Hearing instrument wearing healthcare professionals performing auscultation procedures as part of their job requirements often turn to their audiologist to find an amplified stethoscope solution that will not only amplify the breath and/or heart sounds they need to hear, but will enable them to keep their hearing instruments in the ears. Recently, the Audiologist’s Choice Bluetooth Amplified Stethoscope (AC-Scope) was commercially made available and initially demonstrated great promise. Unfortunately, the device was plagued with signal transmission issues that either precluded necessary pairing between the AC-Scope’s amplifier and the hearing instrument streamer or, even when successfully paired, resulted in intermittency sufficient to interfere with performing clinical procedures. So, back to the drawing board for the AC-Scope and back to the $100,0000 dollar question: what is the best amplified stethoscope solution for healthcare professionals with hearing loss who are current wearers of hearing instrumentation?
Based on conversations with colleagues who have been working directly with patients in this area, here are the current suggestions as to how to proceed with potentially identifying a viable amplified stethoscope solution for your hearing instrument wearing patients. Keep in mind, there isn’t one solution that will work with every patient; unfortunately, there will also be instances were none of the suggestions will work for a particular patient. It is best to be prepared to offer at least two (if not all) of the following options:
FOR RIC or OPEN-FIT BTE WEARERS:
1. Try any one of the commercially available stand-alone amplified stethoscopes designed for non-hearing instrument wearers (i.e. 3M Littmann, E-Scope II with traditional earpieces, Adscope, or Thinklabs DS32A) and have the patient attempt to use the stethoscope with hearing their instruments remaining in the ears. Many patients may not be able to tolerate the use of traditional stethoscope earpieces with hearing instruments in the ear however, some patients may and it is worth a try.
2. Invest in the modified E-Scope II with headphones (model #718-7710); hearing instruments remain in the ear while the user places the headphones over the ears during auscultation procedures. If feedback is an issue, the E-Scope II with oversized headphones
3. If the hearing instrument wearer uses a streamer, invest in the E-Scope II with headphones (model #718-7710) along with the necessary E-Scope patch cord (item #711-7129) to hardwire the E-Scope II directly to the streamer. This configuration will require the use of a standard audio-in cable typically packaged with the hearing instruments’ streamer. In addition, the headphones that come with the E-Scope II will not be used by the patient during auscultation procedures but come in handy during the fitting procedure; when working with the patient, the audiologist can wear the headphones to listen-along as the patient performs auscultation procedures to get a better idea of not only what the patient needs to hear, but to possibly assist in cuing the patient as to what to listen for while making informed decisions as to how to best program the hearing instruments specifically for this type of listening activity.
NOTE: in either situation, it will most likely be necessary to re-programming the hearing instrument to ensure the low-frequency auscultation sounds of the lungs and heart can be detected. For more detailed information, sign up for the free-to-view webinar on Amplified Stethoscope Options for Hearing Instrument Wearers via Audiology Online.com
FOR CUSTOM HEARING INSTRUMENT WEARERS:
1. Replace traditional stethoscope earpieces with special adapters called stethomate tips; success rate is very low but may work.
2. Have special earmolds designed to serve as an interface between the custom hearing instrument and the stethoscope earpieces.
3. Invest in the modified version of the E-Scope II amplified stethoscope with headphones (model #718-7710).
If none of the above solutions work, the only other option is to remove hearing instruments and to use a stand-alone amplified stethoscope during auscultation procedures.
I have fairly good hearing in one ear (lower end of normal), but wear an OPN 2 BTE-RITE in the other for severe/profound hearing loss.My work environment is busy and noisy, with very wiggly patients who are unable to cooperate even briefly (DD/ID).
I contacted the manufacturer for suggestions, but was referred back to my audiologist, who has not been helpful. She even suggested I bring in any info I find so she can share it with other clients. I went to my first appointment with her clutching a handful of articles about stethoscopes!
Are there any amplified stethoscopes that can amplify one ear and allow for typical hearing in the other? Or, allow for volume control of the unaffected ear?
Are there oversized headphones that can attach unilaterally or bilaterally to a standard stethoscope?
Could you comment on the UltraScope Clinical, please?
Is there a list of audiologists who specialize in stethoscopes (other than yourself)? I would be willing to travel for a clinic fitting!
Thank you so much!
Hi Debbie:
sorry it took so long to get in touch. My web site was periodically down and it has been fixed and I am back! I checked out the Ultra Scope clinical and it would seem that the UltraScope Classic is something that may worth a try given your situation. The only drawback is that it appears you need to remove your hearing aid to use it but worth a try.
Another option would be to take a look at the Think-Labs One (TL-One) and try it in different configurations. First, try it with the packaged ear phones just to get an idea of what things sound like. Next, try using the TL-One with a pair of oversized headphones while using your hearing aid. The issue with trying to perform auscultation with your hearing instrument is that the instruments may need to be significantly reprogrammed to help perceive lung and breath sounds; this is were the audiologist comes into play.
From what little I know regarding your situation, in my opinion, your best option may be to try the TL-one with oversized headphones without your hearing aids….
Contact me off line at au@oaktreeproducts.com and I can help you find an audiologist in your area who may have more experience with amplified stethoscopes. Unfortunately, there really isn’t an easy one-size-fits-all solution and requires a lot of trial of different configurations. Let me know. Thanks.
Hi. I’m a french student in medicine. I would like to know if the E-Scope would be adapted to cochlear implant system. I have already tested an electronic stethoscope two years ago but it wasn’t very adapted cause I heard to many interferences. Thanks! (Forgive my English)
hello Emma:
it should be. Send me your personal email and I will try to get you additional information in terms of how it is to be used with a cochlear implant.
Hello, I recently received my BAHA 5 processor and am wondering which stethoscope would be best utilized. I hear fine out of my right ear, but had to have a cochlear implant behind my left ear. I am a respiratory therapist and a major part of my profession is determining breath sounds. I do not want a bunch of adapters and connectors, I would like to use the Bluetooth capabilities of the BAHA 5 processor.
Joe, best bet is to use the TL-one with the earphones that come with on your good ear to see if that works out. That to me is the easiest solution without a lot of adapters and connectors. There currently is no amplified stethoscope that has true bluetooth capabilities as connecting to any hearing device will require a hard wire to a streamer. I will need to look into the BAHA 5 processor a little more closely as I have not had much experience in this area but will reach out to my colleagues. Will get back to you as soon as I can
Any thoughts about using Lyric Hearing Aids (http://www.lyrichearing.com/) and a standard non-amplified stethoscope?
Since Lyric is designed to fit deeply in the ear canal, I would certainly try to use traditional stethosocope. Two potential issues: 1) individual tolerances of having so much real estate in the ear canal (Lyric plus ear pieces of stethoscope; some may not be able to tolerate it for a variety of reasons but worth a try), and 2) depending on how Lyric programmed, may experience challenges to hear the necessary low frequency breath/heart sounds. End of the day, always worth a try…..
If standard stethsocope doesn’t cut it but you can comfortably wear a stethosocpe with traditional ear pieces, would try an amplified stethoscope as well.
My hearing loss is mild and presently I do not have any problems with the stethoscope, but I do need hearing aids. Can any of stethoscopes be connected to an iPhone and the sounds played through the iPhone in real time? So I (and the patient) can hear their own breath and heart sounds without removing my hearing aids.
Dr. Moser:
at this time, there isn’t an amplified stethoscope with capabilities to stream information to iPhone in real time. There is a ViScope product avaialble that amplifies sound and also provides a visual display BUT it is not designed to interface with eharing instruments.
I am an Educational Audiologist. I have a student that needs a stethoscope. Her hearing loss is mild to moderate through 1k, severe from 1.5k to 8k. She wears Phoank Bolero Q 70P BTE hearing aids. Would the E-Scope II with oversized headphones work for her? I understand she’ll also need the program change to her hearing aids.
Hi Sara:
couple of things; E-Scope II with oversized headphones could work. I would also try the E-Scope with standard ear pieces and ask your student to try it without hearing aids. As an audiologist, it pains me to suggest to take out hearing aids BUT our ultimate goals is to get her to hear what she needs to hear and it worth trying it both ways.
I have the 3 series by Starkey, and have the surf link mobile. I have the Escope already, and was using the headphones (with my previous hearing aids.). Will the patch cord work with surf link mobile streamer? Can there be a second memory setting that will work with the hearing aid? I’ve called Starkey and they do not have a lot of knowledge when it comes to stethoscopes and their aids. So imagine my surprise when I saw a patch cord can be used with a streamer. I want to see if the surf link mobile is compatible. Thanks!
Hi Heather:
sorry that it has taken me this long to respond! I simply missed the comment. Here is the deal; in your situation, the patch cord SHOULD work. Re: memory; there is a need to have the hearing instrument adjusted to take into consideration the LOW frequency sounds that auscultation requires. Hearing aids typically cannot be set as low as the most necessary heart sounds (i.e 60 Hz) but the audiologist should open the lows as much as possible (and perhaps play around with compression ratios since these sounds are also so soft). Making a stethoscope work with hearing instruments is very challenging so working with your audiologist is key. I hope this helps. Let me know if you need more information.
I have just received my Escope II (very exciting!) which I will be using with a streamer. Where can i get more information for my audiologist on how my hearing aids should be adjusted to use the stethoscope? I currently wear mini RITE aids in both ears
Shona:
Congratulations. Sounds like you are pretty excited. The E-Scope II tends to be the best solution in many cases although each individual case is filled with so many nuances, there are fitting and programming challenges that require working directly with your audiologist. My suggestion to any hearing instrument wearer interested in using an amplified stethoscope is to first talk to your audiologist so that the audiologist can manage and coordinate potential viable solutions based on your individual needs and circumstances. I often recommend to my colleagues to have a 2nd or even 3rd (if possible, based on individual circumstances) back-up plan to really find the solution that works the best. Unfortunately, there is no magic bullet or one-solution-fits-all answer when it comes to amplified stethoscopes and hearing aids. If your audiologist has specific questions, they can certainly contact me directly. Thanks and good luck! Let me know how it goes.
My new stethoscope is connecting nicely through streamer but the microphones in the hearinig aid are still active so i can still hear everything around me at normal levels too. Will need to find a solution to this but still very impressed with my new gadget!
I hope that electronic stethoscopes will solve this problem once and for all. Their prices have been declining slowly but steady for a while now, what’s your opinion, are they a commercially viable alternative to amplified stethoscopes?
Hi Daniel;
Electronic stethoscopes are the same thing as amplified stethoscopes. Any stethoscope that is battery operated is considered electronic. I apologize for any confusion my post may have generated.
The 3.5mm stereo jack on the Cardionics E-Scope 711-7129 patch cord is compatible with the 3.5mm plug on the Streamer’s patch cord.
thank you Robert; I just also received confirmation from the E-Scope manufacturer that the E-Scope can interface in a hardwired fashion with the Oticaon Streamer. I thought this was the case but figured it would not hurt to double check
I recently became hearing impaired and am now fitting my first pair of BTE hearing aids. I have Oticon Alto Pro hearing aids with a streamer and would like to know if the E-Scope II stethoscope with the E-Scope patch cord will be able to connect with my streamer. I work in an Emergency Department in South Africa and urgently need a stethoscope solution.
Eddelene:
The answer to your question is yes, the E-Scope should be able to get hard-wired to the E-Scope II. The one caveat is you will need to work with your audiologist or hearing instrument specialist during this type of fitting because it will require some re-programming of your hearing instrument to a program that is appropriate for hearing breath/lung and/or heart sounds. While inconvenient, another option would be to forgo the need to patch the stethoscope to your hearing aid and simply invest in an amplified stethoscope; this would require you to remove your hearing aids during ausculation procedures. Again, I realize that it isn’t ideal but wanted to offer another solution as there really isn’t a one-size fits all and not everyone is happy with the results of every solution.
Thanks for your reply. Do I understand correctly that the E-Scope II will be able to get hardwired to the Oticon streamer (ConnectLine Streamer Pro)?
I believe the answer is yes; I have e-mailed the manufacturer and will confirm with you via the comments sections as soon as I hear from them.
I just also received confirmation from the E-Scope manufacturer that the E-Scope can interface in a hardwired fashion with the Oticaon Streamer. Please keep in mind that you will need to go to your audiologist to have appropriate adjustments made in your hearing aid program (hearing aids programmed for low tones and automatic noise reduction DISABLED on the program to let the heart/breath sounds be heard).
Hi Eddeline
i am the distributor for the E-Scope II in South Africa and i also happen to wear Oticon hearing aids with a streamer. I have done some experimentation and I can hear via my hearing aids but they would have to be reprogrammed if I needed to work with the E-Scope
You can contact me at info@medtec.co.za or 011 792 2190
The difference is that with a mono jack the device would be transmitting a L channel feed only, rather than a merged R + L feed with the stereo jack.
The Mini-Microphone input jack is stereo, not mono.
@Robert: It makes no difference, as the ReSound Mini Mic only transmits in monaural.
The GN ReSound Unite Phone Clip+ (and identical Beltone Direct Phone Link 2) do not have an audio input jack. However, the Unite Mini Mic has a monaural line level input jack.
Also, important for electronic stethoscope users, in the Aventa v3.4 (& up) programming software, there is the ability to enable varying levels of streamed audio bass boost for their Alera and Verso hearing aids, which I documented in this article.
Dan Schwartz,
Editor, The Hearing Blog
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