How to Choose the Best Littmann Stethoscope

Choosing the right stethoscope can be daunting. With so many brands, models, and even colors to choose from, it's not always easy to make an informed decision. This guide is designed to help medical students and healthcare professionals find the stethoscope that best fits their specialty, setting, and budget.

The Best Ways to Choose a Stethoscope

• Determine Your Requirements & Uses
• Listen, See, & Feel
• Trust Your Colleagues & Instructors
• Do Your Research
• Look for Special Offers

Stethoscope History

The stethoscope was invented in Paris, France in 1816. French physician René Laennec rolled up a sheet of paper, placed one end to his ear and the other to his patient's chest, and noted that the sound of the heart was amplified. Laennec named his invention the "stethoscope," from the Greek stethos (chest) and skopein (to examine).

In the early 1850s, New York physician George P. Cammann developed the first widely used stethoscope with two earpieces. This binaural design remained in use for more than 100 years with very few changes.

In the early 1960s, Harvard Medical School professor Dr. David Littmann introduced a stethoscope that was lighter and offered much-improved acoustics. Since then, Littmann® has continued to refine the design, introducing the tunable diaphragm, ambient noise reduction, and Bluetooth® connectivity. Littmann® remains the standard for stethoscopes in the US and Canada.

Stethoscope Types

The three most common types of stethoscopes are:

• Acoustic Stethoscopes
• Tunable Diaphragm Stethoscopes
• Electronic Stethoscopes

Acoustic Stethoscopes

Acoustic stethoscopes transmit sound from the chestpiece to the listener's ears through air-filled hollow tubing. The name comes from the acoustic pressure waves that make our eardrums vibrate. The tubing contains and channels these waves until they reach the listener.

The chestpiece of an acoustic stethoscope generally has two sides: the diaphragm (a flat disc) and the bell (a hollow, cup-shaped side).

Diaphragm

When the diaphragm is placed against a patient's body, sounds from the body cause it to vibrate. This creates acoustic pressure waves that travel up the tubing to the listener's ears. The diaphragm is most effective for higher-frequency sounds such as breath sounds and normal heart sounds.

Bell

When the bell is placed against a patient's body, vibrations from the skin produce acoustic pressure waves that travel to the listener's ears. The bell is most effective for lower-frequency sounds such as certain heart murmurs and bowel sounds.

For cardiac exams, both the diaphragm and the bell should be used.

Tunable Diaphragm Stethoscopes

Many Littmann® stethoscopes feature a tunable diaphragm, a single membrane that captures both low- and high-frequency sounds without turning the chestpiece over. The listener switches between frequencies simply by changing the pressure applied to the chestpiece.

Light pressure lets the listener hear low-frequency sounds, while firm pressure brings out high-frequency sounds.

Electronic Stethoscopes

Electronic stethoscopes, also known as digital stethoscopes, amplify body sounds electronically. They convert acoustic sound waves into electrical signals that can be amplified and processed for improved auscultation. Some models also actively reduce background noise.

Because the audio is captured electronically, sounds can be recorded, saved, and shared. The Littmann® CORE Digital Stethoscope, for example, connects to Eko software on a smart device to visualize, record, and share auscultation data.

Stethoscope Parts

Stethoscopes are made up of 8 common parts:

• Chestpiece
• Diaphragm
• Bell
• Stem
• Tubing
• Headset
• Eartubes
• Eartips

Chestpiece

The chestpiece is located at the bottom of the stethoscope and is placed on the patient to capture sound. The chestpiece is made up of the:

• Diaphragm
• Bell
• Stem

Some chestpieces, including those on many Littmann® models, have a tunable diaphragm that lets the listener move between high- and low-frequency sounds by adjusting the pressure on the chestpiece.

Diaphragm

The diaphragm is the larger, flat side of the chestpiece. Its wide surface area allows the listener to pick up higher-frequency sounds across a broader area.

Bell

The bell is the smaller, cup-shaped side of the chestpiece. Because it is smaller than the diaphragm, it allows the listener to detect lower-frequency sounds in a more focused area.

Stem

The stem connects the stethoscope's tubing to the chestpiece. On Littmann® stethoscopes with two-sided chestpieces, rotating the stem opens the side of the chestpiece the listener wants to use.

Tubing

The tubing is made of flexible rubber or PVC and connects the chestpiece to the headset. It is the pathway sound travels from the chestpiece to the listener's ears.

Littmann® Cardiology IV™ Stethoscopes use dual-lumen tubing, which eliminates the rubbing noise generated by traditional twin-tube stethoscopes.

Headset

The headset is the upper half of the stethoscope. It is made up of the:

• Eartubes
• Yoke
• Eartips

Eartubes

The eartubes are the hollow metal tubes that connect the tubing to the eartips and carry sound between the two.

Eartips

The eartips sit at the very end of the headset and go into the listener's ears. Good eartips should be soft but firm, providing a snug, comfortable seal. A proper seal also helps block out ambient noise.

Determine Your Requirements & Uses

The field you work or study in may determine which stethoscope you need. Many healthcare professionals need a standard, classic stethoscope to hear typical heart, lung, and bowel sounds.

Others, such as cardiologists, need to detect a much wider range of frequencies and rely on a more advanced stethoscope to do so.

Closely tied to your requirements is how you expect to use your stethoscope. Before choosing one, answer this question: How will I use my stethoscope day to day?

Medical Students

The most important question a medical student should ask is: What does my program require? If your institution has specified a particular stethoscope, start there.

If you're not sure whether there is a requirement, ask. Reach out to your program, professors, or advisors before classes and clinical rotations begin.

For students in nursing or PA programs, a versatile stethoscope is the best choice, since you'll be assessing a wide range of patients with varied needs.

Common Stethoscope Uses for Medical Students:

• Vitals
• Blood Pressure
• Lung Function
• Heart Function
• Bowel Sounds
• Patient Assessment
• Patient Monitoring
• Diagnoses

SurgoMed's Pick for Medical Students: Littmann® Cardiology IV™ Stethoscopes

These stethoscopes deliver outstanding acoustic performance, making them an excellent choice for medical students. They're also highly versatile and well suited to a wide range of specialties and clinical settings.

RNs and Nurse Practitioners

Nurses in hospitals and clinics generally need a durable, classic stethoscope versatile enough to assess and monitor multiple patients throughout a shift. Outside of cardiology, most nurses don't require a specialized stethoscope. The key is finding one that is affordable and built to last.

Common Stethoscope Uses for RNs and Nurse Practitioners:

• Vitals
• Blood Pressure
• Lung Function
• Heart Function
• Bowel Sounds
• Patient Assessment
• Patient Monitoring
• Inpatient Exams
• Outpatient Exams

SurgoMed's Pick for RNs and Nurse Practitioners: Littmann® Classic III™ Stethoscopes

These stethoscopes are an ideal tool for healthcare providers working in non-critical care settings, for both pediatric and adult patients.

Advanced Practice Clinicians

PAs and APRNs are often responsible for autonomous treatment decisions. Because of this added responsibility, many choose a more advanced stethoscope that offers greater amplification than a classic model.

Common Stethoscope Uses for Advanced Practice Clinicians:

• Vitals
• Blood Pressure
• Lung Function
• Heart Function
• Bowel Sounds
• Patient Assessment
• Patient Monitoring
• Diagnoses

SurgoMed's Pick for Advanced Practice Clinicians: Littmann® CORE Digital Stethoscope

This stethoscope offers up to 40x amplification, allowing clinicians to pick up even the faintest sounds. It also records and shares auscultation sounds to support diagnosis and treatment.

Pediatricians and Infant Care Specialists

Pediatricians and infant care specialists often need a smaller stethoscope to examine their patients. They also face the added challenge of keeping young patients calm when they may be anxious or upset.

Pediatric stethoscopes are designed with smaller patients in mind, offering a smaller diaphragm for more focused sound over a smaller area.

Common Stethoscope Uses for Pediatricians and Infant Care Specialists:

• School Physicals
• Pediatric and Infant Exams
• Vitals
• Blood Pressure
• Lung Function
• Heart Function
• Bowel Sounds
• Patient Assessment
• Patient Monitoring
• Diagnoses

SurgoMed's Pick for Pediatricians and Infant Care Specialists: Littmann® Classic II Pediatric & Infant Stethoscopes

These stethoscopes have a dual-sided chestpiece with a small 3.3 cm diaphragm, making them well suited to pediatric patients. A non-chill rim and diaphragm help keep young patients comfortable during exams.

Cardiologists

Cardiologists need a stethoscope that captures a wide range of high- and low-frequency heart sounds. It must allow them to move easily between frequencies and provide enough acoustic clarity to support an accurate diagnosis.

Cardiology stethoscopes are built for exactly this purpose, with features such as a tunable diaphragm that lets cardiologists focus on specific sounds originating from the heart.

Common Stethoscope Uses for Cardiologists:

• Cardiac Exams
• Heart Function
• Vitals
• Blood Pressure
• Patient Assessment
• Patient Monitoring
• Diagnoses

SurgoMed's Pick for Cardiologists: Littmann® Master Cardiology™ Stethoscopes

Designed by Littmann® specifically for cardiology, these stethoscopes feature a tunable diaphragm that lets the listener switch between high- and low-frequency sounds simply by adjusting pressure on the chestpiece.

Listen, See, & Feel

When choosing a stethoscope, it's always a good idea to try out different models and brands. Since so many stethoscopes are purchased online, one of the best ways to compare them is to ask friends or colleagues if you can try theirs.

When trying out stethoscopes, remember to listen, see, and feel.

Listen

The most important thing to compare is how well you can hear the sounds you're targeting. Place the diaphragm on your chest. If it's tunable, vary the pressure to hear different frequencies. If the stethoscope has a bell, place it against your chest and listen for lower-frequency sounds.

5 Questions to Answer When Trying Out Stethoscopes:

1. How loud was my heartbeat?
2. Did adjusting the diaphragm make a meaningful difference?
3. Do I prefer using a bell to target low-frequency sounds?
4. Which brand had superior sound quality?
5. Could I hear body sounds clearly enough to make an accurate assessment or provide the proper treatment?

Chances are, any Littmann® stethoscope you test will stand out for sound quality. Internal Littmann® testing showed that heart sounds heard through the adult diaphragm of a Littmann® stethoscope were more than four times louder (20 dB) than the same sounds heard through a competing brand.

See

After listening, compare the stethoscopes visually. Seeing how each one is built can help you judge how it will hold up to your specific needs.

Hold the stethoscope by its headset and let it hang vertically. Look for obvious kinks or bends. These can indicate stiff tubing, which pulls on the eartips and makes the stethoscope uncomfortable and harder to use.

Look at the eartubes and notice how they cross. Symmetrical eartubes, like those on Littmann® stethoscopes, are ideal because they allow the eartips to seal comfortably.

Finally, check the available colors. While it's the least important feature, stethoscope color lets you express a bit of personality while remaining professional.

Feel

The last step of your inspection is to feel the stethoscope and notice the subtle differences in quality between brands.

Feel the eartips. Many stethoscopes come with hard eartips that have sharp, squared edges, which can irritate your ears with repeated use. Look for soft, rounded eartips, like those on Littmann® stethoscopes.

Pull the eartips. Do they come off easily, or do they snap securely into place? Eartips that come off easily generally won't provide the best acoustic performance.

Feel the chestpiece. Does it have a tunable diaphragm? If so, does it respond easily or require a lot of effort? Smooth operation helps you avoid fumbling with your stethoscope during a patient exam.

Feel the headset. Is it adjustable, and how easy is it to adjust? One size does not fit all, so make sure you can set the headset for maximum comfort.

Feel the quality. How sturdy does the stethoscope feel? Will the parts hold up to everyday wear and tear, or do they feel cheap? You want a stethoscope that performs well and lasts.

Feel the weight. Place the stethoscope around your neck. Does it feel light and comfortable, or like a crash cart hanging off your neck? A quality stethoscope combines a sturdy build with a lightweight design you can comfortably wear around your neck or carry in your pocket.

Trust Your Colleagues & Instructors

While you're trying a friend's or colleague's stethoscope, ask what they think of it. Their input is invaluable, especially if they use their stethoscope in the same setting as you.

The same goes for medical students. If you're unsure which stethoscope will work best for your classes and labs, ask your instructors. They've likely seen hundreds of students over the years and have valuable insight into which stethoscopes hold up best.

Suggested Questions to Ask Friends, Colleagues, or Instructors:

• How long have you had your stethoscope?
• How are the acoustics of your stethoscope?
• How well does your stethoscope help you make an accurate assessment?
• How comfortable is your stethoscope?
• Where did you purchase your stethoscope?
• Do you think your stethoscope was a good value?
• Have other colleagues or students mentioned which stethoscopes they prefer?
• As a student, am I required to have a specific type of stethoscope?
• Would you purchase your stethoscope again?

Do Your Research

Your stethoscope is one of the most important purchases you'll make as a current or future healthcare professional. It's an instrument you'll likely use every day, and there is a wide range of options to choose from.

Reading guides like this one is a great start. Browsing online reviews and product information is the best place to begin your search, where you can compare specs, pricing, and features. From there, you should be able to narrow your choices down to just a few stethoscopes.

That's when the opinion of a trusted friend or colleague and some hands-on testing can help you make a final decision. Online reviews are helpful, but feedback from people you know and trust is unmatched.

As you research, keep these key stethoscope features in mind.

10 Important Features to Look for in a Stethoscope:

1. High-Quality Acoustics
2. Good Fit for Your Specialty or Program
3. Tunable or Non-Tunable Diaphragm
4. Comfortable Eartips
5. Durable Materials
6. Easy to Clean
7. Lightweight Design
8. Brand Quality
9. Affordability
10. Warranty Coverage

Look for Special Offers

Quality should take precedence over cost, but that doesn't mean you can't find a great deal on a high-quality stethoscope.

Some retailers offer special discounts on featured brands. Check for sale prices or store-wide discount codes you can apply to your stethoscope purchase.

At SurgoMed, we want to make sure you have the right equipment at the right price, so you can get back to what matters most: caring for your patients. That's why we've partnered with the best in the industry, Littmann® Stethoscopes, to offer best-in-class stethoscopes at a price you can afford.

Shop our selection of Littmann® Stethoscopes and know you're purchasing from a reputable distributor who will make sure you have what you need when it matters most.