General practitioners have used the stethoscope since 1816, when it was invented by René Laennec of France. Before this time, physicians had to thump the body repeatedly over key organs and listen to the quality of the sound for clues as to the person’s health. This method of determining organ health was, of course, non-standardized, and it was very hit or miss.
According to Hans Pasterkamp, writing in the American Journal of Respiratory and Critical Care Medicine in in 1997, there are several technologies that provide superior auscultation to the stethoscope. Yet the stethoscope remains the tried and true device for respiratory therapists. This is due in part to the simplicity of the device as well as the fact that a stethoscope can last for many years if properly cared for. However, when choosing a stethoscope for respiratory therapy, you must be selective. Not all stethoscopes have the level of sensitivity required to listen in on the lungs and other organs of the respiratory system.
Traits of a Good Stethoscope
In general, a high-quality stethoscope for a respiratory specialist will come with both a diaphragm and a bell. The diaphragm consists of a taut sheet of plastic or fiber, and it transmits high frequency sounds. The bell is a cup-shaped hollow, and it transmits low frequency sounds. The chestpiece holds both the diaphragm and the bell. A swiveling chestpiece is preferable to a static one because if you can quickly switch from the diaphragm to the bell, you will save time over the course of a shift. However, you can find stethoscopes that feature a single tunable diaphragm. This feature enables you to listen to both high and low frequency sounds without rotating the device.
All stethoscopes feature tubing, and a good stethoscope minimizes tube length while maximizing tube thickness. These two traits allow for maximum sound fidelity. Because the body’s various noises are transmitted via pressure waves through the hollow tubes, thick tubes allow for superior sound propagation from the diaphragm or bell to the ears.
Of prime importance—especially to the respiratory therapist who frequently does long rounds in the ER—are the ear tips. Your stethoscope will ideally feature soft silicone ear tips that will mold to the shape of your ear canal. This will allow you to take them in and out of your ears comfortably for hours at a time. Poorly fitting ear tips, or a “one size fits all” design, can cause discomfort and numbness.
The chestpiece is the business end of a stethoscope and should be fashioned from machined and hand-polished aluminum. This manufacturing process ensures durability while keeping weight to a comfortable minimum. If the chestpiece swivels, it should have an indicator dot that tells you which sound channel is active. This will save you time as you go from patient to patient compared to a more primitive stethoscope model. The highest quality bell comes with a non-chill bell ring. This simple addition prevents patient discomfort and increases cooperation in children.
Tubing should be sourced from latex-free PVC as this prevents irritation in individuals allergic to latex. Tubing should also be non-stick and water resistant as these features inhibit bacterial growth. Some stethoscopes come with longer-than-average tubes to increase the distance between doctor and patient, which increases patient comfort. However, you should purchase this type only if you’re confident that the tubing will still cancel out ambient noise.
Chrome-plated brass headsets are a good compromise between durability and cost. The best headsets come with adapters that prevent young children from pulling the headset out of the practitioner’s ears. This uncomfortable experience can cause damage to the inner ear.
The highest quality diaphragms are described as “ultra-thin.” Both the thickness and material of the diaphragm are important considerations. Earlier stethoscope models featured plastic diaphragms, but fiber versions provide superior sound transmission.
While virtually all stethoscope models provide the basics, respiratory therapists must take care to use quality models that provide high sound fidelity. The noises generated within the lungs and organs are more fleeting than those that occur within the cardiovascular system. If you stick with the features listed above you will have no trouble finding a model that will provide you with the features you’ll need for years to come.
Wrapping It Up.
Following the aforementioned keys, Respiratory Specialists will be able to select the best stethoscope that is most suited for the job.