The stethoscope is an essential piece of equipment for medical professionals. Even with the advent of a wide range of technologically advanced medical equipment, simply being able to hear a patient’s heartbeat, blood pressure, respiration, bowel sounds, and more in seconds is still a vitally important part of the diagnostic process. However, for the hearing impaired medical professional, standard stethoscopes can create a challenge because it can be challenging for them to hear the sounds they need to.
All is not lost, however, because advances in stethoscope technology mean that health professionals with hearing disabilities can use a stethoscope to improve their health care delivery.
What Stethoscope Options Are There for The Hearing Impaired?
The first thing to remember is that not all hearing impairments are the same. And the type of hearing loss someone has will impact their accessibility needs when it comes to finding the best stethoscope.
Most hearing loss is in the higher frequency ranges, but other types of hearing loss, such as reverse-slope hearing loss, mean losing the ability to hear sounds in the lower frequency ranges. It is worth noting that body sounds, such as heartbeat and respiration, tend to be in the lower frequency range.
Similarly, the extent of hearing loss can vary wildly. For example, some people with hearing loss will experience mild impairment for which they don’t need a hearing aid, whereas others may have an impairment to the extent that they need a cochlear implant.
The varying types of hearing loss will significantly impact the type of assistive technology medical professionals need when choosing their stethoscopes.
Digital vs. Analog Stethoscopes
Traditionally, stethoscopes are a pretty low-tech piece of equipment. The chest piece has a diagram on one side and a bell on the other. Air-filled tubes run from the chest piece to the ear tips. The tube and the chest piece work together to amplify sound as it moves towards the earpiece. This allows you to be better able to hear small sounds within the body.
An electronic stethoscope has the same goal, but it uses a different technique. With these types of stethoscopes, the chest piece contains a microphone that will convert the acoustic sound waves into electronic signals that can then be boosted and fed into the earpieces.
Many people still choose to use a traditional stethoscope. Still, there are a wide variety of electronic stethoscope options, some of which can be a big help to people living and working with hearing loss.
The Cardionics E Scope I is a popular standalone electronic stethoscope, as is the 3M Littman, the Welch Allyn Master Elite, Thinklabs One, and the Electromax. However, there are many other brands and models available.
- Connects to Eko software to visualize and share heart sound waveforms (smart device not included)
- Up to 40x amplification (at peak frequency, vs. analog mode)
- Active noise cancellation reduces unwanted background sounds
- Toggle between analog and amplified listening modes
- Soft-sealing ear tips provide an excellent acoustic seal and comfortable fit; Tunable, dual-sided...
Different Amplified Stethoscope Options for People with Hearing Loss
Various options will allow people with a hearing impairment to use a stethoscope. Which is the best depends on the hearing impairment and personal preferences.
Some types of amplified stethoscopes work better with some hearing devices or with no hearing device at all. While no one solution is perfect, some workarounds can be effective for people with most types of hearing loss.
People with Hearing Aids
For people who use hearing aids, for example, a stethoscope that has been modified to be compatible can be a solution. Of course, the type of compatibility will depend on the type of aid. But wearing a hearing aid can make the stethoscope more challenging to use even when it has been made compatible.
This is because hearing aids are often specifically programmed to amplify high-frequency sound. Because sounds like heart sounds and respiration are low-frequency sounds, wearing a hearing device can make it more difficult to hear them, not more. In addition, some hearing aids can be reprogrammed to amplify low-frequency sound, which makes them more usable with a stethoscope.
Using a stethoscope while wearing hearing aids can be difficult, especially in-the-canal (ITC) or completely-in-canal (CIC) hearing aids. In these situations, you can pick up a customized earmold for your stethoscope that will fit around your ear and allow you to use your hearing aid simultaneously as the stethoscope.
Another option is using specialized tips, known as stethomate tips, that allow you to connect your stethoscope to your hearing device. However, these can be uncomfortable because of the pressure needed from each instrument to provide a seal.
Alternatively, many electronic stethoscope models can be used with headphones and their ear tips completely removed, whether that be a traditional style headphone or a convertible style headphone. This allows the sounds to be sent to the ear without any discomfort. In some cases, however, the closeness of the microphone to the hearing device can cause feedback.
In this case, oversized headphones can often be a better option, although these are unpopular because of aesthetic reasons.
People who use behind-the-ear (BTE) hearing aids compatible with direct audio input (DAI) are better positioned than many. Some amplified stethoscope models can connect directly to the hearing aid via DAI.
This option eliminates the discomfort issue, and as long as the hearing aid is correctly programmed, the problem with filtering out low-frequency sounds can be reduced at the same time.
If the BTE hearing aid isn’t DAI-compatible, there is an option for the ear molds to include an additional vent through which the stethoscope ear tips can be placed. But this can be a fiddly and cumbersome solution.
Because none of these solutions are perfect, many people with hearing aids choose to take them out when they use a stethoscope, but this is time-consuming and can interfere with effective communication with the patient.
People without Hearing Aids
For people without hearing aids, however, the best option is often simply the standalone amplified electronic stethoscope. This is because an acoustic stethoscope won’t amplify the low-frequency body sounds, such as the heart and breath sound, enough to counteract the hearing loss.
With an electronic stethoscope, however, body sounds can be amplified enough to be heard by people dealing with a mild hearing impairment. In addition, this type of digital hearing device can be precisely calibrated to the impaired frequency of sounds. Doing so gives medical professionals with a mild hearing impairment the best possible chance to use their stethoscope effectively.
Another benefit of an electronic stethoscope over a traditional stethoscope is that it can mask background sounds. All of the sound waves picked up by the microphone are processed before being played through the earpiece, which includes noise reduction.
For people with a hearing impairment, background noise can make hearing the target sound even more difficult. So using an assistive listening device that masks these sounds can make a big difference.
While acoustic stethoscopes will naturally mask ambient noise to some extent, an electronic stethoscope will also actively filter out these sounds.
If the ambient sound is a big issue, for example, working in a noisy environment, it can be better to opt for a stethoscope that uses acrylic instead of metal for its chest and earpieces. These will help to mask the background noise further.
Amplified stethoscopes can also be calibrated to the type of sound you are listening for. For example, two chest pieces can be used with a conventional stethoscope: the bell and the diaphragm. These are necessary because different body sounds are at different frequencies, although they are all clustered around the lower frequency end.
The bell chest piece is better able to pick up lower frequency heart sounds, whereas the diaphragm chest piece is better able to pick up higher frequency breath sounds.
There is no need to switch between the bell and the diaphragm chest piece with an amplified stethoscope. Instead, the microphone can pick up higher and lower frequency body sounds.
People with A Cochlear Implant
Some electronic stethoscopes can connect directly with the implant via an audio jack for medical professionals who use a cochlear implant. This allows the heart and breath sound to be fed into the cochlear implant to make it easy to hear.
To Wrap Up
Stethoscopes have been an essential piece of medical equipment since their invention in the early 1800s, and they are still used on a day-to-day basis by many health care professionals. However, because of the low sound frequency of body noises, a hearing impairment can make it very difficult to hear, even with a conventional stethoscope.
An electronic amplified stethoscope can overcome many of the challenges of stethoscopes use with hearing loss. Different solutions are available depending on whether you use a hearing aid, and there are even solutions for cochlear implant users.
Some of these solutions are imperfect, but as with most medical and health technology solutions, improvements are being made all the time to make stethoscopes even more accessible for those with a hearing impairment.