Intro to Your Stethoscope

Well, to be more accurate, let's call this blog "An intro to using your scope for the first time." Although most of our scopes and all of our professional models come with detailed instructions for use, we’d like to provide a more personal tutorial on using and wearing your scope.

Okay, so you've purchased your first stethoscope. Let’s face it, you've probably played with it a bit, but now it's time to get down to business. How do you use the darn thing? Wait, how do you even wear it?

Before you start any auscultating, let's just briefly point out how to wear a scope during use. A proper fit is essential for optimum performance.

Wearing your scope for use

For most of our Adscope series, the binaurals are fixed at a 15° angle forward. Insert the earpieces so that they point forward towards the bridge of the nose. That will ensure the eartips fill the ear canal allowing for an uninterrupted sound pathway, and a snug aural fit to block outside noise. If you position them backwards, the earpiece will actually rest against the Cymba cavity, obstructing transmission.

On scopes with rotatable binaurals (Adscope 641 series, all Proscopes), you’ll want to rotate the aural tubes slightly and evenly to obtain that same, or an even more customized fit.

Once in your ears, check the fit and comfort of the eartips and headset. Most scopes include multiple pairs of eartips, typically of different sizes, often of different materials and consistencies. Select the size and style, that provides a snug but comfortable fit. On our Adscopes, we provide the small set of Adsoft eartips on the scope. On models equipped with additional pair, you will get a slightly larger set in an accessory kit. If there’s a third pair of Adsoft, it will be of the smaller size (Some models include a firmer pair of earpieces.)

Now, check the tension of the spring that holds the headset to your ears: too loose and it will not make a good seal; too tight and it will get awfully uncomfortable fast. You can increase tension by squeezing on the headset near the tension spring. To reduce tension, flex gently as shown in the diagram. Remember, you’ll be wearing your scope on and off, all day, every day, so make sure it’s comfortable.

Selecting and using the chestpiece

If you have a dual-head (combination diaphragm/bell) chestpiece, you will select (or index) one side while deselecting the opposite side. Some scopes have an indicator dot, while others have a slight bend in the stem that indicates which side is in action. Gently tapping on the chestpiece (first one side then the other) will show you which side is active. Eventually, you’ll just “know” which side is in operation.

To use the diaphragm, apply sufficient pressure to just slightly deflect its surface. You'll know when optimum pressure is applied as the sound will be markedly louder and clearer. To use the bell, you want to apply just enough pressure to make a seal, but no more.

If you have a scope with AFD technology, you’ll have to learn how to alter your touch – the pressure you apply – in order to adjust the frequency response of the AFD diaphragm. A light touch will transmit lower frequencies, similar to the bell side of a traditional chestpiece. Firmer pressure will transmit the higher frequency sounds, similar to the diaphragm side of a traditional chestpiece.

Regardless of which technology is featured in your scope, practice on yourself until you get comfortable with its use. (Remember to practice with care; try not to twist the tubing and headset in whays for which it wasn't designed, which may dislodge the eartips from a proper seal, or kink the tubing, which may obstruct sound.)

Carrying your scope

Finally, a tip on wearing your scope – when not in use, most of you will wear it by wrapping it around your neck. ADC scopes tend to be fairly well balanced so they’ll mostly stay put. Try to keep the tubing over your shirt collar, as skin oils will cause the tubing to harden. Also, remember to check any fittings on the scope regularly (chestpiece, earpieces). Over time and with constant rubbing against your clothing, these fittings might come loose and even fall off.

So you're ready to auscultate

You’re finally ready to actually start using your stethoscope. Check out the auscultation section of our Learning Center to get started. Note the link at the bottom of the section to the UCLA Auscultation assistant, which provides excellent audio samples of virtually every heart and lung sound pathology. Good luck with your purchase and have fun.

Further reading

The Stethoscope section of our Learning Center, with articles about the anatomy of a scope, the history of auscultation, and how to care for your scope.