Stethoscopes may be one of the most common pieces of medical equipment, but that doesn’t mean buying the right stethoscope is simple. With quality ones costing $100 or more, it’s a big decision and one whose repercussions can last your career.
This guide will walk you through important considerations when stethoscope shopping, from the history of the device to smaller details to consider.
History of the Stethoscope
Derived from the Greek words “stethos,” meaning chest, and “skopein,” meaning to view or see, stethoscopes originated in 1816 when French physician Rene Laennec rolled up a piece of paper into a tube and discovered that it provided a better sound than simply placing one’s ear against a patient’s chest.
A quarter-century later, George P. Camman created the first two-eared version. From there, the design underwent a few changes, but none as acoustically effective as Dr. David Littman’s. He patented his design in the early 1960s. Today, Littmann is still the most trusted stethoscope brand in the industry.
Parts of the Stethoscope
Important aspects of a standard stethoscope include the earpiece, the tubing and its length, the chest-piece and the shape. Stethoscopes now come in a choice of standard or electric. Although electric stethoscopes are state-of-the-art and look high-tech, they’re not necessary for everyone.
Typically a standard stethoscope will have two earbuds made of either silicone or rubber. Finding the correct fit will determine the quality of the sound the wearer hears. Depending on the brand and quality of the stethoscope, the device may come with different sized earpieces to ensure correct fit. (If they are not included, you can always buy a set of them online. They’re usually no more than $20.) Your ear pieces should fit snuggly, but they shouldn’t be so tight that they impede your hearing or drown out the patient’s internal sounds.
Stethoscope Tubing and Length
Stethoscopes come in a variety of sizes, usually between 22 and 31 inches (55-80 cm); the most common length you will find is 27 inches (70 cm). For some clinicians, length doesn’t matter, but keep in mind that the shorter the stethoscope, the closer to the patient you are. Most HCPs find that 27 inches provides enough length that both patient and provider can maintain their personal space.
Another factor to consider: your back health, especially important for nurses! With a longer length, you might find you don’t have to lean over as much.
And if you’re worried that longer stethoscopes might lend to worse sound quality, don’t be. Research from the National Institutes of Health doesn’t bear out this common assumption.
Tubing quality is another important consideration. Most moderately priced stethoscopes ($60 to $80) have tubing that will last. Cheaper options ($15 to $30) may have thinner material, be more susceptible to cracking and wear out sooner.
Stethoscope Chest Piece: Diaphragm and Bell
There are two important parts of the chest piece of a stethoscope: the diaphragm and the bell. The diaphragm is flat and picks up high-frequency sounds, such as those made by the heart, lungs or bowels. It’s also great for obtaining a blood-pressure reading with the help of a sphygmomanometer. Some basic stethoscopes, in fact, only have a single-sided chest piece with a diaphragm.
In dual-sided versions, the smaller, curved side of the chest piece is the bell. It excels at picking up low-frequency sounds, such as heart murmurs or bruits, as well as high-frequency sounds in pediatric patients.
One of the coolest innovations (no pun intended!) with these pieces is that they now come in hypoallergenic material in some models. Freezing metal against a patient’s bare chest could soon become a thing of the past.
Most stethoscopes are two-eared and comprise a single tube with a round chest piece at the end. But there are other shapes to choose from. For example, if you conduct a lot of blood-pressure readings, you may consider one with a flatter, more oval chest piece, as this shape can more easily slide under a blood-pressure cuff. Note that chest-piece shapes do not usually affect the sound quality, so feel free to choose based on personal preference.
Best Stethoscope for Your Profession & Specialty
Depending on the field you work in, you may have different requirements for a stethoscope. For example, some clinicians only need a simple stethoscope that can pick up basic heart, lung and bowel sounds. Others, especially those specializing in cardiology, need to hear a greater range of frequencies only audible with a more advanced device.
Best Stethoscopes for RNs
If you’re a registered nurse in a hospital or an outpatient setting, you should consider a good-quality, basic stethoscope. The 3M Littmann Classic III is a top-rated, mid-priced stethoscope that will suit your needs for basic assessments — and it will last.
If you work in cardiology, consider buying a stethoscope that’s got your specialty in its name. Littmann’s 3M Cardiology IV has more than 2,000 five-star reviews on Amazon. One nurse praised its acoustic sensitivity and sound clarity, no matter how much the amount of background noise present. It’s pricey, but it will allow you to hear subtle changes in arrhythmias and more.
Best Stethoscopes for Advanced Practice Clinicians
PAs and APRNs make autonomous treatment decisions more often than RNs. For this responsibility, a top-of-the-line stethoscope, like the 3M Littmann Master Cardiology, will come in quite handy. It doesn’t have a bell, but you can tune the diaphragm to pick up low or high frequency sounds with a simple pressure change. The Master Cardiology also includes an adapter for infant or pediatric auscultation and costs around $200.
Best Cardiology Stethoscopes
Regardless of your title, if you work in cardiology, you can’t go wrong with the 3M Littmann Master Cardiology. But if you don’t want to spend $200, consider Littmann’s 3M Cardiology IV. You will save $50 without sacrificing device capabilities or sound quality.
Best Stethoscopes for Nursing or PA Students
Nursing and PA school teaches students about a range of populations and specialties, so a versatile stethoscope is crucial. For example, the 3M Littmann Classic III Monitoring stethoscope will work well, thanks to its tunable diaphragm. Use it for physical assessments, diagnoses and patient monitoring. It costs $90 on Amazon. MDF is another popular brand among students because it’s more affordable. Most of their products run from $25 to $55.
Best Stethoscopes for Pediatric Providers
Imagine yourself as a scared, sick child being poked and prodded in an unfamiliar environment. For these kiddos, a less intimidating stethoscope can make a big difference. The adorable ADC Adscope Adimals 618 Pediatric Stethoscope‘s interchangeable animal designs for the chest piece are sure to prompt many smiles. Just be aware that a few Amazon reviewers noted the sound quality wasn’t as good as with other stethoscopes and it’s less effective on teenagers.
If you’re not as concerned with aesthetics, there are several other pediatric stethoscope options. Littman’s 3M Littmann 2122 Classic II Pediatric is the most popular for its balance of cost ($80), sound quality and durability. If catching even the subtlest sounds amid tons of background noise is crucial to your job, then consider the Welch-Allyn-Harvey pediatric stethoscope. At $420, it’s one of the most expensive stethoscopes out there, but you won’t need to buy another one for the rest of your career.
Best Electric Stethoscopes
If you need an electronic stethoscope, hopefully your employer reimburses you! They can cost up to 10 times the amount of a standard stethoscope. The Littmann 3200 BK, $420, can amplify sounds up to 24 times while eliminating 85 percent of ambient noise. Thinklabs One Digital Stethoscope, $500, only has a diaphragm and works with headphones. On the relatively affordable end, there’s the Eko CORE Digital Stethoscope for $250.
Tips for Buying a Stethoscope
Buying your a new stethoscope may be intimidating, but here are a few tips and tricks to finding your perfect match.
1. Don’t go overboard.
If you are in school or training, ask your instructors for recommendations. You discover you can borrow one. If you’re working, learn about the type of stethoscope you need and get one that will last — but that doesn’t mean buying the most expensive one out there. Unfortunately, stethoscope theft is common. Chances are you’ll leave it at work at least once and you won’t always get it back.
2. Choose a color that will stand out.
The most common colors of stethoscopes are black and blue, which means your stethoscope will look like 65 percent of your coworkers’ if you choose these colors. In addition to picking a stand-out color, consider engraving it with your name.
3. Consider your retailer carefully.
If you ask around, you may learn a local store provides discounts for health professionals or your employer. There are also plenty of online retailers that cut prices during Nurses’ Week and other holidays. Just check the reviews before making an online purchase since you can’t try it on — Amazon contains a wealth of knowledge. And don’t buy from a site you’ve never heard of without doing additional research. The reason for their low prices could be that they sell knock-off devices.
4. Don’t forget the carrying case!
Stethoscope carrying cases are practical — they keep your device clean and protected — and they’re another opportunity to show off your personality. They come in different colors and patterns and rarely cost more than $20.
Whether you’re just starting your healthcare career or you’re a seasoned HCP, buying a stethoscope can be stressful. But knowing the basics, outlined here, and doing a little research on your own will ensure that you don’t have to go through this process all over again for quite some time.
Stethoscope History, Littmann.
Anatomy of a Stethoscope, Littmann.
Last updated 2/11/2020