Pediatric Stethoscope: The Comprehensive Guide
Having the correct medical equipment for working with your patients is crucial for you in delivering good paediatric care.
The stethoscope is a simple, yet enduring and crucial medical device essential for the diagnosis of many diseases and conditions.
The pediatric stethoscope is a simply an adapted stethoscope designed to give you the best acoustics when caring for infants and young children. In paediatrics, misdiagnoses from transmitted sounds through using large adult stethoscopes is a common and dangerous pitfall.
While stethoscopes are simple instruments, all stethoscopes are not equal in durability, sensitivity, size, or function.
Pediatric stethoscopes are much like adult stethoscopes, except for a small difference in the size and shape of the chestpiece to allow for more accurate auscultation, and their availability in child-friendly shapes and colors. Here are the enduring favourites amongst pediatric physicians:
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The Background on Stethoscopes
All stethoscopes, including pediatric stethoscopes, are medical devices for amplifying the sounds generated by organs and processes inside the body.
Listening to sounds inside the body is called auscultation, and another name for stethoscope is phonendoscope.
Modern stethoscopes usually consist of a small disc at the end of a flexible tube.
The disc is covered with a taut, usually plastic, surface which resonates when placed over the heart, lungs, arteries, veins, or intestines.
The vibrations then pass up the tube to your ears in a, hopefully, airtight passageway.
The disc is connected to two earpieces, and the practitioner listens to the sounds through the devise.
Using a stethoscope to listen to the body is called mediate auscultation.
Listening to a patient’s body with the unaided ear is called immediate, or direct auscultation.
This involves placing your ear directly on the patient’s body.
Part of the reason the stethoscope was invented was because its male inventor wanted a way to examine female patients without getting too personal.
Stethoscopes were invented in 1816 at a hospital in Paris by Rene´ Laennec.
Early models were little more than a wooden tube which was placed on one ear for hearing sounds inside the patient’s chest.
Flexible tube stethoscopes with two earpieces came along by the early 1830s.
Another frequent use of stethoscopes is with sphygmomanometers for measuring blood pressure.
There are also specialized types of stethoscopes used by people in the machining and automotive industries for amplifying sounds inside engines and other mechanisms.
The word stethoscope comes from the Greek words for chest (stethos) and examination (scopos).
However, stethoscopes are used for listening to and examining sounds in the lungs, intestines, arteries and veins, as well as the heart and chest.
The Workings of a Stethoscope
All stethoscopes are relatively simple devices with about eight basic parts.
But here’s the deal, there are important differences in the quality of manufacture, the materials used, the sensitivity and accuracy of the acoustics, and the style, look, and feel of each model and manufacturer.
There are also differences in price, packaging, warrantee, and customer service.
These are the basic parts of all stethoscopes:
- The chestpiece is the metal disk you hold on the patient’s body. This part is most often made of aluminum, stainless steel, zinc, or titanium. The chest piece holds the next two parts.
- The diaphragm is part of the chestpiece which resonates and transmits the sounds. It can be single or double-sided. When the chestpiece is two-sided, one side is larger with a flat diaphragm and the other side is a smaller cup, known as the bell. The diaphragm snaps in place.
- The chill ring is a flexible ring stretched around the edge of the chest piece. It forms a seal against the patient’s body and is also warmer to the touch for the patient than the bare metal of the chestpiece.
- The stem is the piece connecting the chestpiece and the earpiece tubing. It is made of a flexible material like rubber.
- The acoustic tubes are the two flexible tubes going to the earpieces. The tubes can be made of rubber, PVC, silicone, or neoprene.
- The headset is at the top of the acoustic tubes and is usually made of thin, flexible metal. Some headsets are adjustable to fit different size heads.
- The ear tubes start at the end of the flexible acoustic tubes and are also usually made of metal. Some ear tubes are brass plated.
- The earpieces, also known as the ear tips, thread onto the ends of the ear tubes and fit inside your ears. You can choose from a wide selection of materials and sizes in hard plastic and soft silicone types. You can also get custom-made ear tips, if you have a hard time finding ones that fit your ear canal.
Here’s the kicker…
Pediatric stethoscopes have all the same parts as other stethoscopes.
The main difference is in the size and contour of the chestpiece, diaphragm, and bell.
Pediatric models are also available in colors and shapes attractive to children, and even some adults.
When looking for quality in a pediatric stethoscope, the packaging can be a good tip off of how well the devise is made.
Lower quality instruments are often sold loose in a plastic bag, and better quality devices are packed in sturdy boxes filled with an insulating packaging material cut-out for holding the stethoscope securely in place.
Using a Pediatric Stethoscope
When using the right stethoscope correctly, you can distinguish between different areas within organs, for example the mitral, tricuspid, and aortic regions of the heart.
Having a stethoscope with good acoustics is important for being able to hear the small variations in sound in different areas of the body and for detecting abnormalities.
Sounds which are audible through a pediatric stethoscope can be low or high-frequency.
Higher frequency sounds directly vibrate the diaphragm.
Lower frequency sounds vibrate the skin, and these vibrations are more easily detected with the bell.
If the stethoscope you are using does not have a bell, but only a diaphragm, you can distinguish the frequencies by how much pressure you exert when pressing the chest piece on to the patient’s body.
Lower frequency sounds are more easily detected with a light touch and higher ones by pressing the chestpiece more firmly against the skin.
Bottom line when using a stethoscope is having parts that are airtight within the unit and which fit tightly in your ears and against the patient’s body.
Having this airtight system is crucial for getting the maximum accuracy from the device.
Stethoscopes for pediatric auscultation have a smaller bell which seals more tightly against the chest of your small patient.
The size of the bell in pediatric models is usually about one-inch and is optimal for conforming to the small contours of an infant or young child.
The design of pediatric models of stethoscope maximizes comfort for the patient and accuracy for the practitioner by providing superior acoustics for listening closely to sounds in the smaller body cavity of a pediatric patient.
Pediatric models also come in a wide range of tube colors which brighten the interaction between you and the youngster.
You can also choose a design with colorful animal models molded into the chest piece and a wide range of colors of tubing.
Easy-to-read name tags that clip onto the tube are also available and make you more accessible to your patients and other staff people where you work.
Pediatric stethoscopes are specifically designed for the greatest accuracy and comfort when working with pediatric patients.
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