Home > Stethoscopes Information .:
Table of Contents
Introduction to Stethoscopes
- Stethoscopes & the Hearing Impaired Professional
- Factors for Successful Stethoscope Use
- Fine tuning of the hearing instrument
- Choosing the best stethoscope and appropriate interface
- Learning/relearning to distinguish body sounds
Stethoscope Articles
Stethoscope Links
______________________________________________________________________
Introduction to Stethoscopes
1) Stethoscopes & the Hearing Impaired Professional
With a hearing loss, the most obvious issue is whether you are able to appreciate heart, lung, and bowel sounds. Someone with a profound hearing loss cannot hear with a traditional stethoscope, but he can accomplish the desired result in an alternative way. So first ask yourself, "Can I use a stethoscope? If not, what are my options?" Many of us will need to select an amplified, electronic, or special stethoscope. Special stethoscopes include visual display stethoscopes, modified stethoscope setups, and tactile stethoscopes. More information on stethoscopes can be found on these pages. It is recommended that you either borrow an appropriate stethoscope or obtain one on a trial basis from a manufacturer so that you can be sure it is going to work for you before you invest a lot of money into it. Go to a medical school or hospital and ask if you can spend time with a cardiologist. Spend a few mornings or afternoons with the cardiologist and practice using the stethoscope. Ask what sounds you are supposed to identify. Remember that it takes years for a hearing medical professional to learn to distinguish and identify subtle sounds.
If you cannot hear with a stethoscope, inquire about other ways to auscultate important sounds. Are there visual and tactile clues on physical examination? Can you use other equipment which might not be used traditionally in this situation? For instance, there is a computer program called Stethographics which converts heart and lung sounds into a visual display; there is also a tactile stethoscope under development. Make arrangements to test these alternative systems on patients at a hospital. Keep in mind that many people reject the possibility of alternatives simply because they cannot imagine a different way of doing things. It is up to you to challenge these assumptions and find solutions.
2) Factors for Successful Stethoscope Use
Successful stethoscope use is a very important issue for medical professionals with hearing loss. Optimal stethoscope use depends on three important factors:
- Fine tuning of the hearing instrument:
- Programming hearing aids to emphasize lower frequencies
- Creating cochlear implant maps that eliminate room noise, emphasize lower frequencies, and lower the threshold for sound detection.
- Choosing the best stethoscope and appropriate interface:
- BTE hearing aids
Some behind the ear hearing aid models have direct audio input or silhouette capabilities that allow for direct interface with stethoscopes that have output jacks such as...
 
(Images courtesy Becky Morris)
...the Starkey ST3 stethoscope (left) or the Cardionics E-Scope II (right).
 
(E-Scope II photo courtesy of Cardionics)
Dual canal earmolds can also be modified so that the binaurals of the stethoscope will fit into the second canal (the "vent") on the earmold. These figures are courtesy of Steven Applebaum, DO and are a part of his article:
Applebaum, S. (2003). Stethoscope use without behind-the-ear hearing-aid removal. Journal of the Association of Medical Professionals with Hearing Losses, 1(3).
 
- CIC/ITE hearing aids
Stethoscopes can be used with completely in the canal (CIC) and in the ear (ITE) hearing aids by interfacing through headphones or special earmolds:
E-Scope II belt model with headphones
Bob Mendoza stethoscope/stethoscope amplifier with headphones
Labtron Electromax stethoscope (minus binaurals and tubing) with headphones
Special stethoscope earmolds like this one from Westone (photo courtesy Westone) are also an option
- Bone conduction hearing aids (The images within this section are all courtesy of Amie Osborn. For more detail on these stethoscope setups, visit Amie's website http://www.treachercollins.org)
Stethoscopes can be used with a bone conduction hearing aid by interfacing through an FM receiver:
Bone conduction hearing aid with Lexis FM receiver attached via a boot
E-Scope II and Lexis FM transmitter
Bone conduction hearing aid with TMX telepin attached via a boot
Modified Philips Stethoscope and FM receiver with TMX neckloop
Bob Mendoza Stethoscope/Stethoscope Amplifier and FM receiver with TMX neckloop
- Cochlear Implants
Stethoscopes can be used with cochlear implants by interfacing through a patch cord or a silhouette such as the HATIS headset:
E-Scope II attached to Clarion Platinum series speech processor via a patch cord
Bob Mendoza stethoscope/stethoscope amplifier attached to Clarion S-Series speech processor via a patch cord
E-Scope II attached to a HATIS headset which is placed on the ear beside the Nucleus BTE speech processor. The HATIS headset transmits sound to the Nucleus BTE telecoil (Photo courtesy Nghi Lu)
E-Scope II attached to Nucleus BTE speech processor via a patch cord
(Photo courtesy Nghi Lu)
- Alternative stethoscope options (PDA photo and tactile stethoscope photo courtesy of Cardionics, PDA/E-Scope II photo courtesy of Stethographics)
For individuals with a very profound hearing loss (or individuals who desire to supplement what they are hearing through a stethoscope), a visual display or a tactile stethoscope is an option:
Stethographics visual display software on a PDA can be hooked up to a stethoscope with an output jack such as...
...the E-Scope II. The E-Scope II and the Stethographics software on a PDA can be purchased as a package from Cardionics
Cardionics currently has a tactile stethoscope under development. Once available, it will be sold through Becky Morris at Beyond Hearing Aids
- Stethoscope accessories
Direct Audio Input (DAI) boots allow stethoscopes with output jacks to be directly interfaced (via a patch cord) to some behind the ear hearing aid models. The DAI boot is the center component in between the hearing aid and patch cord. Consultation with an audiologist is recommended, these DAI boots must be ordered through your audiologist.
(Photo courtesy Becky Morris)
http://amphl.org/images/silhouette.jpg
Silhouettes such as the new HATIS headset allow stethoscopes to provide a sound signal to the telecoil on some behind the ear hearing aid models or behind the ear cochlear implant speech processors. The HATIS headset can be ordered through Beyond Hearing Aids
(Photo courtesy Becky Morris)
Patch cords allow for direct interface between stethoscopes and hearing aids/cochlear implants. These can be custom made by Bob Mendoza to fit all kinds of unique situations.
3) Learning/relearning to distinguish body sounds
:. Cardionics' Student Auscultation Manikin
:. Cardionics' Learning CD's
:. Stethographics' Learning CD's
:. The Auscultation Assistant
:. The R.A.L.E. Repository
For additional detail on the above three important factors, see:
Rennert, N., Morris, B., and Barrere, C.C. (2004, February). How to cope with scopes: Stethoscope selection and use with hearing aids and CIs [PDF]. The Hearing Review,34-75.
Stethoscope Articles
Articles are arranged in alphabetical order by author. Some articles may require Adobe® Acrobat® Reader®. Download Adobe® Acrobat® Reader® if you do not have it.
Applebaum, S. (2003). Stethoscope use without behind-the-ear hearing-aid removal. Journal of the Association of Medical Professionals with Hearing Losses, 1(3).
Barrere, C.C. (2003). Books and CD's for Learning to Interpret Stethographics Waveforms. Journal of the Association of Medical Professionals with Hearing Losses, 1(2).
Fabry, D.A. (1993). Clinical and Communication Access through Amplification for a Medical Student with Severe Hearing Loss: Case Report. J. Amer. Acad. Audiol. 4, 426-431
Morris, R. (2001). "HOW TO COPE WITH SCOPES" or 'Stethoscopes and Hearing Aids - What are the Options?[/url]' BeyondHearingAids.com
Rennert, N., Morris, B., and Barrere, C.C. (2004, February). [url=http://amphl.org/articles/rennert2004.pdf]How to cope with scopes: Stethoscope selection and use with hearing aids and CIs [PDF]. The Hearing Review,34-75.
Stethoscope Links
Below is a list of links to amplified, electronic, and visual display stethoscopes. If you wish to read more about how to utilize these stethoscopes, please go to the general stethoscope information section of the AMPHL website.
Please note that some of the following websites are distributor websites. These distributor websites are included because some manufacturer websites do not contain as much product information on their stethoscopes as these distributor websites. In this case, the manufacturer websites have also been listed so that you can order directly from them if you choose.
Stethoscopes
:. Master Elite Electronic Stethoscope by Welch Allyn
:. Littmann 2000 Electronic Stethoscope by 3M
(Manufacturer: 3M)
:. Littmann 4000 Electronic Stethoscope by 3M
(Manufacturer: 3M)
:. Starkey ST3 Amplified Stethoscope by Starkey Laboratories
(Manufacturer: Starkey)
:. Philips Electronic Stethoscope by Philips Medical Systems
:. E-Scope II Electronic Stethoscope by Cardionics
:. Adscope 655 by American Diagnostic Corporation (Only available through distributor: Hopkins Medical)
:. ElectroMax Stethoscope by Graham-Field
:. Echo+Plus by Doctors Research Group
:. Electronic Stethoscope ES-100 by RES-Q Products
:. Androscope i-stethos by Andromed
:. ds32a by Thinklabs Medical
Stethoscope Earmolds
:. Earmold Design, Inc.
:. Westone
:. Precision Laboratories, Inc.
Patch Cords
:. [url=mailto:robm_94928@yahoo.com]Robert Mendoza[/url]
4404 Hollingsworth Ct
Rohnert Park,CA 94928
(707)-585-0609 V
http://www.cihais.com
|
