With a range of medical supplies available on the market today, stethoscopes, although considered basic, are crucial. Stethoscopes are important for listening to heart rate and recording blood pressures, and are used in basic vital signs of any and every patient. The first priority of every first responder is airway, breathing, and circulation. Stethoscopes are the keys needed when determining lifesaving assessments. The decisions for buying stethoscopes are critical since paramedics are using them in noisy environments where hearing and differentiating sounds can be difficult, and breath sounds are important no matter who is taking them or wearing maternity scrubs. An excellent choice is the Welch Allyn Harvey DLX stethoscope. Enclosed are some features to look for in a stethoscope, and where the Harvey DLX ranks in each category.

1. Tubing Design
There are two basic designs for tubing that go from the chest piece of the stethoscope to the ear pieces. The original design uses two separate tubes, which is known as a Sprague design. The two tubes offer excellent hearing, compared to a single tube. However, one significant problem is that the tubes often rub together and create more noise — or artifact — that can compromise what the paramedic is listening for. The Harvey DLX stethoscope features dual bore tubing, but the Welch Allyn brand name ensures that artifact has no presence in this superior stethoscope.

Another style uses a single tube, rather than the dual tubes. These were designed to help eliminate some of the artifact. These models vary greatly in quality — lower quality models have narrow tubing that can make it difficult for the transmission of sounds. Lower end models are often found in clinics where they are used for taking blood pressures.

Bilumen tubing incorporates the best of both worlds. It uses a single tube that has a split lumen which goes to each earpiece. Basically, it has two tubes inside a single tube. This offers improved hearing without the artifact. The bilumen models often offer better sound quality and decreased artifact.

2. Chest piece design
There are two different designs for the chest piece of a stethoscope — combination or single design.

The combination chest piece has two heads that can be rotated to select from either a diaphragm or a bell. The diaphragm is used to listen to high frequency sounds, while the bell side is used to hear lower frequencies. This is the technology used in the Harvey DLX stethoscope. It is simple to use, eliminating the margin of error.

The single head chest piece uses a unique design. To hear low frequency sounds, one rests the chest piece in place with light pressure. To hear high frequency sounds, one applies firm fingertip pressure on the chest piece. This pressure alters the frequency response by changing the contact points. There are some newly designed single head chest pieces that use a lightweight acrylic design. This is intended to increase the amplification significantly, but some complain that it is difficult to find the exact right pressure.

3. Test run
Before you purchase stethoscopes, or any medical equipment for your organization, get input from your colleagues. Have them test various models on the market to determine what they feel works best in their working environment.

If you expect your paramedics to be able to differentiate lung and heart sounds in the back of an ambulance, you need to purchase a good quality stethoscope. It is one of the essential tools needed to provide the best level of patient care. Their input is valuable and it offers them ownership in the decision process.

To sum it all up, the Welch Allyn Harvey DLX Double-head Stethoscope is the easiest-to-hear and most accurate heart sounds of any stethoscope on the market today. The stethoscope is optimized for listening to higher frequency and critically important heart sounds like murmurs, clicks, and ejection sounds. It provides clear transmission of the first and second heart sounds, and has ideally sized bell bridges that fit in the intercostal space between the ribs. The tightly constrained diaphragm provides superior response at targeted frequencies. The stethoscope also features an additional corrugated diaphragm for detecting mid-range and lower frequencies.

There was once a time when first aid consisted of assessing a patient based on physical, outwardly apparent signs and symptoms, and treatment based on an educated guess of what was going on inside the patient. Today we have sophisticated medical supplies and equipment, but almost none is as instrumental in health care as vital sign monitors. Blood pressure can be taken using a traditional  blood pressure cuff, and pulse can be checked manually, but how often? There are a variety of monitors available to instantly alert medical care providers to a change in a patient’s status. This can sometimes mean the difference between life and death.

The basic vital signs monitors measure the five main bodily functions, body temperature, pulse rate, respiration rate, blood pressure, and blood oxygen saturation.

Vital signs monitors enable healthcare professionals to evaluate their patients quickly, enabling them to progress to other tasks more efficiently and focus on improving the patient’s health.  The advanced technology engineered in vital signs monitors makes them optimal for hospitals.  However, because the basic vital signs monitors are compact and portable, they’re perfect for use in homes, clinics, at the sites of medical emergencies, etc.  With this state-of-the-art equipment now available to the public, vital signs monitors will be increasingly used in the home as patients can be monitored by family and friends and receive treatment from healthcare professionals where the patient feels most comfortable.  If you’re caring for someone at home, you’ll find the following information pertinent to your tasks.

Using vital signs monitors will provide critical information about a patient’s state of health.  They are a way of quickly assessing how serious an illness is and how well the body is coping with the resulting biological stress.  The more unstable the vital signs are, the sicker the patient is.  Vital signs can also mark the state of chronic diseases (i.e. hypertension).  When manually taking vital signs, it’s important to remember that the slightest error can have dramatic results.  If there is user error or patient error, an accident or a mistake, false readings will occur.  If these are not remedied quickly, improper decisions and treatment could possibly be carried out.  However, using vital signs monitors will eliminate such errors.  Nonetheless, it is of the utmost importance to understand exactly what you are measuring.

Thermometers can range from the basic mercury variety to more sophisticated electric thermometers. Body Temperature is checked in order to gauge how well the body stores and releases heat, detect abnormally high body temperature (hyperthermia) or abnormally low body temperature (hypothermia), and monitor the effectiveness of some medications. Though normal body temperature varies from person to person, the average is 98.6 °F.  Temperatures may vary throughout the day, ordinarily being lowest in the morning and rising in the evening.

Pulse Rate is described as the number of beats per minute (bpm). Pulse rate is conventionally measured using a stethoscope and blood pressure cuff. The pulse rate provides clues about the function and health of the heart. It determines whether the heart is pumping blood adequately, and monitors certain symptoms such as palpitations, dizziness, fainting, chest pain, or shortness of breath. Pulse rate can also monitor medical conditions or the use of medications.

Respiration Rate, measured using a stethoscope, is the rate at which a person breathes.  The best time to measure this is when a person is resting.  The normal rate for adults is 12-24 breaths per minute.

Blood Pressure measures the force of blood inside an artery in two measurements, systolic pressure and diastolic pressure. Systolic pressure is when blood flow is first heard, representing peak blood pressure that occurs when the heart contracts. Diastolic pressure is when blood flow can no longer be heard, representing the lowest blood pressure that occurs when the heart relaxes between beats.

Blood Oxygen Saturation evaluates how well the lungs are providing oxygen to the blood during rest, exercise, or a medical procedure through the use of a pulse oximeter. It examines oxygenation and the saturation of hemoglobin in the blood.

There is a variety of patient monitors available, from the basic vital signs monitor to the advanced anesthetic monitor or 5 agent gas monitor, required for patients undergoing anesthesia. There are also many patient monitors that are multiparameter. One simple monitor widely used is the pulse oximeter monitor to detect the oxygen saturation, or SpO2, in the blood through the skin. A sensor with a special light is attached to the finger or earlobe for an almost instant reading.

When used in a hospital setting, monitors may be classified into basic categories. There are handheld and portable monitors which are useful when going on a round of patients. Defibrillator monitors are those which include an AED in the monitor itself. These are also usually portable, and are used often in EMS services. Tabletop monitors are not portable, but may include more features than those of the portable variety. Some of the bulkier Vital monitors are also networkable with other medical resources, although not all of them are. They also may be wired, or use wireless signals, depending on the specific model.

Another type of monitor, one that provides information by telemetry, is especially critical in cardiac units, and there is usually a need for a large number of these monitors. There must be extras to replace broken or damaged monitors or modules, so having a very large inventory is both essential and costly.

In today’s day and age, it is well-known that CPR is vital in emergency situations of respiratory distress. Having made progress from the traditional mouth-to-mouth resuscitation, today’s rescue workers perform CPR using CPR masks or barriers. CPR masks come in various shapes and sizes.

The most basic CPR equipment is the CPR shield, a low-cost barrier that is basically a flat covering for the face with air holes for the nose and mouth. The shield is mainly used in CPR practice procedures to protect trainees from exchanging germs on a mannequin that is used multiple times.

The most common CPR mask is also known as a pocket face mask. It is kept in a pouch or plastic case, and is found in all basic first aid kits. Anyone with any manner of CPR training, including lifeguards etc. will have a CPR mask on hand. The CPR mask ensures safety by having a one-way filter valve in place. When the person giving breaths breathes into the mouth of the patient the one way filter valve prevents any mucus, blood, or vomit from going back into the resuscitator’s mouth. When used with the correct technique, the mask forms a seal around the victim’s airway so that breaths go straight in. Some are also equipped with elastics to go around the victim’s head. This ensures that the mask stays in place during the CPR process. The classic CPR mask is inflated to fit around the victim’s airway, but some are made of a thin plastic that folds up, and can be worn on a keychain.

Some masks come with a built-in oxygen intake tube. This tube allows for oxygen to be taken from the atmosphere and delivered to the patient. The use of a built-in oxygen intake tube can be very helpful because it can alleviate some of the strain and stress on the person who gives rescue breaths during CPR. CPR procedures require a great deal of physical work during a stressful situation, which can compromise the effectiveness of the rescue.

Yet another type of CPR mask is the bag valve mask. This CPR mask requires the use of two hands to operate. One hand is used to seal the mask over the mouth while the other hand squeezes air from the bag into the mouth of the patient. Used mostly when two rescue workers are performing CPR together, the bag valve mask requires almost no work on the part of the rescue worker.

CPR masks can be purchased online or in person from health supply retailers. One thing to consider when purchasing a CPR mask is that the material that it is made up of is latex-free. This is important not just for the resuscitator, but for patients as well, because so many people are now known to have latex allergies, and a rescuer would not want to induce an allergic reaction while performing CPR.

Being an EMT is a tough job, and it doesn’t take long to figure out that the equipment you’re using can make everything go more smoothly… or drive you totally crazy. One of the most essential pieces of gear is your EMS bag. You take the bag with you on every call, and you depend on it to store, transport, and organize all your supplies. When responding to an emergency, a good EMS bag can save you time and help you treat the patient faster by allowing you to find what you need in an instant. On the other hand, a poorly designed bag can leave you scrambling for the right supplies while precious seconds tick away. A bag that is hard to maneuver can also cause strain, slowing you down on the way to the scene of an emergency or even causing injury. Take the time to find the EMS bag that is right for you, and you will appreciate it on every call.

Follow these tips to make sure you are purchasing the ultimate EMS bag:

The Right Fit

You’ll be spending a lot of time carrying your EMS bag around, so make sure you can transport it comfortably. The StatPacks G1 Perfusion ALS/BLS EMS Bag is a great example of a versatile pack designed with your comfort in mind. It features ergonomic shoulder straps, and the shoulder straps as well as the back panel are padded to make carrying a fully loaded bag as effortless as possible. The shoulder straps and waist belt can be stored out of the way if you prefer to carry the bag by the side handle.

Make It Your Own

Why should you settle for someone else’s attempt at organizing your EMS bag? Choose a bag that allows you to customize the storage options to fit your unique assortment of gear. You need your supplies to be easily accessible, and you don’t want to waste space on pockets or compartments that you don’t need. Meret’s OMNI v.2 ALS/BLS Pack offers extensive flexibility with a customizable main compartment and the option of attaching or removing side modules, elastic loop strips, and deep pockets.
And if you’re looking for style in addition to utility, you can’t ask for a better recommendation than Meret, the brand of EMS bags that’s been featured on NBC’s popular TV series "Trauma." Click here to watch full episodes and see a variety of Meret bags in action!

Easy Access

No matter how much gear fits compactly into your EMS bag, it won’t be of any benefit to you (or your patients) unless you can find the right piece of equipment or EMS supplies as fast as possible. Good EMS bags are organized and feature see-through pockets so you can find what you need. It’s also helpful to have a main compartment that opens completely, allowing you to access any supply in an instant. Think about the supplies you use the most often and make sure there is room to store these items in easily accessible compartments.

Stay Safe

Emergency rescue work can put you in dangerous situations, like working in bad weather, at night, or near high-traffic roads. Your EMS bag should have safety features to maximize your visibility, like the StatPacks G1 Perfusion ALS/BLS EMS Bag’s reflective piping and tie down loops. With a bold, high-visibility stripe on the back of the pack, motorists and pedestrians will be able to see you clearly even in the worst conditions.

Think Long-Term

You may be experienced in emergency care, but you don’t want to be stuck providing “life support” to an EMS bag that breaks down on the job. Make sure any bag you choose has durable construction, rugged material, and reliable zippers. The Meret OMNI v.2 ALS/BLS Pack is made of tough 1200 Denier coated TPE that is resistant to water and stains. In addition, all surfaces that touch the ground are reinforced with PVC for maximum durability.

The Extras

While you don’t want to choose a fancy extra over something essential, like safety or ease of use, well-designed extra features can make the difference between a good bag and a great one. For example, the G1 Perfusion has a safety whistle built into sternum strap buckle for easy accessibility. The Omni v.2 features an enclosed front pocket that keeps paperwork protected and easy to find. Helpful features like these are thoughtfully included in the EMS bag design to help you out on the job.
Have any buying tips of your own? Leave a comment and let us know what you love- or hate- about your EMS bag.

Dangerous heart defects are usually about the last thing on a new parent’s mind when they are bringing their newborn home from the hospital. As long as the baby looks healthy, they are only too happy to check out of the hospital and bring their new bundle of joy home. However, critical congenital heart defects (CHD) that are not diagnosed soon after birth can cause serious problems after babies go home – even death. And heart problems are not as rare as most people think. Heart defects are one of the most common types of birth defects, and about 1 out of every 125 babies is born with a congenital heart defect.

Fortunately, many heart defects are treatable and babies born with these heart defects can go on to lead active, productive lives. But a baby can’t receive treatment unless someone realizes there is a heart defect present. It is estimated that hundreds of American babies die each year because they were born with heart defects that were treatable, but unfortunately were not detected in time. When a newborn is seen by a pediatrician before being discharged from the hospital, the doctor will listen to the baby’s heart with a stethoscope to make sure the heart sounds like it is working properly. This method can pick up on some heart defects, but unfortunately it does not pick up on everything. Babies need further evaluation to detect the presence of other types of heart defects. However, additional screening for heart defects is not usually done in most hospitals.

Why aren’t all babies being screened for heart defects so they can receive the appropriate treatment? You might think it is difficult or expensive to screen newborns for heart defects, which explains why it is not being done in most cases. But the truth is, screening newborns for heart defects is fast, easy, cheap, non-invasive, and only requires standard equipment that is already available in every hospital!

All it takes to detect many of these heart defects is to use pulse oximetry to measure the amount of oxygen in the baby’s blood. A pulse oximeter is a small monitor that can be strapped to a newborn’s foot and beam light through the foot to determine the level of oxygen saturation in the blood. It doesn’t hurt the baby, and it only takes about a minute. Pulse oximeters are essential pieces of medical equipment that are used regularly to monitor patients. New advancements in pulse oximetry technology have lead to even more accurate and easy to use monitors, like the Nellcor N-65 OxiMax Pulse Oximeter. The Nellcor N65 is a convenient handheld device that can monitor oxygen saturation and pulse rates. It uses the latest digital signal processing technology to provide more accurate readings over a wider range of measurements, and it’s even resistant to signal interference. If hospitals were to use pulse oximeters like the Nellcor N65 to screen newborns for heart defects, they would be assured of the most reliable results, and the testing itself would be fast and simple to perform.

Research studies have proven that pulse oximetry is an effective way to catch most congenital heart defects. On July 6, 2009, the American Heart Association and the American Academy of Pediatrics released a statement reviewing the current research. They conclude that using it to screen newborns is effective, low-cost, and safe. Based on their conclusion it seems obvious that pulse oximetry is something that should be recommended for all newborns, but these organizations stop short of actually saying pulse oximetry should be used to screen all babies. Instead, they recommend more research before they will decide whether this should become standard of care.

However, as Dr. Darshak Sanghavi, a pediatric cardiologist, explains in a New York Times blog, parents don’t have to wait for this life-saving test to be accepted as the standard. Parents can simply ask a nurse or doctor to use pulse oximetry to screen their newborn for heart defects before leaving the hospital. The ideal time to use pulse oximetry is after 24 hours of life but before being discharged from the hospital. The test should not cost anything since the hospital already has the equipment.
What parent wouldn’t want the assurance of this simple test?

You may have never heard of Charles Chamberland, but chances are you’ve benefitted from the invention credited to this seventeenth century French microbiologist. The autoclave is essentially a specialized steam cooker used to sterilize equipment. Surprisingly, the autoclave shows up in more places than you’d think, and is essential for ensuring patient safety in many situations.

Picture this- you’re sitting in the doctor’s office, dentist’s chair, or even a tattoo parlor.  As they approach you with a sharp-looking metal instrument, you nervously wonder how clean this instrument really is. Sure, it looks clean, but what if there’s some nasty germ that got on the equipment from the last person it was used on? Is soap and water enough to ensure your safety?

You’re right to wonder, but thanks to the autoclave, you’re probably safe (as long as the equipment was sterilized correctly, of course). Physicians, dentists, tattoo artists and others use autoclaves to kill any bacteria, viruses, or fungi that may be present on instruments.  The autoclave uses steam, intense heat and high pressure to sterilize items. Autoclaves, or sterilizers as they are sometimes called, come in a range of types and sizes to meet the needs of different settings.

Autoclave Types

Stove Top Autoclave

The simplest autoclave is a stove-top model. It looks like a large pot with a bolt down lid and a pressure gauge. As the name implies, the stove top autoclave requires an external source of heat. While this is the most affordable type of autoclave sterilizer, the stove top autoclave is both inconvenient and very dangerous if not used correctly.

Front Loading Autoclave

Front loading autoclaves are more popular than stove top models because they are easier and safer to use. (However, they are also potentially dangerous and must be used with caution.) These self contained units include a heat source and they allow the user to set controls to the desired temperature and cycle length. Smaller counter top sterilizers are convenient for medical and dental offices or tattoo parlors. Larger installed units are generally found in hospitals, laboratories, and other facilities that regularly need to sterilize a large volume of items.

Both manual and automatic front loading autoclaves are available. Manual sterilizers generally have dials on the control panel that allow users to set temperature and cycle time. Choosing a manual front loading autoclave is a great option for small medical practices or other offices that need effective sterilization at an affordable price.

Automatic autoclaves may be a little more pricy, but they offer the maximum convenience for sterilizing equipment. Users can select pre-programmed cycles or enter their own specifications. With an automatic sterilizer, the user can push one button and have the unit sterilize and dry a load without any further human input. Some automatic autoclaves even open their doors by themselves to allow heat and steam to vent after sterilization.

Autoclave Effectiveness

Autoclaves are very successful at killing germs like bacteria, fungi, and viruses. In fact, autoclaving is the standard method for sterilizing non-disposable medical equipment in order to ensure patient safety.

However, in very rare situations an autoclave may not be enough. Sterilization alone is not effective against prions that cause Mad Cow Disease and Creutzfeldt-Jakob Disease. The Centers for Disease Control and Prevention (CDC) recommend that contaminated equipment should also be immersed in Enzol Enzymatic Detergen during the sterilization cycle for in order to destroy the prions. Also, a microbe called “Strain 121” can actually survive the very high temperatures in a sterilizer. Not that Strain 121 poses a threat to anyone’s health- this microbe was discovered living in thermal vents deep under the ocean. Still, it illustrates that sterilization is not perfect.

A more common problem with autoclave sterilization occurs when something goes wrong with the cycle and the proper temperature and pressure is not maintained for long enough to kill all pathogens. Several quality control methods have been developed to ensure that the sterilization was effective. Autoclave tape and some medical packaging contain chemical indicators that change color when the necessary autoclave conditions are reached. Biological indicators (“spore tests”) use spores to also create a color change and are more reliable than the chemical indicators. Physical indicators contain an alloy that melts when the autoclave cycle has run properly.

To keep an autoclave working properly, it should have maintenance performed ever six months. A spore test or biological indicator should be run at regular intervals, and autoclave tape or bags with indicator dye should be used with every load. The owner’s manual of an autoclave will also describe daily and weekly maintenance needed for optimum performance.

Bag instruments to be autoclaved that will not be used immediately. This will keep instruments sterile after they are removed from the autoclave until they are ready to be used.

When used properly, autoclaves are an effective and essential way to sterilize equipment and instruments. The steam sterilization used by autoclaves is non-toxic, low cost, and reliable. Autoclaves have greatly contributed to patient and consumer safety in doctor’s offices, hospitals, dentists’ offices, and tattoo parlors.

The unit itself is made of a soft material which still has firmness to it but allows for some flexibility in order to get it into position to apply it. Contained within the material are a series of wooden slats which help to perform the rigidity of the ked board. It consists of a head piece which also has a hard collar for the cervical section of the neck which stops the movement of the cervical spine.

It then has some straps attached to it so the unit can be locked firmly in place to prevent movement. It comes with a cushion that is placed behind the head and then has handles on either side in order to be able to lift the patient.

in order to get the most benefit of the ked extrication device, proper use and application is critical. To begin with training should be carried out in the proper use of the ked board and it also requires good teamwork to get the most benefit from it.

Individuals that are taking part in applying the ked extrication board to a patient should know what their specific job is. Usually the perfect scenario is to have 5 individuals plus a doctor or paramedic that is in charge. It must be remembered that before the ked device can be used the patient must be stabilized first.

When the ked is prepared and ready to use it is placed between the seat and the victim, and the cervical spine must be kept rigid while this is taken place. The ked board has to be completely and correctly lined up so that the wings of the ked are where they should be under the armpits and lined up with the torso. In order to do this this means leaning the patient forward slightly again though the spine must be kept rigid. All of this must take place by doing only one movement forward. Once this is done then the straps are fastened securely and in proper order. Most often the most senior personnel on the scene will determine if and when the ked extrication device is to be used.

Cryosurgery

Skin lesions like warts can be unattractive, uncomfortable, and sometimes even painful. Cryosurgery is an effective treatment method that uses extremely cold temperatures to destroy the tissue. Specifically, when the temperature drops low enough, ice crystals actually form inside the skin cells and cause necrosis, or cell death.

Cryosurgery, which is also referred to as cryotherapy, is often a better option than other treatment methods because it is less invasive than scalpel surgery or electrocautery. Compared with other methods of removing skin lesions, cryosurgery causes less pain and scarring. It’s also an affordable procedure that is relatively safe and simple for qualified physicians to perform. Many specialists perform cryosurgery, including dermatologists, gynecologists, and urologists. Pediatricians, general practitioners, and family physicians can also safely use cryotherapy to treat common skin lesions.

Cryosurgery Options:

Liquid Nitrogen

Liquid nitrogen is the most common method of cryotherapy used by doctors. It can be used to treat more skin lesions than the other methods, including cancerous lesions. The liquid nitrogen is kept in a dewar flask and applied using cryospray or a cryoprobe. This method provides an extremely cold temperature (-196°C, which in Fahrenheit is equivalent to the hard to imagine temperature of -320.8°F). Liquid nitrogen is very effective at treating skin lesions; however, the super cold temperatures can also cause unintended side effects, like damage to healthy skin. When liquid nitrogen is applied with a swab, the temperature is about -20°C.

Although liquid nitrogen works well for cryosurgery, it can present logistic problems. Large equipment and a significant investment are required to begin offering liquid nitrogen treatments. The shelf life of a typical dewar is only about 3-6 weeks, which means that physicians have to pay to buy more liquid nitrogen even if they hardly used it. Especially for doctors who are not performing cryosurgery frequently, liquid nitrogen can be too expensive. Additionally, standard dewars are not portable (spray devices are portable). Liquid nitrogen must also be shipped through a special delivery from a local gas company.

Verruca-Freeze

Verruca-Freeze is the coldest portable cryosurgery unit available. Although nowhere near as cold as liquid nitrogen, Verruca Freeze has an effective temperature of up to -70°C, which is well below the -20°C to -30°C threshold needed to destroy most benign skin lesions.

Verruca-Freeze is convenient because it is portable, easy to apply, and has an impressively long shelf life of over five years! Treating skin lesions with this cryosurgery system is bloodless, odorless, and self-anesthetizing. 21 different benign skin lesions can be effectively removed with this treatment. In fact, Verruca-Freeze has a success rate of 91.3% on the first application, and 100% on the second.

Verruca-Freeze can be applied with CryoCones or CryoBuds, and the whole procedure takes only two to three minutes. In addition, the formula (which contains trifluoroethane, pentafluoroethane, and tetrafluoroethane) is non-flammable, environmentally safe, and will not incur any hazmat fees.

Histofreezer

The Histofreezer^® Portable Cryosurgical System has been proven effective by 19 years of widespread use. It is clinically proven to produce results that are comparable to liquid nitrogen, but with less scarring and blistering. This portable system is also more convenient to use than liquid nitrogen, and has a much lower cost-per-application.

Histofreezer can be used on the 9 most common benign skin lesions. The effective temperature is -55°C, which is cold enough to destroy unwanted tissue quickly and efficiently. Use Histofreezer for a high average skin lesion resolution rate of 93.4% (actual resolution rate varies from 100% to 86% depending on the type of lesion; resolution rate is based on application of Histofreezer with post-treatment of 27% salicylic acid/17% lactic acid).

The Histofreezer solution is made of 95% dimethyl ether, 2% propane, and 3% isobutene. It is environmentally friendly and contains no CFCs. However, it is flammable, and H-60 and H-505 are subject to hazmat fees. The shelf life is two to three years, which is a significant improvement over liquid nitrogen.

23.7 million Americans currently live with diabetes, and that number is expected to nearly double over the next 25 years.  A lot has changed since the early twentieth century, when diabetes was a clear death sentence. An extraordinary discovery in 1921 held out the first hope for treatment - insulin. Over the past ninety years, diabetes treatment has advanced by leaps and bounds as more effective types of insulin were developed and disposable syringes, glucose meters and pumps became available. Famous actors, musicians, political leaders and sports stars with diabetes clearly demonstrate that diabetes does not need to hold anyone back.

Still, living with diabetes isn’t always easy, even in 2010. If you are like many other Americans with diabetes, controlling your blood glucose levels might be a difficult challenge for you. Is it really that important? The famous Diabetes Control and Complications Trial, conducted between 1983 and 1993, proved that people who kept their blood glucose levels low had a much smaller chance of developing complications like eye, kidney and nerve disease. For pregnant women, controlling blood glucose levels is even more important. If the mother’s blood glucose levels are too high, especially in early pregnancy, her baby has a much higher chance of serious birth defects.

Standard blood glucose testing tells you how much sugar is in your blood when you take the test. But it doesn’t provide an overall indication of your blood glucose control. A1C testing is the gold standard for measuring long-term blood glucose levels. A1C levels indicate the average blood glucose levels over the past 2 to 3 months. Your physician may do this test for you periodically during office visits.

Now, you can take control. With Bayer's A1CNow SelfCheck you can test your A1C level in the privacy and comfort of your own home. The easy-to-use test provides fast results and is as accurate as the test your doctor uses. A1C testing should be used in addition to regular blood glucose monitoring and visits to your doctor.

Available for under $30, the A1CNow SelfCheck won’t put a big dent in your pocket. Compare that to the more invasive continuous glucose monitoring systems (CGMS) which go for at least $1000, not to mention the disposable sensors, which will cost you an additional $10 each day!

3 Great Reasons to Check Your A1C with A1CNow® SelfCheck:

1. Protect your health

Lowering your A1C by even one point translates into a big advantage – a 40% reduction in your risk for serious diabetes-related complications. Avoid potential problems such as blindness, kidney disease, nerve disease, and amputations.

1. Determine how well you are managing your diabetes

Even if you see your doctor regularly, checking your A1C in between doctor visits can let you know if changes in your diet, exercise, and medication are helping or hurting your efforts to maintain low blood glucose levels. An A1C level above 7 percent might indicate that you need to work with your doctor to adjust your diet or medication to better control your blood glucose levels.

1. Find out when it’s safe to get pregnant

If you are thinking about trying to have a baby, you can test your A1C every 2-4 weeks to see if your glucose control is improving, staying the same, or getting worse. Poorly controlled diabetes can cause serious birth defects in the first few weeks of pregnancy, before some women even know they are expecting. An A1C of 7 percent or below means you have no increased risk of having a baby with a birth defect. But the risk increases with higher A1C levels. An A1C of 11 percent or above means there is a 25%, or a 1 in 4 chance, of birth defects. Check your A1C, and talk to your doctor if you have any concerns before you get pregnant.

Your health is too precious to lose. Take the next step in managing your diabetes and preventing devastating complications by monitoring your A1C levels.

Like sundials and typewriters, the acoustic stethoscope has finally met its electronic match. While some gadget lovers have embraced the new electronic models, more “old school” types have shunned the electronic scopes and clung more tightly to their well-worn acoustic ones.

Is change always good? Who really needs an electronic stethoscope?

If all you need is a pulse and heartbeat, by all means, don’t trade in your traditional scope. But the electronic stethoscopes offer clear advantages for clinicians who need excellent acoustics. In cardiology or other diagnostic settings, you can’t afford to risk the harm to your patient’s health, and the damage to your practice, from misdiagnosing a condition. Electronic stethoscopes help clinicians correctly identify difficult-to-hear heart sounds, like S3 gallops, aortic regurgitation murmurs, and abnormal lung sounds.

Respiratory specialists, EMTs, and nurses in demanding situations would benefit greatly from electronic stethoscopes as well. With amplification and background noise reduction, these stethoscopes offer sound quality far beyond traditional acoustic scopes. Medical students looking for an extra edge will also benefit from an electronic stethoscope, which will serve them well throughout any rotation and into the beginning of their careers. Electronic stethoscopes are particularly vital for any clinicians who are hard of hearing.

3M Littmann offers four electronic stethoscopes with a range of features, and a range of prices, to suit your needs. All electronic stethoscope models come with a two year manufacturer’s warranty.

3M Littmann Electronic Stethoscope Model 3000

The Model 3000 is Littmann’s most basic (and affordable) electronic stethoscope- but it’s still one impressive scope! With 18 times the amplification of high-end cardiology scopes, you will hear heart and lung sounds as never before. Innovative Ambient Noise Reduction (ANR) technology reduces background noise by up to 75% using acoustic canceling, so the sounds you need to hear are still crystal clear.

It won’t take long before you are just as comfortable with the Model 3000 as you were with your old traditional scope. The chestpiece features a one-button, ergonomic control for changing the volume and frequency mode. Traditional cardiology tubing means that your scope folds up and slips into pockets as easily as any acoustic stethoscope. A single AAA battery will power your stethoscope for approximately six months (200 hours), and a low-battery warning will alert you when it is time to replace the battery.

The enhanced sound quality of this electronic stethoscope is invaluable when listening to faint body sounds, when a patient is obese, or when the health care provider has limited hearing.

3M Littmann® Electronic Stethoscope Model 3100

In the Model 3100, 3M Littmann took the design of the earlier Model 3000 and improved it with enhanced sound quality, ease of use, and functionality. This electronic scope offers 24 times the amplification of high quality acoustic stethoscopes, and Ambient Noise Reduction reduces background noise by an impressive 85%. Frictional Noise Reduction technology is an added plus that minimizes distracting handling noises.

The Model 3100 surpasses the 3000 with its detailed, yet simple interface. An unobtrusive LCD screen displays the patient’s heart rate, current settings and the remaining battery life. You can navigate the menu or switch frequencies from bell to diaphragm mode with the touch of a button. Your electronic stethoscope will be ready as soon as you are thanks to instant-on technology. Even with all these advanced features, The Model 3100 only weighs about as much as a cardiology-grade stethoscope, so it’s easy to carry and wear. The Littmann Model 3100 has a rugged design intended to last for years.

This scope is ideal for practitioners who want exceptionally clear body sounds with a life-like auscultation experience similar to using a Littmann cardiology stethoscope. The moderate difference in price between the 3100 and the 3000 is more than offset by the enhanced sound quality and ease of use.

3M Littmann® Electronic Stethoscope Model 3200

The Model 3200 combines the exceptional sound quality and ease of use of the Model 3100 with advanced capabilities that allow you to record, save, send, and analyze body sounds.  Similar to the 3100, this electronic scope features 24x amplification and Ambient Noise Reduction of 85%, in addition to Frictional Noise Reduction.  The Model 3200 is also surprisingly simple to use. It has instant-on technology and only weighs as much as a cardiology-grade scope. The Littmann Model 3200 is built to withstand the rigors of daily use.

The difference between the 3100 and the 3200 lies not in the interface or crystal clear sounds themselves, but in what you can do with the body sounds. The Model 3200 has the capability to record, save and play back body sounds, which gives you the option of sharing them with a colleague or reviewing them when writing up patient charts. A built-in Bluetooth connection allows you to transmit sounds to your PC in real-time. Zargis® StethAssist™ software, included free with every Model 3200, can visualize body sounds or play them back at reduced speeds. You can also purchase the Zargis® Cardioscan™ Heart Murmur Detection Software which helps physicians analyze cardiac sounds to identify and classify suspected murmurs.

The Model 3200 is a great choice for specialists who want an electronic scope that gives them the ability to consult with colleagues or review subtle body sounds. It’s also an important teaching tool to help students learn to identify difficult to hear sounds. You will pay a little more for the advanced features on the Model 4200, but they are definitely worth the investment for many practitioners.

Littmann® Electronic Stethoscope Model 4100WS with Ambient Noise Reduction

The Model 4100WS is an advanced electronic stethoscope that comes with digital signal processing and 3M ™ Sound Analysis Software. With this auscultation system you can save, store, and playback heart and lung sounds. You can even send recordings of body sounds to your PC, handheld device, or 4000 series Littmann scope with an infrared transmission. Phenocardiograms give you a way to view recorded sounds to help with analysis.

The excellent sound quality of the Model 4100WS provides 18 times the amplification of a quality acoustic stethoscopes and Ambient Noise Reduction of up to 75%.  Three frequency modes give you maximum flexibility for listening to heart, lung and other body sounds: Bell (20-200 Hz), Diaphragm (100-500 Hz), and Extended Range (20-1000 Hz).

Compared to the other models, the electronics on the 4100WS are a little more noticeable. However, the interface is still easy to navigate, and the heart rate is conveniently visible on the LCD screen. This stethoscope is an excellent choice for diagnostic settings, telemedicine, and teaching. Although it is the most expensive model, the price is an investment for a truly impressive and versatile auscultation system.

P.S. If you missed the earlier posts, make sure to go back and check out Part 1 of the Buyer’s Guide to learn about the 3M Littmann cardiology scopes and Part 2 for a comparison of the other 3m Littmann acoustic stethoscopes.

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