Introduction on how to use a stethoscope
A stethoscope is a symbol of physicians, nurses and physician assistants. Everyone knows the basics of it. You just need to put the ear tips in your ears and diaphragm/bell on a sick person/patient before listening.
But a stethoscope can do more than that.
Getting more comfortable in using your stethoscope will make you a better doctor, nurse, student or clinician.
You might be playing with it a little bit as you get to know it. Now, it is time for you to get down to your business.
How should you use this thing?
First, let us learn how to properly wear it.
Insert the ear pieces to your ears. Make sure that the tips are pointing forward, which must be toward the bridge of your nose.
This is to ensure that the tips will fill your ear canal. It will allow you to hear uninterrupted sound pathway. This will also prevent or block surrounding noise.
What happens if you position the ear tips backwards?
The ear piece will be resting against your Cymba cavity, which will cause an obstruction in the transmission of sound while you are using it.
When the ear tips are in your ears, make sure that they fit snugly. They must also be comfortable to wear.
Before you place the ear tips of your stethoscope, hold its headset first. Place it in front of you. The ear tubes must be pointing away.
Read more: Stethoscope Reviews 2016
Using the chest piece
If your stethoscope has a dual-head chest piece, you need to select one side and deselect the other side. Some stethoscopes have an indicator dot, allowing you to know which side is in action and which one is deactivated.
Now, if the unit does not have a dot, you can simply tap the chest piece on one side and then the other. This will also let you know which side is active and can be used.
The diaphragm is used to listen to high-frequency sounds. When you need to use it, you have to apply enough pressure. As you apply optimum pressure, the sound will become louder and clearer.
The bell is ideal for low-frequency sound. To use it, you need to apply just enough pressure. Do not overdo it as you will not hear anything.
It is important to practice using the bell and diaphragm until you get comfortable with it. You should use the stethoscope with care. Make sure that you are not twisting its tubing or headset. This will only dislodge the ear tips from a proper seal. You must also prevent not to kink the tubing as it will obstruct the sound.
Holding the chest piece is also essential. The best way to hold it is to place it between the distal part of your middle finger and index fingers. It is usually held by your dominant hand. This type of grip will avoid creating extra noise. It will also let you press the piece against your patient’s skin without your fingers rubbing the piece, which will create disturbance in properly hearing body sounds.
When touching the patient’s skin, you must only apply a gentle touch.
Placing the chest piece
When you are still learning on how to use a stethoscope, you must make it a habit of placing the piece against your patient’s skin. This is to hear the best sound transmission.
Some trained healthcare professionals may place the piece over a layer of clothing, like a t-shirt. This is usually done when they are in a hurry. However, this is not advisable as you may miss sounds that are crucial in the proper diagnosis of your patient.
When listening to heart sounds, you should listen to the four primary areas:
- Left sternum
- Right sternum
- 4th rib
- Left nipple line
When listening to heart sounds, you will be assessing the rate, rhythm and type of heart sound. You must also try to listen to murmurs, gallops and clicks, which are known as adventitious sounds.
Heart sounds may sound the same the first time you try to listen to them. However, as you hone your skills, you can easily differentiate heart sounds.
On the other hand, if you are listening to lung sounds, you must start above the patient’s clavicle. Then, make sure that you ask the patient to lean forward to expose the triangle of auscultation.
A stethoscope can also be used to detect bruit, which is an abnormal sound of blood indicating narrowing of arteries. This is usually heard in patients with arteriosclerosis. This can be detected in the neck, kidneys, iliac, femoral arteries and umbilicus.
Get a stethoscope with right ear tip size
You must make sure that your stethoscope has the right ear tip size. If not, you will not appreciate its acoustic performance.
When getting soft-sealing ear tips, make sure that they fit snugly into your ear canals. Remember that ear tips can be small and large. Opt for the one that will fit tightly and comfortably in your ear canals.
When using your stethoscope, make sure that there are no obstructions while trying to listen to body sounds. Else, you will fail to hear crucial sounds.
Avoid putting your stethoscope in your pocket as it may accumulate dirt or lint. This can obstruct sound pathway. If you cannot avoid placing your device in your pocket, make sure that you are conducting a routine cleaning.
Check its seal
Stethoscopes have an airtight seal to transmit proper body sounds of the patient to the user’s ears. If the seal or tubing is loose or cracked, transmission of body sounds will fail so you will not be able to hear body sounds of your patient.
In addition to learning how to use a stethoscope, it is also important to know the proper way to carry it when it is not in use. Most clinicians or healthcare professionals carry it by wrapping the stethoscope around their neck.
Avoid it as much as you can. If you need to wrap it around your neck, make sure that it is over your shirt’s collar. This is to avoid the tubing to come in direct contact with your skin’s oils. The oil of your skin will cause the stethoscope’s tube to harden.
You must also check its chest piece and ear piece regularly. Most of them will tend to lose their fittings as they are constantly rubbed against your clothing. They may even fall off as the device gets older.
How to amplify sounds?
This is with the use of the stethoscope’s diaphragm. It is a part of the device that vibrates. When it vibrates, a column of air inside the device will travel from up and down so you can hear the body sound.
The diaphragm’s surface area is greater than the column of air moving within the tube. With that said, the air traveling in the tube should travel more than the diaphragm. It causes magnification of pressure waves leaving your ear tip. The larger pressure waves will make louder sounds causing the sounds to be amplified.
How to reduce noise?
A high-end stethoscope utilizes a noise reduction technology that perfectly reduces extra noise from surrounding. With this type of technology, you can easily detect critical sounds while avoiding hearing noise outside. You can hear gallops, murmurs, abnormal lung and heart sounds. All the sounds that you need to hear can be heard with the use of the device equipped with this type of technology. This is especially useful if you are working in a noisy environment.
The great thing about it is that you can easily intensify the sound. This is especially great if you are trying to hear faint sounds.
But even if you do not have a stethoscope with such technology, you can still hear critical body sounds by constant practice. Doctors and nurses need to hone their auscultation skills to properly diagnose their patients. Although auscultation or listening to body sounds is just a part of the diagnosis process, you must still get it correctly so you can give accurate diagnosis.
The tips and steps mentioned above on how to use a stethoscope are necessary to help you properly hear body sounds that are crucial in the diagnosis of your patients. It does not matter what brand of stethoscope you are using, as long as it is made of high quality materials, it can still help in auscultation.
Nevertheless, it is still worth to invest in a high-quality stethoscope. This is especially true if you are working in the cardiology department or emergency cases.
When optimizing acoustic performance of your stethoscope, you need to make sure that the headset is properly aligned. The ear tips must fit snugly in your ear canals but they must be comfortable, too. Before using this device, make sure that you check for obstructions. Clean it regularly as dirt can disrupt sound transmission. With proper care and maintenance, you can easily hear body sounds and your stethoscope can last for a very long time.