How To Use a Stethoscope

A stethoscope is an essential tool for any healthcare professional, as it allows us to listen to internal body sounds such as the heart and lungs. However, it can be difficult to know how to properly use a stethoscope if you are new to the field or are unfamiliar with the different parts and settings. In this blog post, we will provide a step-by-step guide on how to use a stethoscope, including information on the different parts of the stethoscope, the proper way to hold it, and how to adjust your exam technique for the best sound quality. Whether you are a student, a nurse, or a doctor, this guide will help you to become more comfortable and confident when using a stethoscope.

Step 1: Choose a Stethoscope

Choosing the right stethoscope can be a daunting task, especially if you are new to the field or are not sure what your specific needs are. However, it is important to choose a stethoscope that is best suited for your profession, as different types of stethoscopes are designed for different purposes. For example, a cardiology stethoscope is designed for use by cardiologists and other healthcare professionals who need fine-tuned auscultating abilities, while a pediatric stethoscope is designed for use on children and has a smaller diaphragm. Similarly, a digital stethoscope is ideal for those who need amplified sound and the ability to record and store sounds. It's important to consider what type of patients you will be working with, the type of sounds you will be listening to and your specific needs before choosing a stethoscope. It's also important to try different types of stethoscope and pick the one that feels comfortable for you. Some stethoscopes fit tighter in the ear canals and may bother some users. Wondering which stethoscope is right for you? Check out my post on the different types of stethoscopes or search my recommendations by profession. 

Step 2: Put on the Stethoscope Correctly 

Properly wearing a stethoscope is essential for both comfort and effectiveness. To begin, hold the ear tubes of the stethoscope in front of your face with the ear tips angled away from you. Next place the ear tips of the stethoscope securely in your ears and ensure that the tubing is not twisted. If you are having issues with pain, consider trying the various sizes that come with your equipment or consider adjusting the tension. The headset or ear tube tension refers to how tightly the stethoscope fits. Tension can be increased or decreased by squeezing the ear tubes together to increase headset tension and by pulling apart to decrease tension.

Step 3: Choose the Bell or Diaphragm

When using a stethoscope, it is important to know when to use the bell and when to use the diaphragm. The diaphragm is used for high-frequency sounds, such as those produced by blood flow and normal breath sounds. The bell, on the other hand, is typically used for low-frequency sounds.

Most double sided stethoscopes have a twist and lock mechanism allowing the user to switch between the diaphragm and bell. Always make sure you are in the correct position when listening with either side of the stethoscope.

It's also important to note that some stethoscopes come with a tunable diaphragm which allows you to alter sound characteristics in diaphragm mode by adjusting the pressure applied on the chest piece. It's always a good idea to use both diaphragm and bell when examining a patient, especially when performing a thorough cardiac exam. 

Step 4: Listen to Your Patient

Now that you have selected which side of the auscultation piece to use, it’s time to position yourself to take a listen. For the most clear exam, it is essential to place your instrument directly on the patient's skin. It can be tempting to skip this step and listen over the top of a hospital gown or clothes, however these barriers can significantly alter the sounds. Set good habits for yourself while you are a student and commit to doing a thorough examination.

When listening, it's important to not press too hard on the patient's chest, as this can reduce sound quality. Note that when using the bell, too firm of pressure and overly stretch the skin, causing a sound similar to the diaphragm. It's also important to note that the position of the chest piece will need to be adjusted depending on the area of the body being examined and the type of sound you are trying to amplify. For example, the chest piece should be positioned differently when listening to heart sounds compared to lung sounds. 

Step 5: Properly Store your Stethoscope

Always keep the chest piece clean and dry and avoid sharing your stethoscope to prevent the spread of infection. It is best practice to clean your stethoscope in between patients. Most stethoscope companies recommend using cleansers with 70% isopropyl alcohol solution and avoiding bleach.  It's important to note that different stethoscopes have different cleaning instructions, so be sure to check the manufacturer's instructions for your specific stethoscope. With a little practice and by following these simple guidelines, you will be able to wear and use your stethoscope comfortably and effectively.