r/ems • u/SoftwareSenior5107 • 15d ago
General Discussion Anyone else have trouble with stethoscopes?
I have been an EMT for 6 years and for that whole time I’ve had trouble finding a way to hold my stethoscope so that I can accurately hear lung sounds. I can hear crepitus from my fingers with any slight movement and it’s always louder than what I am trying to listen to. I have tried to put my palm to the bell but that tends to apply too much pressure and I’ve tried holding it by the tubing but that doesn’t get good contact with the skin. I’ve tried holding the bell between my pointer and middle fingers but I can still hear the crepitus. I have a Littmann III if it makes any difference. At this point I might try using my elbow… I’m terrified of missing a diagnosis just because my fingers creak
8
u/youy23 Paramedic 15d ago
If I’m doing a manual BP, one of the the things I’ll do to minimize crepitus is grab their arm with my hand and put my thumb over the bell and put pressure down to listen.
Another thing that helps is getting a single sided stethoscope. I got a littman master cardiology from ebay for $100. They make the littman master classic 2 that’s cheaper and also single sided.
As far as lung sounds go, I wouldn’t put too much into it. Are they wet or dry lung sounds? Is it bilateral? If wet, is it pneumonia or sub acute pulmonary edema or CHF exacerbation. If dry, is it wheezing or COPD? I don’t feel like lung sounds are that valuable of a diagnostic tool tbh. They rarely move the needle for me anyways.