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.