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You are here: Home » Medical Equipment & Supplies » Stethoscopes & Accessories » Stethoscopes and Accessories Listed by Manufacturer » Littmann FAQ's & Repair » Littmann Stethoscope Frequently Asked Questions

Littmann Stethoscope Frequently Asked Questions

Littmann® Stethoscope Frequently Asked Questions

  • What is a "Tunable Diaphragm"?
  • How does it work?
  • What are the advantages of using a tunable diaphragm?
  • Are tunable diaphragms available only on Master Classic II
    & Master Cardiology stethoscopes?

  • Why would I want a tunable diaphragm on a double-sided stethoscope?
  • How does the chestpiece contribute to sound quality?
  • What materials are used in manufacturing the Litmann stethoscope chestpieces?
  • What is the optimal tubing length for stethoscopes?
  • What is your refund / return policy?
  • What type of tubing does Littmann® offer?
  • How should I routinely clean my stethoscope? Can I sterilize it?
  • Can I put a tunable diaphragm (like on the Cardiology III Pediatric side) on the bell of my old Cardiology II SE stethoscope?
  • If I have the old “threaded” eartips, is ther any way I can keep them from falling off?
  • Do Littmann® stethoscopes contain latex?
  • Do Littmann® stethoscopes come with eartips?
  • Can I use any size of eartips?
  • Why do the grey eartips feel different than the black eartips?
  • Can any of the Littmann® stethoscopes be used during an MRI?
  • I can’t hear anything out of my stethoscope. What is wrong with it?
  • Does 3M Littmann® provide a warranty for their stethoscopes?



    Q. What is a "Tunable Diaphragm"?

    A. Traditional combination chestpieces have a bell and diaphragm. The bell is meant to be used for low frequency sounds. The diaphragm should be used for high-frequency sounds. Several years ago, 3M Littmann Stethoscopes introduced a unique patented, single-sided chestpiece on the Master Cardiology and Master Classic II stethoscopes.

    This single-sided chestpiece combines both bell and diaphragm modes into one side. The patented construction of the suspended diaphragm membrane, combined with the internal attenuator ring within the chestpiece result in what is reffered to as a "tunable diaphragm". 

    Q. How does it work?

    A. The correct way to use a double-sided stethoscope is to use light pressure when auscultating with the bell, to hear low-frequency sounds. In order to hear high-frequency sound, the diaphragm should be used, applying firm pressure.

    As with a traditional bell, when using a stethoscope equipped with a tunable diaphragm, one should use light pressure to hear low-frequency sounds. Increasing the pressure on the chestpiece will cause the suspended diaphragm to move inward, resting on the internal ring of the chestpiece. When this happens, the how-frequency sound waves are attenuated, or reduced, allowing only the high-frequency sounds to be heard,

    Q. What are the advantages of using a tunable diaphragm?

    A. When using a stethoscope with a tunable diaphragm, the user does not have to remove the chestpiece from the patient in order to change from the bell to diaphragm mode.

    When listening to low-freqency sounds with a tunable diaphragm as opposed to a bell, there will be an increase in amplitude, or loudness. This is because the sound is coming through a diaphragm with a larger surface area, as opposed to the smaller opening on a standard bell. The sound pressure level increases with an increase in contact area on the patient.

    Q. Are tunable diaphragms available only on Master Classic II & Master Cardiology stethoscopes?

    A. Littmann stethoscopes have incorporated this patented technology in most of the product line. The Master Cardiology, Cardiology III, Cardiology II SE and Select models all feature Litmann stethoscope’s tunable technology.

    Q. Why would I want a tunable diaphragm on a double-sided stethoscope?

    A. Having tunable technology on a double-sided stethoscope offers the user more versatility. As previously mentioned, low frequency sounds will have increased amplitude than those heard with a traditional bell, and the tunable diaphragm provides the convenience of not switching sides.

    Q. How does the chestpiece contribute to sound quality?

    A.There are a number of design elements associated with the chestpiece that contribute to the sound quality in a stethoscope.
    For example, comparing the weights of the chestpiece of each Littmann model, you will see that the Master Cardiology has the heaviest chestpiece. This weight is one of the factors that contributes to the superior sound quality that is heard when using this product.
    Size also contributes to sound quality. A wider diameter surface on a chestpiece will increase sound intensity over one that is small. A wide diameter surface area on a chestpiece may contribute to sound intensity, but it can also result in outside noise getting into the systerm.

    It is very important for the user of the stethoscope to get a good seal between the chestpiece and the patient, to get the best sound quality available for the model of stethoscope that they are using. If thereis not a good seal at the site where they are auscultating because the chespiece is too large, outside noise will get into the system. This can obscure the body sounds that one is trying to hear. For this reason, the practitioner should find a model that best accommodates their patient population and application needs.

    Q. What materials are used in manufacturing the Littmann® stethoscope chestpieces?

    A. The materials used in manufacturing the chespieces of Littmann® stethoscopes vary. The metal prtion will either be stainless steel or an alloy. This information is available in the Littmann® Product Comparision Chart.
    The diaphragm is composed of a composite disc, surrounded by a flexible material. The composite disc, flexible surround, and rim that holds the diaphragm to the chestpiece do not contain natural rubber latex or dry natural rubber as components.
    Some tunable diaphragms have a tiny pinhole in the center of the disc. This is not a defect in the product, nor does it contribute to the tunable function. This hole is a result of a manufacturing process of the product. It also helps eliminate air pressure that was created in the system when pressing down on the chestpiece. This air pressure may be uncomfortable, especially if the user has a very good seal in their ear canals as a result of the soft sealing eartips. Because this was experienced mostly in the Master Cardiology and less so with other models, as of October 1997, the hole was eliminated in most models. It can still be found in the Master Cardiology, and the small side of the Cardiology III.

    Q. What is the optimal tubing length for stethoscopes?

    A. Quite often health care workers raise questions regarding tubing length based on early publications claiming shorter tubing length provides better acoustic response. Some instructors have recommended their students buy the shortest tubing possible. In an attempt to clarify many of the myths surrounding tubing length, 3M has tested their Littmann stethoscope product line to offer the following information about tubing length.
    To explain our test results, it will be helpful to compare the tubing of the stethoscope to a garden hose. For examples, an increase in the length of a garden hose will decrease the pressure at the end of the hose as a result of frictional and other internal forces. The same effect occurs when the tubing length of a stethoscope is increased. However, in the case of stethoscope tubing, change in length is relatively small: this decrease in acoustic pressure is not detectable by the human ear.
    Additionally, as tubing length increases, resonant frequency decreases. Considering this fact: an increase in tubing length provides a better response to the lower frequency sounds (an advantage in auscultation). Many heart sounds fall below 150 Hz and are considered low frequency. Because it has been shown that the human ear is least sensitive to low frequency sounds, improved low frequency response may be an advantage.

    Taking these two factors into account, there is no detectable difference in acoustical performance between stethoscopes with shorter tubing vs. that with longer tubing.
    When purchasing a stethoscope, you should consider your own needs and practices. Longer tubing might be appropriate for health care providers wearing the stethoscope around their neck as it drapes better. Your height and arm length should also be a factor to determine optimal tubing length. Many practitioners would like a little more distance from sicker patients while auscultating. Longer tubing also reduces the stress to the lower back of the practitioner who needs to bend over the supine patient.

    Q. What type of tubing does Littmann offer?

    A. The tubing used in 3M Littmann® Stethoscopes comes in a variety of lengths and colors. As shown on the Product Comparison Chart, some tubing is single lumen, or only having one opening and the high-end models are double lumen. If you were to cut a double lumen tube across, you would see two openings contained in the single tube. The reason for this design is based on studies done some time ago that suggested an advantage in the sound quality when two separate tubes are used for listening to body sounds. An additional advantage to the Littmann stethoscope two-tubes-in-one design is that noise artifact created by separate tubes rubbing together is eliminated.
    The tubing used in all Littmann stethoscopes is a PVC (poly vinyl chloride) tubing that becomes hard when exposed for long periods of time to the lipids found in human skin. Wearing the stethoscope around the neck may cause stiffening of the tubing over time. The rate at which this happens will vary with the individual body chemistry. If worn around the neck, Littmann® recommends avoiding contact with the skin. It is also recommended that the tubing be cleaned regularly with a solution of mild soapy water, this can be followed by wiping with alcohol.
    The tubing in Littmann stethoscopes have never contained natural rubber latex or dry natural rubber as components, with the exception of an extension used on the Anesthescope and the Ploss monitor.

    Q. How should I routinely clean my stethoscope? Can I sterilize it?

    A. Avoid extreme heat, cold, solvents, and oils. The entire stethoscope can be wiped with alcohol, or mild soapy water. The stethoscope should never be immersed in any kind of liquid, or steam sterilized. If sterilization is required, it should be gas sterilized in a 3M Steri-Vac Aeration Cabinet.

    Q. Can I put a tunable diaphragm (like on the Cardiology III Pediatric side) on the bell of my old Cardiology II SE stethoscope?

    A. No. The new Cardiology III has an attenuating ring behind the daphragm to make the tunable function possible.

    Q. If I have the old “threaded” eartips, is ther any way I can keep them from falling off?

    A. Yes. You can super glue them on, or try clear nail polish. First remove the eartips, then apply a very small amount of glue or nail polish to the HEADSET (not the eartips), and then reposition the eartips. Be sure that the glue is dry before inserting the eartips into the ear canal.

    Q. Do Littmann® stethoscopes contain latex?

    A. Littmann® stethoscopes with the exception of the Littmann Anesthescope and Ploss Monitor do not contain natural rubber latex or dry natural rubber as components.
    Q. Do Littmann® stethoscopes come with eartips?

    A. Yes, all 3M Littmann® stethoscopes are equipped with eartips. In some models additional sets are located in the crystal box included with the product. Eartip information can be found on the Product Comparison Chart.
    Older Littmann® stethoscopes have the threaded type eartips. In early 1994, the more secure snap-tight eartips were introduced. Threaded and snap-tight eartips are not interchangeable.

    Q. Can I use any size of eartips?

    A. It is important that the proper sized eartips be used to achieve optimal acoustical performance. This is especially true when using the soft-sealing eartips. If the soft-sealing eartips are too large for the user, the compression of that eartip while in the ear could result in poor acoustical performance. This could also be true if the eartips are too small.

    Q. Why do the grey eartips feel different than the black eartips?

    A. Soft-sealing and firm grey eartips are made of a hypoallergenic elastomer. They are different in feel because of the fact that a different formulation is used in each type. Littmann stethoscope eartips do not contain natural rubber latex or dry natural rubber as components.

    Q. Can any of the Littmann® stethoscopes be used during an MRI?

    A. No, they all contain metal.

    Q. I can’t hear anything out of my stethoscope. What is wrong with it?

    A. 3M Littmann® stethoscopes have a reputation for quality, and superior acoustic performance. If the acoustic performance seems to be lacking, or absent the following areas should be checked before assuming there is a problem with the stethoscope:

    Proper Headset Alignment

    Littmann® stethoscopes havee headsets which have been designed to be worn at an anatomically correct angle, oriented toward the users ear canals. Improperly wearing the stethoscope headset can result in poor acoustical seal, and in some cases, complete sound blaockage. Before placing the eartips in your ears, hold the stethoscope headset in front of you so that the eartubes point away from you. When the eartips are in your ears, the eartips should be pointed forward. Not everyones ear canal are the same. If after inserting the eartips in proper manner, the fit does not seem comfortable, and acoustic performance does not improve, grasp each of the eartubes to adjust the headset for a custom fit.
    Proper Fit of Eartips

    It is important that the proper sized eartips be used to achieve optimal acoustical performance. This is especially true when using the 3M Littmann® Soft-Sealing Eartips. If the soft-sealing eartips are too large for the user, the compression of the eartip while in the ear, could result in poor acoustical performance. This could also be true if the eartip is too small. Finding the correct size for your ears will result in the best acoustical performance.
    Obstruction

    If the stethoscope is commonly carried in a pocket, or hasn’t routinely been cleaned, it is possible that the pathway (chestpiece, tubing headset or eartips) may be obstructed by lint or dirt. Routine care and maintenance can prevent this from happening.

    Complete Seal in the System

    Stethoscopes rely on an airtight seal in order to transmit body sounds from the patient to the users ear. Loose parts in the chestpiece, loose tubing, or cracked tubing can prevent an airtight seal.

    Indexed Chestpiece
    When using a double-sided stethoscope, the user needs to open or index the bell or diaphragm by rotating the chestpiece. If the diaphragm is open, the bell will be closed, preventing sound from coming in through the bell and vice-versa.
    If all of these issues have been addressed please send the stethoscope to the 3M Health Care Service Center for repair.

    Q. Does 3M Littmann provide a warranty for their stethoscopes?

    A. A 3M Littmann® stethoscope is a lifetime investment. Beyond the liberal warranty policy, 3M has a lifetime refurbishment program that is unsurpassed in the industry.
    Except in the cases of abvious abuse or accidental damage, or if a material or manufacturing defect is discovered during the warranty period, repairs will be made without charge upon return of the instrument to 3M. Otherwise, the warranty periods will be listed along with the product information.




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