HSWT

Stethoscopes

No, this will not be a discussion of the history of stethoscopes, or why or if they're still useful. I think they are, and will be for the foreseeable future, at least for some purposes. So no, this will about which is the best stethoscope, using data and numbers, so watch out.

As anyone who knows me can attest, I like data and information and evidence. There's not as much out there about stethoscopes as you might think, but I've collected what I've found over the years. There are really only two places I've found anything that looks like relatively objective evidence about stethoscopes.

http://www.forusdocs.com/reviews/Acoustic_Stethoscope_Review_page7.htm.

https://www.ncbi.nlm.nih.gov/pubmed/1597610

For the second, I've never actually found the full article and have to go off the abstract, (feel free to send it to me if you have it).

End result is that the most popular (which is probably why it's considered the standard, and not because it's actually the best stethoscope) is the Littmann Cardiology III (now replaced with the Cardiology IV, although the diaphragm of mine keeps falling off).

If you have the time and interest in really hearing different sounds, Welch-Allyn scopes are probably the best and clearest, although not the loudest. They have 3 versions, the elite, the DLX, and the DLX triple head. The differences here are my own views plus those of some folks I spoke with.

Elite

-bell is easier to use, doesn't catch lowest frequencies

-diaphragm is non-chill (patients appreciate this!)

DLX

-bell is great, takes practice to use

-diaphragm has great resolution

-lack of non-chill rim

DLX Triple Head

-all of the above, plus can be used as a mace

All of these have an interchangeable pediatric diaphragm, which as a MedPeds physician I really appreciate.

There are a number of stethoscopes which are reportedly phenomenal, but they are no longer being made. These include the Littmann Cardiology, Littmann Cardiology II (not SE), and the Hewlett-Packard (later Phillips) Rappaport-Sprague. You can apparently find them on ebay periodically (although I just checked and the Rappaport-Spragues go for $500+, so may just want to go with the Littmann for this category).

TL;DR

-Welch-Allyn DLX is my favorite stethoscope, although a little heavy, the Elite is a very reasonable second

-Welch-Allyn DLX Triple Head can be used as a military flail (which apparently weren't real things, who knew?)

-Littmann Cardio III or IV are probably decent to start with, easy to use, reasonably loud, but probably will miss subtle findings