Hey everyone — I start my EMT course next month and I’m deciding between the Littmann Classic III and the Littmann Cardiology IV. I’ve read that the Cardiology picks up quieter, more detailed heart sounds, and I’m a little biased toward it, but I don’t want to overdo it for an EMT role and look like I’m “over-equipping.”
My priorities are: reliable BP auscultation, clear heart and lung sounds in noisy environments, durability for daily field use, and decent value for the money. Also curious whether using a Cardiology steth as an EMT is practical or just a flex.
Littmann III-
Littmann Cardiology IV-
Any advice?
A lot of people say it’s overkill, I absolutely disagree. The more you can hear the better. Just know you won’t be using it for heart tones, but being able to auscultate breath sounds while on a gravel county road sounds like a dream. I personally have the classic III and it’s a great scope but there have been many times where I wish I had a cardiology or even the electronic scopes.
Definitely be prepared to possibly lose or break it as it’s just an unavoidable experience. You’re bound to eventually need a new one anyways.
I say go for it and get the cardiology
Absolutely the best product for listening to lung sounds. I bought mine near the end of medic school, and it’s still going strong. AirTag and a zip tie has helped it never grow legs.
Anyone who says the stethoscope doesn’t make a difference is either a liar or has never tried a nice scope.
I mean, we’re not differentiating most heart sounds, but it’s still great for listening for S1 and S2 on chest trauma and noting any changes throughout transport.
It’s just all around better to hear more than less
Listening to detailed heart sounds is not only overkill for EMT, it would even be overkill for a paramedic. There is no benefit you will get for all intents and purposes within EMS of having this expensive stethoscope. In fact, if you do hear some heart murmur, it will likely go right over your head and you won’t understand much from it anyway.
One of the cardiologists who lectured us just used really cheap stethoscopes and always said “the most important thing is not the stethoscope, but what goes inbetween the stethoscope(your head)”
Another EMS secret for you, you are just starting your career so you don’t know this one yet. Equipment in the rig gets lost all the time and unless you are a very lucky EMT, you aren’t getting it back. With this considered, do you really want a fancy expensive stethoscope? Personally, I would rather lose a $50 stethoscope that gets the job done rather than a $200 stethoscope.
I’ve somehow parted with my raptor shears and my cardiology 4😂. Been on the road a hair over a year. I found both after I lost them, and lost them again 😂.
When that 12 is over, or 24 if you’re that weird kind of masochist, you forget a lot of things. If I was starting again, I’d get something cheap/on the cheaper end. I just use whatever cheap ass one they stock on our ambulances. More than adequate for BPs and Lung Sounds in my pretty limited experience.
ProTip get a badge lanyard for your expensive scissors, you can work and they'll remind you to put them away when they hit your leg as you start walking.
I don't blame you. I've gotten in my car with a radio in my pocket after my shift was over...
Did you make it home?😂😭
I realized right after starting my car so I was able to give it back.
But man if I drove home I wouldve just went to sleep!
A little over 21 years in EMS. I'll listen to heart sounds. I don't usually know what I'm listening to, but abnormal and normal are easy enough to differentiate.
But yeah, the Cardiology IV makes a huge difference, especially if you put the bell attachment on it. The bell gets a much better sound for BPs.
That cardiologist also has a multitude of other diagnostic tools available that steer decision-making more than auscultation. EMTs generally have the physical exam and that's it. So effective auscultation is MORE important, not less important.
Can you explain to me what an EMT is going to do by auscultating heart sounds? Lol
They don’t even know what they are listening to
^ this person must be an EMT with a cardiology IV and is feeling defensive lmao.
Critical care medic who was also a physiologist in a hospital:
Yes, heart sounds are important for differentials and medication decision making. Just because you haven't practiced enough to get good at it doesn't make it a bad skill to have. Conditions such as aortic stenosis have unique considerations when it comes to preload dependance and pressor choice, and if you were to choose something like dobutamine, you could kill them. Same issue with nitrates.
Regurgitation benefits from faster heart rates to an extent, which is another consideration. It is also a good way to detect flow murmurs and have anemia as a differential, S3 sounds for overload, and S4 sounds for hypertrophy.
For example: your patient has HF and pulmonary edema, but on auscultation you hear a grade 4 systolic murmur in the RUSB that radiates to the carotids. If you were to immediately start high dose nitro, you'd probably kill them.
It's okay to not be good at heart sounds, because it takes time to learn just like lung sounds. I would say more often than not it doesn't influence treatment decisions....but that's pretty much every assessment we do. Should we stop assessing pupils, abdomens, and mental status now too?
Of course not, because even though they're not always going to change our treatments, it's a part of a differential, and there are times it impacts our choices.
Great information, thank you, but that is so far above OP's level that it's comical. We're talking about a person just starting EMT school.
Right...but how do you suppose he learns aside from starting early? It takes time as a skill, the same as lung sounds.
If you can afford it or get it as a gift absolutely it’s a nice scope if you plan on a career in healthcare for a while. It’s always good to invest in yourself and your equipment. Should also add as a new emt it’s hard to hear stuff, and having a nice scope makes it much easier. Littman 3 is also good and mid range.
The people who say ”you’ll get made fun of for it” probably don’t listen to heart and lungs on patients so take that with a grain of salt.
Who is makin fun of the person with a fancy toy? So weird.
My wife got me a cardio 4 ~5 years ago, its got my name engraved on it, some cool colours, and i really like it in premise
In practice it makes effectively no difference, and gets used less than my cheapy used to, as it stays in my duffle in the truck and only comes out if i anticipate needing it on scene based on notes, because im paranoid of losing it.
I dont think it will get you made fun of. In fact without close attention, people won’t be able to tell the difference.
I just fail to see what benefit spending an extra $100 will provide. For the purposes of EMS, you should be able to hear everything and more with Littman 3. If you can’t hear something, you aren’t using it correctly. A more expensive stethoscope isnt gonna change that.
This. At some point it gets down to writing your notes with a blue cap pen versus a 100 dollar, titanium shell aerospace tolerance tactical pen. Doesn’t write much different and it’ll make you cry when you lose it
Get an inexpensive one first, in case you end up not liking what we do for a living. You do it for a couple years, then get yourself a good one.
I don’t consider it overkill when it’s a noisy background. By noisy I don’t mean the apocalypse is occurring behind me. This is patient, family or partner talking, truck noises, radio background, and other things that you can’t control. I used a standard littman for years as a basic. I got my cardiology IV about 6 months after my medic
A stethoscope in the $50 range is going to work just fine for your scope of practice. Learning to differentiate heart sounds is pretty pointless at this stage, since you won’t have the education needed to understand the pathophys.
For now, focus on EMT school and getting the foundations down really well. You picked a great career for curious people, and there will be plenty of time for cardiology down the road!
Don't. Scopes get lost, broken, and stolen all the time. Not worth it.
This is the main reason I wouldn’t. I have never had a littman I use a cheapy stethoscope that does the job. After having two pairs of prescription glasses stolen, my lunch and a patch off my backpack, I wouldn’t dare bring anything even remotely valuable on the ambulance.
Yes but go for it if you want or have bad hearing in general. I think ppl should learn on the cheaper ears first before getting a fancy one. That way, you actually hear, learn, and recognize sounds from your own skill, not because you used a fancy stethoscope.
I have a Master Cardiology, I feel it makes a difference and spending a decent chunk of change on it makes me take better care of it. At the end of the day if you take good care of it it’s just a $250 one time payment over the course of a whole career. My goal is to be the best provider I can be, so I’ll pay up in pursuit of that goal.
I got myself a Cardio IV after finishing EMT school 4 years ago and I still use it today. I like it because I know it, if I can’t hear lung sounds, it’s probably because they’re shit, not because of the scope. I’ve never had trouble with a manual BP.
Maybe overkill, who cares, if you want it and you can afford it, why not get yourself something nice. Just treat it like any other expensive piece of equipment and take care of it and keep track of it.
Never been made fun of for it (??) and anyone who would do that is a dweeb you shouldn’t focus your emotional bandwidth on, set yourself up for success however you see fit.
Just get a lightweight and call it a day. Save the extra money to buy super fancy trauma shears instead.
I say hold off a bit. Use a less expensive set of ears. Know your lung sounds and heart tones. Then get a good stethoscope. Also buy an AirTag attachment it to it and have your name engraved on the bell. Please do not carry it around your neck.
Big dawg, you’re not diagnosing heart murmurs. You’re taking grandma back home from the hospital. Or listening to blood fill the chest cavity from an MVA. In either case, the stethoscope isn’t gonna decide treatment.
It’s good to hear more detailed heart sounds, but if you’re starting out an emt course with no past medical experiences, it would be better to start with the classic 3. It’s just as reliable in the field and is not as likely to be stolen, which happens a lot with raptors.
As an EMT you will listen to detailed heart sounds exactly ZERO times. Absolutely overkill for just about anyone in prehospital (medics included). Lmao you’d be able to hear the detailed sounds and you’d have no idea how to interpret them. Your EMT stethoscope is for getting blood pressures and listening to breathing sounds-
I used a 12 dollar cheapo stethoscope for EMT school. DO NOT invest in either of those stethoscopes until you’re sure this is what you want to do. Also people will cringe hard if they see you spent 100 bucks on a stethoscope for EMT school, u don’t know if this is what you want to go into yet because you haven’t done it yet.
This is the equivalent to buying a high tech, carbon fiber lacrosse stick for your first time playing lacrosse. Might be the industry standard but u don’t know if you’ll even wanna be in the industry yet.
There are plenty of stethoscopes in the 20-40 dollar range that will be more than enough for you to get a solid set of vitals / breathing assessment
Even in the hospital, you will not gain much from detailed heart sounds. In PA school we still learned about murmurs and gallops but I can't say I dedicate much time to remembering these outside of preparing for an exam. In real life, you will just quickly listen for a few seconds and if you hear anything abnormal, you will get an 12 lead or an echo and use that to make a diganosis.
Especially in EMS you will gain little information from listening to heart sounds. You will end up doing a 12-lead anyway and use that to decide treatment. There is not a single medic who makes clinical decisions based on heart sounds.
And you're absolutely correct, most people in EMS wouldn't be able to understand even if they heard something abnormal. Especially at EMT level.
Because it's literally impossible for people to learn things that you don't know 🙄
It’s as if you didn’t even read my comment. I explicitly stated that I’m talking about the EMT scope of practice, yk, because this post is asking about which stethoscope he should get for his EMT. I’m sorry, did you read somewhere that OP is a cardiologist? Didn’t think so. An EMT won’t know how to interpret heart sounds, not sure what your point is.
Fuck no! Great audio quality!
Don't cheap-out on your ears, lung-sounds don't give a single fuck
Yea I don’t get the comments saying it’s overkill. Will the classic III work just fine, yes, but we work in noisy environments. I want to be able to hear what I’m supposed to hear on any scene and in any truck. Back of a diesel at a concert? Yea gimme the most sensitive scope so I can at least hear something lol
If you can afford why not, just make sure to get your name engraved on it. Some people might give you a hard time about it but who really cares. I personally love my Cardiology IV and it has proven to be worth the investment.
I hear just fine with the cheap ass stethoscope I stole from my last job. But if you must, there's a 70$ littman that's all you need.
Not at all. I have never once been clowned on by any EMT or medic I’ve worked with bc of my stethoscope. The ONLY thing is that scopes get lost easily so put ur name and number on it or name/workplace. Ive only been in EMS for ab 2 years but have the cardiology IV and I think it’s incredibly helpful for grabbing a manual bp or lung sounds during transport, would never buy a diff one at this point.
Indeed that is over the top. A doctor will need to hear specific, subtle lung/heart/bowel sounds. For us, assessing someone in a gas station bathroom or aisle of Wal-Mart... any old stethoscope will suffice.
That being said, if you WANT to carry an expensive piece of personal equipment, nobody should stop you.
For a beginner? Yes. Definitely stick to the cheaper side when starting out. Find out whether or not you want to stay in the field after a while, and how much you want to put into your personal equipment. Just keep in mind to keep track of it, people can and will steal stuff in the field. I've had a cardiology IV for ~3 years now and it's been great. Could be overkill for an EMT-B but idrc, it works and it's my money lol.
So here’s why I went with the IV instead of the Classic III. The tubing is thicker, which in turn means you hear less of that external noise. That’s literally the biggest, and probably the only reason why I went with the IV.
You can’t go wrong with either one, but definitely don’t even bother with the niche Eko ones. They distort sounds quite a bit, and all they’re really good for is for heart tones.
Yeah these are both very overkill for not even being an EMT yet. A nice stethoscope is an investment to be made a ways down the line when you’re sure this is what you want to do, even then it’s really not required.
I couldn’t ever see justifying the cost of a cardio, only reason I have one is because it was a gift.
Before you invest in something fancy, take a year and carry a normal stethoscope around. If you can do that without losing it, then invest in something more if you’d like.
Get it if you want to, it's overkill but who knows, maybe you'll end up in med school one day with these exact same one for residency in a cardiology ICU.
Good ears will have no change to any approach in protocol skills. It's more academic pinky in air shit, you know, stuff that's fun to do around the right audience.
It's just one more thing to keep track of on scene.
The only difference between a $300 stethoscope and a $25 one is $275.
Get an AdScope 612. $45-50 and a great scope.
I bought a core when I was in medic school when they first came out… and I’m way too afraid to carry it. My AdScope is everything I need.
only a eko core 500 is acceptable
You don’t need that serious of a stethoscope this early on. You’re not even in EMT school yet. Focus on learning first. You need to worry about getting good grades, studying, passing tests and being good at the basics.
If you absolutely want to spend money and have a Littmann stethoscope then get a Classic III. They’re about 100 dollars and they’re just fine for EMT needs. I carry one. I’ve been in EMS for years. I’m about to be a paramedic and I still see no reason to buy a cardiology when my classic works just fine.
Is it overkill? Maybe. Did I need it when I started? Definitely not.
But I have a cardio IV now and I really like it. I think it makes auscultation easier in a noisy environment which we basically always are. That being said that's after almost a decade of sirens damaging my ears that weren't great to start with.
When I started I had an Ultrascope I got as a gift and that worked perfectly fine. I broke that in the first year then got a Littman Lightweight II which I was really really happy with for a long time. It really performed weirdly well.
I only got a cardio IV after 7-ish years. Not to say you need to wait, but you'll lose your first stethoscope I promise. Things are hectic for the first 3 years or so. If I were you I'd get the Lightweight II cause seriously it's weirdly decent.
Then lose that or break it and buy the one that makes you happiest to work with. By that point you'll probably have been able to play around with other people's cardios and classics.
Making your job easier to do is not “overkill”, but you also don’t have to spend $200 on it.
Wife got me a cardio IV for our anniversary, love it so much. I can hear BPs, and lung sounds much much better. Especially when running code or in rural areas.
Brother pass the NREMT first thing maybe consider an electronic scope lmao
Yes overkill. Still great tool.
I have one and also an Adscope that I found in an old EMS bag that was being thrown out before I started med school.
I use the Adscope as an anesthesiologist all the time and never bring the Littman because I don’t want to lose it.
Honestly, Get what you think you can afford. And do not go crazy. Take the extra money and buy books that will teach far better assessments skills, than what a fancy expensive stephoscope is going to provide. The most important thing you need to be able to differentiate is lungs sounds: Normal, Rhales, Rhonchi, Crackles, and the most deadly one Silent! The only heart tone you need to know right now in your career is clear or muffled. Clear is no tamponade, muffled in a trauma patient is tamponade. Just get the cheapest good one you can afford. It doesn’t even have to be new. Buy one from eBay or marketplace for a fraction of the cost. They sell ear tips and diaphragms on amazon.
You won’t be able to pick up the quiet sounds in the back of a truck, and most of the time the things that you would want the detail you can’t do anything about in prehospital, especially as an EMT.
You don't have to go crazy. I would consider the durability of the stethoscope over the most minute ability to hear. You aren't going to change the way you treat a patient at the EMT level by hearing absolutely everything, but your stethoscope may take a lot of abuse. That's just my opinion though. My old Littman spent better than 20 years around my neck.
I bought a IV when I was in EMT class after I did my clinical a and ride along invested the money after I knew for sure it was something I wanted to do 3 years later and the thing hasn’t been stolen Worn down and still works perfectly don’t think it’s over kill at all I do think the eko with the little screen is overkill however unless you are hard of hearing and need the sound isolation features
It's a nice toy to have. It's badass and I have loved using it. Get it, it does not matter at all what other people think. I mean obviously don't be performative and wear that thing around. That will get you nicknamed "rookie rescue" and your stethoscope may be stolen. Make sure you get it engraved, though.
just use what your service provides
I have a cardiology IV and a Littmann Classic III and I think the cardiology is overkill yeah. You won’t look like you’re “over-equipping” because they look pretty identical but it’s not worth the stress of worrying about “losing” it lol.
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In 10 years I’ve never paid attention to what brand stethoscope and EMT or medic has used. Nor have I seen any clowning about anyone’s.