Stethoscopes: An Enduring Tool of Medicine

One of the most recognizable tools of the medical profession, the stethoscope has served doctors and patients for nearly two centuries.

Stethoscopes have become so iconic that medical students at many universities receive a stethoscope along with their white coat in their first year of training to symbolize their transition to becoming doctors.

Worldwide, the stethoscope market is worth around $311 million in annual sales, according to Global Industry Analysts, Inc. Demand for these medical devices in the developing world is helping to drive sales and offset losses related to the emergence of convenient handheld ultrasound devices and other high tech medical devices.


History of the Stethoscope

The stethoscope has its roots in early 19 th century France. Rene-Theophile-Hyacinthe Laennec, a physician, used a rolled-up cylinder of paper to listen to a heartbeat. Laennec observed the amplification and developed a hollow wooden baton for physicians to use to listen to the heart. The cylinder was about six inches long, and its bore was shaped like a trumpet.

From there, other physicians innovated and further developed the stethoscope. These devices were made of wood and incorporated rubber tubes and earplugs. Further innovation led to the development of what we now recognize as a conventional stethoscope in the 1840s and 1850s. These stethoscopes incorporated rubber tubes, and ivory or ebony knobs for earpieces. Differential stethoscopes that used two chest-pieces to allow doctors to compare sounds in two different places were also developed at this time.

The basic binaural stethoscope was developed in the early 20 th century. Electronic stethoscopes also were developed at this time.

Uses for Stethoscopes

Stethoscopes have a variety of uses by medical professionals. Some common uses of these medical devices include:

Monitoring the Heart For trained medical staff, a wealth of information can be revealed by listening to a patients chest with a stethoscope. Doctors and nurses can hear atria and ventricles working, and other parts of the heart doing their work. Medical staff can also pick up tell-tale signs that these systems are not working properly. Stethoscopes are often the primary diagnostic tool for detecting heart murmurs and other serious conditions.

Monitoring the Lungs Doctors use these devices to detect problems with breathing. A trained physician can listen to patients take a deep breath and detect problems based on sounds heard as air enters the lungs. Doctors can detect fluid in the lungs or constriction of the lungs, and various other problems, prompting them to make further observations and diagnose the problem.

Monitoring the Bowels A physician can use a stethoscope to detect bowel problems by placing the device on a patients abdomen and listening as food and liquid move through the patients stomach and on to his or her intestines. Most of the time, the bowels will make low-pitched gurgles every few seconds. These sounds may occur more or less frequently, depending on a patients condition.

Measuring Blood Pressure These devices are commonly used as a tool to measure blood pressure, alongside a blood pressure cuff. Medical professionals place the cuff on the patients arm, inflate it, and use the stethoscope to listen for the patients pulse as the cuff is deflated.

Ensuring Quality

Stethoscopes have to be able to detect faint, subtle sounds in order to be useful. Therefore very high standards must be maintained in their manufacturing. Air leaks in a stethoscope can greatly impair their utility. Top quality instruments must be carefully inspected to make sure that all of the components fit snugly together and that junctions are airtight.

There are a variety of risk factors that can cause air leaks in a stethoscope. Quality inspectors must search for cracking, small holes, weak areas in the metal, etc. Manufacturers often test the devices by placing them in a machine that will blow air through the medical devices to search for leaks. Other machines will test the tightness of the junctions by tugging on components to determine whether everyday use will cause the pieces to separate.

Pre-manufacturing inspection is also necessary to ensure that quality raw materials are used. After the devices are assembled, each should also be checked to ensure acoustic reliability.

The Future

Stethoscopes remain a mainstay of most doctors medical equipment, but they are beginning to be supplanted by pocket-size ultrasound devices that provide greater detail and accuracy than traditional stethoscopes. For the near future, the high price of these devices will keep stethoscopes as doctors primary tool. It is expected that as the technology continues to improve, and as manufacturers learn how to produce the devices more inexpensively, they will take a greater share of the market. The devices will likely still enjoy wide usage, however, particularly in situations where access to electricity is limited.

Use & Maintenance

Doctors and other health care professionals who use stethoscopes undergo rigorous and extensive training to learn to interpret sounds heard via this medical device. Many specialize in a select set of readings, such as the sounds made by healthy and unhealthy lung systems.

To ensure the accuracy of stethoscope readings, these medical devices must be properly maintained. Medical professionals should regularly check their equipment for air leaks or parts that need replacing. They should also regularly clean stethoscopes with rubbing alcohol and mild, soapy water to remove debris that may impair the device.

Keeping the devices clean is of vital importance. Global Industry Analysts, Inc. estimates that 90 percent of doctors stethoscopes and 79 percent of nurses stethoscopes are contaminated. This contamination leads to about 2 million nosocomial infections each year. Reducing preventable infections is a major priority of hospitals and other health care providers.

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