Stethoscopes

Don't stress out about stethoscopes!

How to use a stethoscope with hearing aids and fitness to practice can cause a lot of unnecessary anxiety. One of the most helpful tips I have been given by other deaf and hard of hearing health professionals is not to stress out about auscultation. It's only a small part of our work and likely to be perfectly possible.

Electronic stethoscopes can be used with or without hearing aids, some can be used with a PDA to give a visual display and a tactile device is now available.

Depending on your pattern of hearing loss, a normal stethoscope may be adequate.

Do I need amplification?

I've had conflicting information about frequencies of heart and lung sounds from different manufacturers of electronic stethoscopes. Different models amplify up to different frequencies so check out the technical specifications.

Heart sounds are below 250 - 500Hz.

Heard through a stethoscope, normal lung sounds are below 1000 Hz. Wheezes can be higher than 1000 Hz  and tracheal sounds higher than 1500 Hz or even 3000 Hz. In children these can, unusually, be higher. (Pasterkamp H, Kraman S and Wodicka 1997, Respiratory Sounds,  American Journal of Respiratory and Critical Care Medicine 156:974-987)

If your hearing loss is significant at these frequencies, presumably you will need an electronic stethoscope.

Stethoscopes and hearing aids

For an excellent article about electronic stethoscopes see How to cope with scopes: Stethoscope selection and use with hearing aids and CIs [PDF]. (Rennert, N., Morris, B., and Barrere, C.C. (2004, February).The Hearing Review, 34-75.) HIGHLY RECOMMENDED!

There are many health professionals with experience of using these and other equipment on the NOISE mailing list and the AMPHL forum. My main sources of help. HIGHLY RECOMMENDED!

In brief, options are:

• Remove hearing aids and use amplified stethoscope

• Hearing aid in one ear, monaural tubing to other ear

• Use the telecoil in some hearing aids and cochlear implants

• Special ear tips and earmolds can be used over some hearing aids

• Headphones can be used over many hearing aids

• Direct audio input and patch cords can be used with some hearing aids and cochlear implants

More information and links about the interface between hearing aids and stethoscope here.

Before buying an electronic stethoscope, I'd suggest you:

• Read "How to cope with scopes"

• Seek advice from other health professionals with hearing loss (Post a question in the NOISE mailing list and contact us to link into the UK network). You may be able to try out someone else's stethoscopes as well.

• Pass "How to cope with scopes" to your audiologist as you may want to work together to interface hearing aids and stethoscope

• Arrange a trial period to "try before you buy"

Just like being a student again, it takes practice and time to become accustomed to your new stethoscope.