Ok, so we maybe don’t need to as far as to ban them altogether, they have their uses, but I refuse to recommend them to anyone. The dreaded Sprague Rappaport style stethoscopes are those funky looking stetho’s draped around the necks of every nurse and doctor on Scrubs and many other medical shows.
One of the first things any beginning nurse asks is “what stethoscope?”. some decide to commit to the large investment from the beginning with a Littmann or other high-end stethoscope, but for the rest of us that can’t justify $600+ on some rubber tubes and tiny drums, we go searching for something a little more price convenient.
This is where things start to go awry. Time again I see young student nurses buying the Sprague Rapport style stethoscopes. I don’t blame them of course. The stetho’s are cheap, readily available, and so prevalent in television and movies that we get the impression they’re what the pro’s use. But this is far from the truth, so I’ll be clear;
No student nurse or doctor should buy a Sprague Rappaport Stethoscope under any circumstances.
It’s not that I have any particular beef with the designer (ok, maybe a little bit), or the companies selling them. They are cheap, disposable enough that it’s not a tragedy when they are damaged or lost. But they will only hinder you as a student rather than help.
Some will think I’m being a bit harsh on them, but I too fell into the trap of buying one of these when I started my nursing studies, and I often dream of how much easier nursing school would have been without it.
So, what’s the problem?
The reason I don’t recommend these to students is because they are extremely prone to interference and external noises. When you’re a student, you don’t know what to listen for and so minimising as much external noise as possible is essential to hearing what your demonstrators are trying to show you. Even more important during clinical placements when you’re auscultating real patients.
They are prone to interference purely as a result of their design. Unlike most other styles of stethoscope, they have two separate tubes, one for each ear, where others have either a single tube, or single tube with two lumens (holes) for each side. As these two tubes move around and hit each other, they produce a rather loud noise within the stethoscope which will make hearing faint breath sounds, or cardiac murmurs extremely difficult for a qualified nurse, let alone when you’re not sure what to listen for.
When you combine this with the possibility that your patient may not want to hold particularly still (trauma, dementia patients or paediatrics are common contenders) and you’ll be slapping those tubes together like a drummer smashing out a wicked solo.
What do I recommend?
I have a dedicated article on which stethoscopes are the best option for students, but for now, just don’t get a Sprague Rappaport style one. Whatever you choose, your first stethoscope should be a relatively cheap but reliable model that will last you through your studies, without breaking the bank.
Linking your recommendation article would have been nice, since I can’t find it. Also, the sprague gets a bad rap, and this just feels like “pile on the sprague”. Tube noise is overblown, and most noise comes from your hand as you’re learning how to position it and hold it steady. I mean, if 2 small lumens are good, 2 great big tubes should be fantastic, right?
I’d like to see some science on why 2 lumens are better, since there is only one source at the diaphragm. It’s not like listening in stereo. It’s the same sound going to both ears.