Leaderboard

Thank you all for your comments and helpful hints Our service does provide a stethoscope in some cars, but for the most part we all supply our own stethoscope. The way I look at is, I really don't want to be putting something inside of my ears that another person has been using and just so happen to have not cleaned the inside of their ears in the past six months. when I was taking my PCP program, everybody in our class decided we wanted to order our own stethescope and I after some carful consideration and what my wallet would allow me to spend, I decided on the "Littmann Classic 2 SE" I figured it was in the middle of the road and was not too expensive, but expensive enough that I should be able to use it for a while without any problems. Again thanks for all of your suggestions and comments. As a new person to this forum and not sure how one will be taken when posting questions or adding their comments I find it great to see that people actually take the time to try and answer a question or even add a few suggestions. I can see that there are some really seasoned medics on this site with some real great advice, along with some funny comments (DwayneEMTP) which I find very entertaining to read. Looking forward to some more great discussions with all of you

Ummmm....don't go in!

ALL GIRL BIKER BAR An old, blind cowboy wanders into an all-girl biker bar by mistake. He finds his way to a bar stool and orders a shot of Jack Daniels. After sitting there for a while, he yells to the bartender, 'Hey, you wanna hear a blonde joke?' The bar immediately falls absolutely silent. In a very deep, husky voice, the woman next to him says, 'Before you tell that joke, Cowboy, I think it is only fair,Given that you are blind, that you should know five things: 1. The bartender is a blonde girl with a baseball bat. 2. The bouncer is a blonde girl. 3. I'm a 6-foot tall, 175-pound blonde woman with a black belt in karate. 4. The woman sitting next to me is blonde and a professional weight lifter. 5. The lady to your right is blonde and a professional wrestler. Now, think about it seriously, Cowboy. Do you still wanna tell that blonde joke?' The blind cowboy thinks for a second, shakes his head and mutters, 'No...not if I'm gonna have to explain it five times.' heheheheheheheheh I do luv a good blond joke

Ok, I've just got to chime in here.... I was taught (by an amazing instructor) many years ago that you place the B/P cuff about an inch above the antecubital region (the 'front part' of the elbow), and the palpate the brachial artery, and place the diaphragm of the stethescope over it, and lightly press on the stethescope. Begin to inflate the cuff until you cannot hear any 'thumps', and then increase the pressure 30 mm/hg. S-L-O-W-L-Y start to release the pressure in the cuff. As the pressure is being released, you will hear the pulse return, this will be your systolic pressure. As you continute to release the pressure, you'll end up 'losing' the pulse sounds. This will be your diastolic pressure. I will defend the use of the Sprague type stethescopes. I find them easier to hear with (especially in noisier situations). It is my personal choice. If you ARE using the Sprague type, remember the head of the stethescope will turn. I use the large diaphragm for lung sounds and blood pressures. Remember that there is a 'flat side' of the head fixture. This indicates which diaphragm is 'turned on'. This 'flat side' will be toward your patient. When using a stethescope that is 'single lumen', remember to keep your fat little thumb off the back of the head. I've noticed that those stethescopes are notorious for picking up YOUR pulse sounds from your thumb. Also remember that if you take a blood pressure in the left arm and aren't sure of what you heard, if you inflate that cuff again, you'll get a different reading than you initially had. I've seen people who inflate the B/P cuff to a minimum of 250 mm/hg or more rather than the correct way, and I want to auscultate a corotid B/P on them! It's not the proper way to do it, and causes the patient undue discomfort. As has been stated before, the earpieces should be comfortable and fit the ear canal, and the 'arms' on the stethescope shoud be angled slightly forward. This directs the sound into the ear canal, and you don't try to rush though the process because the ear pieces make your ears hurt. Practice is the key here. As you start practicing, do it in relatively quiet places, and then start to work with more noises (television, radio, other people talking; etc). This will help you hone the skill and be able to work in environments that are less than 'dead quiet'.