Saturday, September 20, 2014

LOLA Advanced Assessment Stethoscope

As an EMT, one generally carries a variety of small tools for completing patient assessments, including but not limited to a stethoscope, pen light with pupil gauge, pen, clipboard with pertinent paperwork, trauma shears, oxygen wrench and a radio or phone. Seeing as how keeping one’s gear together and out of the way can be a little troublesome while moving about, taking vitals and performing other tasks such as taping patients to backboards, it goes without saying that a streamlined multi-purpose patient assessment tool would be of great use to an EMT or like-minded healthcare professional. It is this desire that the LOLA Advanced Assessment Stethoscope can fulfill.
The LOLA Advanced Assessment stethoscope is an innovative tool that combines several critical patient assessment tools into one package, namely the stethoscope, penlight, pupil gauge and ruler. Separately, these tools are generally of low quality and difficult to effectively manage. Combined into the LOLA stethoscope, one has an efficient and well-designed tool that will last a great long while.
I’ve had the opportunity to assess the quality and effectiveness of the LOLA stethoscope for a few months now on a wide variety of patients and in different situations and have been overall impressed with everything about it. To better describe this stethoscope, I will break this review down into features I find important.

1)    Packaging: This stethoscope comes packaged in an attractive box that is easy to open and remove the contents from. In the box is a stethoscope with clear earbuds and a small pack containing three other pairs of earbuds and an extra battery for the light. Each pair of earbuds is unique and can be customized to fit the end user.


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2)    Stethoscope head: The stethoscope head is comprised of stainless steel and the tympanum is a clear plastic. The rim of the tympanum does not have a non-chill ring. The plastic is quite rugged as well.



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3)    Light switch: Atop the head is a push-button to activate the light. The button is a constant-on switch and light is emitted from a single LED.  The button itself is rubbery and easy to activate.

4)    Tube: There is just one tube for this stethoscope and it is made of a non-latex material that is rigid yet flexible. On the tube is a pupil gauge with examples of pupil sizes from 1mm-8mm. There is also a 40cm ruler printed on the tube, complete with millimeter markings.


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5)    Ear portions: The ear portions of the stethoscope are stainless steel and end in threads to accept a proprietary metal threaded mounting bud whereupon one can fix one of four different pairs of earbuds to make a custom fit for the user.

6)    Fit: The multiple ear buds were quite useful for me in acquiring a good fit and I achieved a good level of comfort. They came in handy on two different occasions:

a.    I will often watch a show on my phone while waiting for patients but I don’t want to disturb my partner and I don’t have earphones so I just use my stethoscope and keep the volume low on my phone. Works like a charm and I can stay comfortable for over 30min at a time. I couldn’t do that without some decent fitting ear buds.

b.    My friend and I were sparring with rubber training knives one night and having a good time. That is, until he got a little too frisky and ended up sticking the tip of one in my right ear and leaving me with a good 3/16” cut in the inner cartilage (nothing serious, just painful at the time and funny now, seeing as how I used a tampon to help stop the interestingly profuse bleeding). In any case, I had to change out my ear buds so I could actually work without dreading the pain from using my stethoscope. Without my extra buds, I would have been in much more pain than I would have liked.


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See the cut inside my ear? Yeah, that one hurt pretty bad.

7)    Acoustic quality: I have compared this stethoscope’s acoustic qualities with a Littman Master Classic II, Littman Classic II SE, Littman Cardiology III and my mother’s no- name stethoscope from when she was a nurse back in the 1960s (I was a bit of a stethoscope junkie a while ago, sort of by accident) while in an ideal setting (sitting in my room, door closed, none of my sisters fighting, etc) and I found the acoustics to be equal to or better than that of the Classic II SE, Master Classic II and the no-name stethoscope, beaten only by the Cardiology III. My pulse under pressure from a sphygmanometer sounded like a hammer striking wood and my heart sounded loud as well, though not as loud as with the Cardiology III. Unfortunately, I haven’t been trained to pick up heart sounds past the normal atrioventricular and semilunar valve closures (“lub” and “dub”, respectively) so I can’t really comment on aberrant cardiac issues like clicks, rubs or murmurs. Listening to lung sounds were not a problem either.

In actual use, of course, situations are not ideal and are quite noisy. However, while performing my duties as the attendant, I never had a problem acquiring blood pressure readings and lung sounds, even with edemic patients.

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8)    Light quality: The light is a diffuse “cool” white color and is bright enough for finding objects about 3’ away if needed. Seeing the pupil diameter of a patient’s eye requires a closer distance though (especially in the dark) and from my use I it seems about 6-12” is the maximum distance for checking pupils diameters.

9)    Pupil gauge and ruler: The pupil gauge and ruler are both painted onto the tube and are quite clear with sharp demarcations.

10)    Neck hangability: This stethoscope hangs nicely around the neck and the tube material does a good job gripping cloth

11)    Length of the tube: The tube length is a good 21”, which is much nicer for ease of patient care and for patient comfort than my 15” Littman Cardiology III, especially for those times when I am bouncing around in the back of an ambulance and I can’t get a blood pressure on the left arm and must reach over and use the right arm from a right-sided only ambulance. Yeah, you know what I mean.

As with all products, there are a few things that I would like to either see improved upon or tweaked by the end user to make the product easier to manage, namely:

1)    I would love to see a non-chill ring on the tympanum’s rim. Sure, it isn’t necessary but it is a nice feature for better patient comfort.

2)    The metal ear bud fixtures could use a little blue (NOT RED) Loctite to stay on the stethoscope without falling off. One of mine came unscrewed while I was on the job so I hijacked the earbuds off of my old Sprague and jammed them on there so I can use them while I get around to ordering new ear bud fixtures.

Bottom line: This is a very good stethoscope for the money and I highly recommend it, especially for EMTs, CNAs and the like. There are certainly many worse and useless ways to spend your money, like buying a cheap double lumen Sprague or US government bonds, whereas this stethoscope should be with you for years to come.

CARRY ON!

-N8

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