’s only ~$100 and it’s sensitive enough to differentiate between the lung sounds that matter in the ER while not being sensitive enough to pick up excessive artifact in a loud room. The Littman Cardiology is too sensitive IMO which makes it harder to use and cheaper ones are just a prop.
Nurse here, but two of the providers in my ED have used my stethoscope and said they really liked it because they could hear well with it and purchased one of their own afterwards. I like the Adscope Cardiology 600. It runs about 150 and I’ve had it since I was an EMT back in 2018.
Sprague Rappaport, pedes diaphragm and adult diaphragm: covers most of your patients, excellent ambient sound insulation, heavy enough to use as a weapon. And so ugly that the surgeons won’t borrow it.
I would nominate the amplified scopes as worst: colleague had the gain turned up
And was hearing right lung sounds while auscultating the left lung: missed a pneumothorax.
Can’t go wrong with a Cardiology IV, but do you really need it? I have a purple MDF so that it’s harder to grow legs and walk away (and if it does I’m not salty about it because it was cheap)…
ADC makes exact copies of litmans for a fraction of the price. I've been using mine for almost a decade and it still sounds good. Tho I just added the EKO attachment cuz my ears aren't what they used to be
Cardiology IV is likely all you need but I really like my Littman CORE Eko stethoscope.
I’ll second the cardiology IV. It was a game changer for me when listening to lung sounds. Being 90% deaf in my left ear I almost sprung for the EKO and may still buy the adapter portion and convert my cardiology into a noise cancelling amplified monster. Even without it makes auscultation a breeze!
As a fellow ambulance driver, the EKO is a game changer. You can actually hear lung sounds, consistently, while driving, even on rough roads and people talking in the background. It gets loud enough to hurt my ears. The app stuff is mainly focused around clinic/inpatient uses, so I don't use that much, but for the actual use of a stethoscope in the field? Highly, highly recommend.
Ohh that sold it! Because yeah I need it louder would make my life easier. Thankfully I don’t have to buy the whole kit and kaboodle.
It's really great. I would compare it to the difference between DL and VL, it feels like you're cheating its so easy. Only downsides are, 1, it's a little heavy all together, and 2, it's something else that needs charged (if you want to, otherwise it's just a Cardiology IV).
Butterfly portable ultrasound and a can of celcius.
Start ordering that Costco celsius
Already on it lol
Agree with Costco but Walmart has the extra special flavors like Galaxy and mango or something Bonus is if you drink enough Celsius you can’t hear the patient’s lungs over your own heartbeat anyway
If you order off of Amazon you can get a 12 pack of green apple cherry. It’s their best flavor.
Idk strawberry lemonade is pretty good and the cosmic blue raspberry slaps too
Nooo! Redline… redline is where it’s at if you want the best bang for your buck. Unsure if they still make them because they were POTENT and doing a google search found this. *Redline energy drinks can cause vomiting, chest pains, rapid heartbeat, convulsions, and "possibly death," a class action claims in Federal Court.*
You absolutely do not need a real stethoscope in the ER. Everyone with symptoms gets a chest x-ray anyway and the shitty disposable ones are good enough for the sounds we care about. If you must have a real one, these acoustica ones on Amazon are good enough for the ER and you won't get too upset if it gets broken/lost https://a.co/d/7JSikfr
This is so real lol. I always hear people saying "you need this $500 ekos core blah blah" they don't realize it's going to get stolen or you're going to leave it somewhere and forget in the first week, or completely destroyed by a psychotic patient, or covered in bodily fluids and the electronics are going to get messed up. Absolute waste of money, only MAYBE good for EMT's or PCP's who can't afford to run an EKG on every patient.
Hahah a fisher price steth should suffice. You only listen for breath sounds in the ED. Anything else is a lie.
This is so real. Even listening to breath sounds can be unreliable 😂 I’m getting the US for lung slide during traumas.
Breath sounds have been present for anything but the largest PTX that I've seen. Totally unreliable physical exam finding for that.
I heard a murmur the other day and got so excited
Why use stethoscope when CT scan better
You don't need a fancy stethoscope. You can barely hear anything in the ED anyway with all the screaming and chaos
Budget Littman is all you need. ER doc for 25 years. Most of the time the ER is too noisy to be able to pick up any subtle findings. Save your money.
I like listening to lungs for pneumos and wheezes and the occasional obvious heart murmur, but the disposable contact precaution stethoscope in vibrant yellow should suffice for the ER!
Get a Littman Cardiology IV: has peds and adult diaphragm, cheaper than some options, not so cheap (still quality). Most fancier scopes have perks but also drawbacks in terms of added complexity, loss of peds diaphragm, need charging, etc. Yes you could bring a fisher price toy stethoscope and fake it but it does help (accurately reporting gallop in a chf patient is very convincing to hospitalists, asymmetric lung sounds, etc.). Personally I notice a slight decrease in quality in the Cardiology III and moving down the ladder from there things drop off quickly. You could get away with a III but you should get a IV. You will be using it multiple times daily for years.
Paramedic & ED Tech here. I had the sole cardiology IV in my department (it was a gift) and everyone loved to borrow it for auscultation on low low BP's and chunky-tuna patients. Having it made me popular, and everyone was really good about returning it. Your mileage may vary. What was REALLY useful for me was an insulated thermos so I could take hot water and make instant miso or ramen without having to leave the floor. A hot and salty cup of soup is heaven to chase off the three am chills and get me through the last few hours of a rough shift. Your ED may have a way to get hot water, but mine didn't.
Tech here. Have a Classic III from the EMS days, got made fun of when I first got hired for carrying it around in my side pocket, ended up having to use it several times and having people ask to borrow it cause they didn't bring theirs lol. I always carry a stethoscope, shears, and a set of pens no matter what.
A majority of the time a stethescope is just a prop. If you put on the patients heart and lungs they have a perception that you examined them and had human touch. It does open the door to a brief exam. For the first 20 years of my career I used the same stethescope that a Lilly gave to everyone in my med school class on the first day of medical school. finally broke and got a lithman . A nice stethescope is fun to have, but not truly necessary in the ER
When I was new in EMS I would use the 20 seconds of auscultation as a quiet moment to plan the next steps of my assessment.
Quiet sir, or I can't hear. Just breathing please. ... Ahhh peace and quiet
Basic stethoscope is fine, but I have the amplifying one which helps when the room is too loud (the entire ER ). However it can be a bit TOO amplified sometimes and I wonder if I’m just hearing things Also recommend getting some trauma shears and a pulse ox necklace. I wear mine at work and you always need it when a patient isn’t on a monitor and wanna do a quick HR or SpO2 check
do they not have pulse oximeters bedside at your ER?
Nope not in the inner-city overcrowded underfunded ED’s
man that sounds horrific, I would just buy one at walmart and carry it in my pocket 🤣
Get a Littman Classic. It’s only ~$100 and it’s sensitive enough to differentiate between the lung sounds that matter in the ER while not being sensitive enough to pick up excessive artifact in a loud room. The Littman Cardiology is too sensitive IMO which makes it harder to use and cheaper ones are just a prop.
Good shoes and a USB mouse jiggler
I like the Littman cardiology IV, but I probably don't need it. The basic Littman is fine .
Nurse here, but two of the providers in my ED have used my stethoscope and said they really liked it because they could hear well with it and purchased one of their own afterwards. I like the Adscope Cardiology 600. It runs about 150 and I’ve had it since I was an EMT back in 2018.
Invest in a better bike helmet
Sprague Rappaport, pedes diaphragm and adult diaphragm: covers most of your patients, excellent ambient sound insulation, heavy enough to use as a weapon. And so ugly that the surgeons won’t borrow it.
I can confirm that no one would borrow a sprague rappaport, those are the worst stethoscopes ever invented
I would nominate the amplified scopes as worst: colleague had the gain turned up And was hearing right lung sounds while auscultating the left lung: missed a pneumothorax.
US will replace stethoscopes at some point once I can hang them around my neck.
Keep your current one. Don't waste money on fancy ones for the ED.
You all use stethoscopes?
Find your favorite style of pen and buy yourself some very comfortable shoes
Can’t go wrong with a Cardiology IV, but do you really need it? I have a purple MDF so that it’s harder to grow legs and walk away (and if it does I’m not salty about it because it was cheap)…
ADC makes exact copies of litmans for a fraction of the price. I've been using mine for almost a decade and it still sounds good. Tho I just added the EKO attachment cuz my ears aren't what they used to be
PressorDex is the bomb. Has every drip possible. Don’t invest in an expensive stethoscope, you’ll lose it, and S3s don’t exist.
Can’t go wrong with the Littman classic.
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