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.

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.

Leave a comment below to help other buyers by sharing your experience buying or using a stethoscope.

Let’s say you need a stethoscope but you aren’t interested in a cardiology-grade scope. That doesn’t mean you have to settle for inferior quality or acoustics! 3M Littmann offers several models of Classic II and Select stethoscopes sure to meet your needs. Each stethoscope exemplifies the hallmark Littmann quality and attention to detail.

3M Littmann Master Classic II Stethoscope

The Master Classic II gives you the best acoustics available without the price tag of a cardiology scope. The single-sided, ergonomic chestpiece is great for healthcare providers who spend considerable amounts of time using their stethoscopes and will appreciate the award winning, easy-to-hold design. Nurses and EMTs report that the Master Classic II fits more easily under blood pressure cuffs than other bulky, two-sided models. You will still be able to use the bell mode thanks to Littman’s tunable diaphragm. The Master Classic II comes with a three year manufacturer’s warranty.

3M Littmann Classic II Pediatric Stethoscope

The Classic II Pediatric Stethoscope will give you the greatest versatility when working with children. The child-sized bell and floating diaphragm on this dual-head scope will give you the highest acoustic sensitivity for listening to your smallest patients. The kid-friendly tubing colors guarantee that your pediatric patients will love your scope as much as you do! The Classic II Pediatric Stethoscope comes with a three year manufacturer’s warranty.

3M Littmann Classic II S.E. Stethoscope

If you are looking for a traditional, dual-head scope, consider the Classic II S.E. Stethoscope for excellent acoustics and versatility. You can use the diaphragm on one side and the bell on the other side, or take advantage of the tunable diaphragm to switch between low- and high-frequency sounds without turning the chestpiece over. Three year manufacturer’s warranty.  The Classic II S.E.is a great choice for general practitioners, medical students, and nurses.

3M Littmann Lightweight II S.E. Stethoscope

Don’t want a scope that will drag you down? The Lightweight II S.E. Stethoscope is a great entry-level, lightweight scope with clear acoustics. Another plus is the unique chestpiece design that’s easier to orient around blood pressure cuffs and body curves. The chestpiece features a traditional bell on one side and a tunable diaphragm on the other. Two year manufacturer’s warranty.  The Lightweight II S.E. is ideal for nurses and EMTs doing basic auscultation who don’t want to invest in a more pricey scope that’s too heavy anyway.

3M Littmann Select Stethoscope

The Select Stethoscope may be Littmann’s most affordable scope, but it will still give you reliable acoustics. Designed for basic auscultation, the Select is a high-quality alternative to second-rate nursing and sprague scopes. The lightweight design and convenient single-sided chestpiece make this scope easy to use and carry, so it’s perfect for nurses, EMTs, and entry-level users. The tunable diaphragm gives you the versatility of both bell and diaphragm mode without the bulk of a dual-head scope. The Select comes with a two year manufacturer’s warranty.

Pondering Prices

The Classic II S.E. is priced somewhat lower than the Master Classic II and the Classic II Pediatric. For an even more affordable scope go with the Lightweight II S.E. or the Select.

How important is the price tag? You have to factor in how you will be using your scope and how long you expect it to last you. If you’re an EMT and you know there’s a fair chance your stethoscope will get lost during a rescue operation, consider buying one of the cheaper models that will still give you reliable acoustics. But don’t compromise your standards just to save a few dollars if you expect to hold on to your scope for years – the superior quality of the acoustics in the high performance stethoscopes will more than justify the initial investment.

If you’re looking for something more than a traditional acoustic stethoscope, don’t miss the final installment of the 3M Littmann Stethoscope Buyer’s Guide for a discussion of Littmann’s innovative electronic scopes. Read Part 1 of the Buyer’s Guide to learn about the cardiology scopes. Share your own tips with other buyers by leaving a comment about your experience choosing a stethoscope.

This time, we’ll compare the high-performance cardiology stethoscopes. Check back soon for a guide to the Littmann Classic II and Select models, as well as a look at the new electronic stethoscopes.

3M Littmann Cardiology III Stethoscope

The Cardiology III is probably the most popular Littmann stethoscope out there. General practitioners, pediatricians, medical students, EMTs and nurses will tell you they wouldn’t trade in their Card III for the world. Why does everyone love this stethoscope? The Cardiology III provides excellent acoustics, both in terms of loudness and clarity. What sets it apart from the other Littmann cardiology scopes, however, is its impressive versatility. It has a double head with a tunable diaphragm on each side – the large side for adults, the small side for children. The smaller diaphragm also works well for irregular surfaces, such as bony patients. The hallmark Littman tunable diaphragm allows you to hear low- and high-frequency sounds without turning the chestpiece over. Use light pressure on the chest piece to hear the low-frequency sounds (bell mode), and firm pressure to hear the high-frequency sound (diaphragm mode). The Cardiology III can also be converted to a traditional bell by replacing the pediatric diaphragm with a bell sleeve. The Cardiology III comes with a five year warranty.

Is this the right stethoscope for you? If you are ready to invest in a Littmann cardiology stethoscope, you will be rewarded by the superb acoustics of the Cardiology III. And if you are looking for a versatile stethoscope that is suited to examining any type of patient, this is your scope.

3M Littmann Cardiology STC Stethoscope

The Cardiology STC, or “Soft Touch Cardiology,” also delivers outstanding acoustics, as you would expect from any Littmann cardiology stethoscope.  In addition, the innovative chest piece is specially designed to be easy to hold in various hand positions. The unique shape of the Cardiology STC chest piece facilitates movement between auscultation sites. The single-sided, tunable diaphragm enables you to easily switch between the bell and diaphragm mode without the bulk of a double-sided scope, like the Cardiology III. EMTs and nurses appreciate that the sleek design of the Cardiology STC fits under blood pressure cuffs more easily than a dual-head stethoscope. The Cardiology STC comes with a six year warranty. If you are working primarily with adults, and looking for unparalleled acoustics and ease of use, the Cardiology STC was made for you.

3M Littmann Master Cardiology Stethoscope

The Master Cardiology is Littmann’s top-performing acoustic stethoscope. With superior acoustics and a 10 out of 10 Littman performance rating, this stethoscope is ideal for users who want the greatest diagnostic precision. Similar to the Cardiology STC, the Master Cardiology offers the convenience of a tunable diaphragm in a single-sided chest piece. The classy, hand crafted stainless steel   definitely makes a statement and is also easier to hold than a dual-head. A special procedures adaptor is ideal for difficult sites or pediatric use. The Master Cardiology comes with a seven year warranty - the longest Littman warranty available. The Master Cardiology may be what you’re looking for if you need the best acoustic stethoscope available for high-performance auscultation.

The difference in price between these three models is slight, so base your decision on the design and features that are most important to you. Whether you select the versatility of the Cardiology III, the ergonomic design of the Cardiology STC, or the top-of-the-line acoustics of the Master Cardiology, you can be confident that your new Littman cardiology stethoscope will serve you well for many years.

Not sure these are the right scopes for you? Check back soon for the 3M Littmann Acoustic Stethoscope Buyer’s Guide: Part 2 to learn about the Littmann Classic II and Select models.

Share your stethoscope advice below by leaving a comment. Which model do you find works best for your field?