Thursday, January 1, 2009

Electronic Stethoscope Oddities

Happy New Year!

If acoustic stethoscopes — the kind physicians have used for over two hundred years — are the equivalent of typewriters, then electronic stethoscopes are like word processors. Okay, this analogy is non-intuitive, but hear me out. Electronic stethoscopes, like word processors, are newer, more expensive than the previous generation, and are — well — electronic, with all the advantages and disadvantages this implies.

The advantages to electronic stethoscopes are many. As I've written previously in my review of the Littman Electronic Stethoscope Model 3000, it's simply easier to hear heart and lung sounds with an electronic stethoscope than it is with an acoustic stethoscope. (For real-world examples of this, see the previous review.) Plus, some models, like the Littmann 4100 Electronic Stethoscope, allow you to record and playback — think copy and paste — heart and lung sounds for reference or teaching.

But anything electronic is prone to failure, and when electronic stethoscopes fail, they fail spectacularly. Don't misunderstand: I'm a fan of my Littman Model 3000, but it's worth pointing out the oddities you should expect if you decide to purchase one of these things. (Some of these observations are taken from my postings on Twitter.)

First — and this might sound obvious — the electronic stethoscope requires batteries. Eventually, these batteries will die. Unexpectedly. At exactly the wrong moment. Almost certainly, when you're examining a patient. At this time, your electronic stethoscope will make a sad little noise, then — silence. An eerie silence. And unless you're walking around with an extra AA battery in your pocket — which you will suddenly realize is probably a good idea — you will then say, apologetically, "I'm sorry. The battery in my electronic stethoscope just died."

Second, if you carry around an iPhone or a BlackBerry, you will experience intermittently the faint faraway static of your mobile device as you're listening to the heart of a patient. And while this doesn't interfere with your physical exam, it's unnerving.

Finally, if you were planning to place another type of diaphgram on your electronic stethoscope — such as the excellent SafeSeal stethoscope covers by DRGdon't. It will cause unbelievable amounts of feedback. As I learned recently, placing incompatible diaphragms on electronic stethoscopes makes your patients' hearts sound like they're being played by Jimi Hendrix.

(Also posted on Tech Medicine.)