A quick review of a few stethoscopes many of you will encounter as MS-1s and beyond!
Many of you guys will be starting med school in the fall or will be looking for a new stethoscope that is a step up (and hopefully not because it got stolen, I know how that is).
The Omron Sprague Rappaport:
Probably one of the least expensive ones you'll find, but I wouldn't recommend it for medical school or anything other than "easy listening." What they did get right is the fixed diaphragm, and it all makes sense from a pure physics perspective. Having a solid piece plastic/material transmitting sound is the best, instead of a tuneable diaphragm because I feel that tuneables are hard for you to first learn on, as you spend way more time adjusting the pressure on the stethoscope/patient than listening for that heart murmur.
Littmann SE II
A sturdy guy I've had for a while, it's been my workhorse for sometime. However, I spent some serious time trying to make my stethoscope work for me (especially during patient visits, ugh, embarassing), which shouldn't be the case. Some advantages include the higher quality than the Omron Sprague, a single tube instead of the double tubes the Rappoport has (which like to rub against each other and cause needless noise). The quality of the material and the construction is higher than the Rapoport, but it wasn't until I listened to the Harvey Elite that I literally heard a lot of change.
Disclaimer: I know of an awesome cardiologist who uses this stethoscope, so it's all about finding what's best for you! And as everyone else will tell you, the best stethoscope is the one between your ears. It's all about how much practice/experience you have rather than your equipment to a large extent. Go with what makes you happy and gives you confidence =]. Follow up: that heart doc now uses this triple-headed stethoscope that is a Welch Allyn Harvey brand, it's pretty huge with 2 diaphragms and a bell all on the same chest piece. It doesn't have a non-chill rim, and patients stated they could be more comfortable.
Harvey Elite
I've spent hours researching what could be the best stethoscope for me, and there are a lot of criteria, but the Harvey Elite's been the best for me so far. I love the fixed diaphragm, and it's such a change that when I listen with my Littmann SE II, it sounds like I'm listening to a heartbeat within a cave from a distance. The Harvey DLX is probably a step up, but heavier and has no non-chill rim around the stethoscope. I went with the Harvey Elite because it was lighter, and I didn't want to waste time having to warm my stethoscope every time I saw a patient. The Harvey Elite sounds really clear and has both a bell and diaphragm, instead of those fancier cardiology stethoscopes that are diaphragm only. Why they make steths without a bell is beyond me, but maybe I'm just a little bit ignorant/old-school. Follow-up: I got the BP of an elderly patient with a faint pulse when 1 doctor and 2 nurses couldn't get it, and got the same exact value as my attending. I don't know if it was the steth or just tuning in (and the pressure of being in front of everyone! haha), or even just using the bell instead of the diaphragm but I was pretty happy with the way my piece of equipment helped me.
P.S. Save some money and order through Welch-Allyn or the Medical Store, or any group thing your school is doing, because I've seen Harvey Elites sold for $150 or so. Happy listening!
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