A Guide for Non-Doctors. How to Use a Stethoscope

A stethoscope is a device used by doctors, nurses, and nursing students to listen to internal sounds such as those produced by the heart, intestines, lungs, and blood flow in the arteries and veins. It can be used on both animals and people.

There are no restrictions on who can own a stethoscope. Remember that stethoscopes do not diagnose people; people do! Medical personnel are trained to use stethoscopes, but anyone may learn how to use one and use it on themselves.

Why Do Medical Professionals Use Stethoscopes?

The doctor may be looking for abnormal noises in the heart or lungs depending on the concern a patient has shared with a doctor or nurse. He or she is searching for a lub dub sound in the heart, which is the natural sound the heart should make. However, they might hear a whooshing sound instead, in which case the patient will need to be examined further.

The doctor anticipates hearing a typical breathing sound in the lungs, similar to someone breathing into a cup. Wheezing or crackling sounds may be heard, which could suggest that the patient’s lungs are unhealthy.

Parts of a Stethoscope

Before learning how a stethoscope works, it’s vital to understand the components that make up a stethoscope. Among them are:

• The diaphragm is the round metallic portion at the stethoscope’s end that detects low-pitched noises
• The bell is a tiny section of the diaphragm that detects high-pitched noises
• The tube is the part that transmits sound from the diaphragm to the earpieces
• Aural tubes are the tubes in the centre of the earpieces that allow low-frequency sounds to flow through
• Earpieces are the little pieces at the tip of the stethoscope that block out external noises while still receiving sound from the diaphragm

How to Use a Stethoscope

Only after you understand the meaning of the various sounds you hear can you use a stethoscope properly. Before using a stethoscope, there are a few things you should know.

To begin, use a high-quality stethoscope because the higher the stethoscope’s quality, the better the odds of hearing well. Single tubed stethoscopes are favored over double tubed stethoscopes because the tubes in the double tubed stethoscope have a tendency to rub together, making it impossible to hear the sound correctly. Also, if you tap the diaphragm and no sound comes out, the tube is most likely leaking.

The earpieces must also face forward and fit snugly in the ears; otherwise, you will not be able to hear the sounds clearly. Also, check the tension of the earpieces to ensure they are not too tight or too loose, as this can effect whether or not you can hear.

Choose the appropriate chest piece for you based on the purpose for which it will be used. They come in several sizes for children and adults.

Find a quiet place where you can hear clearly without being distracted by background noises.

Make sure you use the stethoscope on bare skin to get accurate results.

There are several ways in which you can use the stethoscope:

Listening to the heart

Place the diaphragm on the left upper region of the chest, where the 4th and 6th ribs connect, if you’re listening to your heart. Apply gentle pressure to the stethoscope between your pointer and middle fingers.
For one minute, concentrate just on the heartbeat. You should be able to hear normal heart sounds if you breathe normally.
Calculate the number of heartbeats per minute you hear. An adult or child over the age of ten has a typical heart rate of 60-100 beats per minute.
For well-trained athletes, a normal resting heart rate is 40-60 beats per minute. Listen for any unusual sounds as you count the number of heartbeats. Anything else than a lub dub is a strange sound.
If you hear a whooshing sound, you may have a heart murmur, which is a disorder caused by blood rushing too quickly through the valves. You should get medical guidance from a doctor in this situation.

Listening to the Lungs

Position the stethoscope on the upper half of the chest, then move it to the midclavicular line of the chest, and finally to the bottom side of the chest.
Listen for regular breathing sounds, such as someone blowing into a cup.
Listen for unusual noises such as wheezing, stridor, rhonchi, and rales. When the airways are pinched, wheezes are heard, and crackles are heard when there is fluid in the lungs.

Wheezing is a high-pitched sound made by people with asthma that can be heard as they exhale and sometimes when they inhale. You don’t need a stethoscope to hear the wheezing sounds; they are audible even without one.
A blockage in the back of the throat causes stridor sounds, which are high-pitched sounds similar to wheezing.
Rhonchi sounds are similar to snoring and occur when air passes through a closed route.
Rales are similar to the sounds created when a bubble wrap is popped, and they are heard when a person inhales. When the lungs are congested, this sound is heard.

Listening to Abdominal Sounds

Position the diaphragm on the stomach and using the belly button as the center, listen to the upper right and left and the lower right and left of the stomach.

Listen for normal bowel sounds like growling and grumbling. Anything apart from that is an abnormal sound.
If you don’t hear any sounds, it may indicate constipation. For constipation however, grumbling sounds should return normally but if they don’t, that means that there might be a blockage in the stomach and therefore you should seek medical attention.
If there are high-pitched bowel sounds, that means that there is a barrier in the bowel.
In case you hear extremely active bowel sounds followed by no bowel sounds that means that there has been a rapture in the bowel tissue.
If you hear slow bowel sounds, that may be due to prescription drugs, trauma, abdominal surgery, over expansion of the bowel, or an infection.

Listening for a bruit

If you suspect that you have a heart murmur, you should examine if you have a bruit since they are similar.
To check for a bruit, on the carotid arteries, position the diaphragm over one of the carotid arteries which is found in front of the neck on either side of the Adam’s apple.
A bruit produces a whooshing sound and that shows that the artery is blocked, when one has a bruit, the whooshing sound is louder than that of a heart murmur.

What you should avoid when using a stethoscope

• Exposing the stethoscope to water or heat may damage it.
• Talking into the drum loudly or tapping hard on it may cause damage to your ears.
• Bending your stethoscope too much may damage it.
• Also, don’t insert the stethoscope into your pocket because you risk spoiling the tubes or getting the earpieces dirty.