Medwork Instruments
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How to use a Sprague-Rappaport Stethoscope
Some of these tips apply to the use of ANY stethoscope as every stethoscope has binaurals (the part that goes into your ears and attaches to the tubing) and every stethoscope with have either a diaphragm mechanism or some sort of bell for listening to the patient. (See bottom of page for additional links to other sites about Stethoscope use and History)
1) Adjust the angle with which the binaural metal tubes face forward in order to provide the best air seal to your ears. Adjustment may be necessary for comfort as well. Both comfort and air seal are important for you to hear at your best. With the binaurals in your ears gently rub your fingers together near the ear. Do you hear the rubbing sound easily? If you can you probably have an imperfect air seal. Readjust. If necessary you can slowly and carefully turn the angle of the binaural to allow the best fit. See item #2 below.
2) Try out ALL the different eartips if you have choices. If you "can't hear anything" this is because of a poor air seal (see item #1 above) or because you have a poor eartip fit. They are misaligned in your ear canals. The best eartips are the ones which give the most comfort in your ears and give a good air seal.
3) All accessories on a Sprague-Rappaport attach in the same way to the chestpiece. You screw the part on or you screw the part off. Sometimes you will harmlessly disassemble a diaphragm assembly without completely removing it from the chestpiece. If you only remove the outside bezel and the transparent disk just unscrew the flat diaphragm backing and reassemble the unit before putting it away in your accessory pouch. Your Sprague-Rappaport will probably arrive with the large and the small diaphragm assemblies on the chestpiece head. Most physicians prefer to replace the small diaphragm with the large bell.
4) Of the two attachments on the chestpiece only one is "ON" at a time. To switch to the other side on any dual stethoscope or Sprague-Rappaport stethoscope hold the chestpiece stem and rotate the outer rotor one half turn (in either direction). You will hear or feel the click when the head turns over and the air hole in the rotor is aligned with the air hole in the attachment you are using.
5) The stethoscope can easily be folded and put into your lab coat pocket or left around your neck.
6) Characteristics and advantages of the various attachments:
Large Bell: Best for loudest and deepest sound. Routinely used to screen for S3, S4 and rumbles. Also used to listen for bruits and A-V malformations.
Medium Bell: For where the largest bell is too large; small children, cachectic patients, ocular bruit auscultation. Localizes bruits better than the large bell.
Small Bell: For where the medium bell is too large. Localizes bruits best.
Large Diaphragm: For routine auscultation of high-frequency sounds, especially in the presence of low-frequency sounds which would tend to mask them; various murmurs, breath sounds, bowel sounds. Also used for checking splitting of S1 and S2 and blood pressures though the large bell is sometimes more appropriate.
Small Diaphragm: Cuts out even more low-frequencies than the large diaphragm and so may provide more detail about high-frequency sounds in the presence of simultaneous low-frequency sounds. Also for use when the large diaphragm is too large, as with children and cachectic patients.
WHAT SHOULD YOU CONSIDER WHEN BUYING A STETHOSCOPE?
General information about stethoscopes
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