Tips to Use a Stethoscope in a Proper Way

While conducting a physical assessment, doctors need skills such as inspection, palpation, percussion, auscultation, and olfaction. The term ‘auscultation’ is derived from the Latin word Auscultaure, which means ‘to listen’. In the field of medicine, auscultation is performed with the help of a stethoscope. The term ‘stethoscope’ is derived from two Greek words called stethos and scopos. While the former refers to the chest, the latter means examination. An acoustic medical instrument, the stethoscope is integral to the diagnosis. This instrument is extremely useful, when it comes to diagnosing medical conditions associated with the organs located in the chest cavity. While the stethoscope that was designed by René Laennec was made of wood, the advancement of medical science has led to the development of several designs with added features. However, even the modern acoustic stethoscopes have simplistic designs. Doctors now also have the option of using electronic stethoscopes that can even amplify sounds.

Parts of a Stethoscope

Doctors are aware of the intensity, quality, or pitch of sounds that is normally associated with certain parts of the body. If they hear any variation from the normal sounds, they can perform other diagnostic tests to confirm the diagnosis. A stethoscope helps the doctors ascertain the presence and location of abnormal sounds. At times, the absence of sounds could help in the diagnosis. For instance, the absence of bowel sounds can be an indicator of bowel problems.

Parts of a stethoscope
The components of a stethoscope include:

✦ Earpieces/eartips
✦ Binaurals (ear tubes or curved metal pipes that connect the earpieces to the tubes of stethoscope)
✦ Air-filled tube
✦ Chest piece

The headset comprises the two earpieces and ear tubes. The chest piece consists of a bell and a diaphragm. While the bell is the cup-shaped side that is used for listening to low frequencies or low-pitched sounds, the diaphragm is the flatter side that is used for high frequencies. A removable chill ring prevents the chest piece from coming in contact with the skin, and also keeps the diaphragm in place. In case of dual-frequency, tunable stethoscopes, the bell and the diaphragm are combined on one side of the chest piece. All the user needs to do is apply varying pressure to listen to low or high frequencies. Low pressure and high pressure needs to be applied to listen to low frequency and high frequency sounds, respectively.

In case of the two-sided chest piece, the user can switch between the bell and the diaphragm, depending on the frequency. It must be noted that only one part of the chest piece can work at a time. The sound can be amplified either through the bell or the diaphragm. If the sound is barely audible through the bell, it implies that the diaphragm is in the position for use. There are certain types of stethoscopes that don’t have a bell.

When the diaphragm is placed on the skin, it vibrates due to the sounds from the body. This leads to the creation of the acoustic pressure waves, which in turn travel up through the tube. The sound is transmitted from the bell or the diaphragm to the earpieces, which fit in snugly in the ears, thereby preventing other sounds from entering the ears.

How to Use a Stethoscope Properly

There are a few aspects that you need to keep in mind in order to use a stethoscope properly. Basically, you need to put the earpieces in such a way that they create an airtight seal with the ears. This is to block the noises from the outside environment, so that you can focus or clearly listen to the sounds emanating from the internal organs. Here are a few pointers on using a stethoscope in a correct way:

Eartips should point forward
✦ After placing the earpieces in the ears, adjust them so that they point slightly forward. Usually, binaurals or the ear tubes are positioned at an angle of 15°, so that earpieces can point forward and align with the ear canal. Ensure that the earpieces are a snug fit.

Eartips should be a perfect fit
✦ If you have placed the earpieces properly, the external noise will become faint. Earpieces are available in small, as well as large sizes. So, make sure that you opt for a size that is a perfect fit.
✦ Make sure that you check the earpieces on a regular basis. Look for cracks. Also, it is essential to clean the earpieces, so that auscultation is not affected by the accumulation of earwax, lint, or dirt.

Don’t place the fingertips on the edge of the diaphragm/bell
✦ The chest piece should also be held in the right manner. It must be held between the index finger and the middle finger of the dominant hand. Fingertips should not be placed on the edge of the diaphragm or bell, as that can lead to noise, which in turn will affect one’s ability to listen to the sounds from the internal organs. Make sure that the stethoscope tube doesn’t rub against the patient’s skin.

Double-sided stethoscope with a bell and diaphragm
✦ If you are using a double-sided stethoscope that has a bell and diaphragm, you will need to rotate the chest piece, so as to open the bell or diaphragm. If the diaphragm is open, the bell will be closed, and vice versa. This is to ensure that sound doesn’t come through the other part. This prevents noise interference, thereby allowing doctors to hear high or low frequency sounds properly.

Tunable stethoscope
✦ If you are using a tunable stethoscope, move the chest piece in a half circle. Once you hear a click, tap the bell and diaphragm to check which one of them is open.
✦ Make sure that the parts of the chest piece are not loose. Look for signs of damage.
✦ Do not touch the tube (tube that runs from the chest piece to the headset) while examining a patient with a stethoscope.

Place the stethoscope on bare skin to minimize noise interference
✦ Placing the diaphragm or the bell on bare skin would also help avoid noise interference that could occur due to the mixing of sounds from the body and clothes.

On a concluding note, it is essential to clean the stethoscope to ensure optimal acoustical performance, as well as reduce the risk of transmission of pathogens. It is advisable to disinfect the bell/diaphragm of the stethoscope before using it on another patient. It can be wiped with a 70% isopropyl alcohol solution. Also, make sure that it is not exposed to extreme temperature, solvents, and oils. Remove the earpieces from the tubes regularly for thorough cleaning.

Tips to Break the Habit of Skin Picking

Breaking the habit of skin picking
Love it, hate it, but you can’t ignore it. No matter if you feel happy, sad, anxious, or just plain indifferent, you can’t resist yourself from picking your skin. Doesn’t it sound like an addiction? An alarming state of a maniac who’s lost it all!

There are many of us who are addicted to skin picking. A habit dear to you right from your childhood. The pleasure you gained in picking on your skin around the nails and lips was enough to keep you busy throughout your childhood. And now, it has grown into an impulsive control “disorder”. Can it really be cured? Well, cure isn’t the correct word. Let’s say, we can help you stop or break the habit of skin picking by the following ways.

Know what causes it
If you accept that it is a disease and you need to come out of it, do a thorough research on it. Skin picking disorder or dermatillomania is caused due to external as well as internal factors. Tanning, dust, smog, and exposure to harmful microbes – bacteria and virus – can be the external factors.
Your diet, water, or other supplements that you have can play a role as well. It can also be passed on to you as a hereditary syndrome. But the most common cause is deep inside your head; as the coping mechanism to deal with high levels of turmoil, anxiety, or stress.
List down things that relax you
Note down the things and activities that help you relax. Do some painting. Play your guitar. Do yoga. Go for a sauna. Read magazines, novels, or books. Watch a movie. Listen to music. Or perhaps take a nap. It will help you curb the anxiety that compels you to start skin picking.

The Hate Approach
It may sound funny, but try this. Many in the world have found great relief in doing so. Take a large picture/poster of your favorite celebrity and paste it in your room. Take a red marker and draw zits and scars all over their face. Now sit and watch it. Then, using the marker draw a bold and dark cross all over the picture. This will remind you what “NOT” to become.

Idle hands are the devil’s workshop
Quite self-explanatory in this case. Keep your hands occupied. Take a squeeze ball or those popular Chinese Caomaru balls. To prevent biting around your nails, apply a bandage in that area or apply some fancy nail paint (for girls). That way, you will be less tempted to dig on your skin. Another reliable practice is to wear gloves. That way your hand remains covered, and your grip on any other object to pick skin completely wears away.

Inspirations on the go
Stick inspirational quotes and sayings everywhere you go. The kitchen (refrigerator) door, toilet door (preferably the inner side), car’s dashboard, or cupboards of your room. In this digital age, you rather set the quotes as wallpapers of your laptop and cell phones. This way, wherever you go, you will be reminded “NOT” to do it.

Keep loneliness at bay
When do you pick ideally? Whenever you are alone doing nothing! So, better we take this “loneliness” out of the scene. Try to remain engaged in something or the other. If you live alone, try to hang out – go to some departmental store, visit your friends, go partying, or go to some fine restaurant and treat yourself with whatever you like.

Healthy lifestyle
It all boils down to the same fact again and again – “A healthy lifestyle is the key to happy well-being”. Do regular exercises – yoga, morning walks, jogs, simple stress-relieving exercises like aerobics, etc. This will refresh you and lower your anxiety level.
Avoid eating too much fried junk food and instead go for nutritious food like salads, sprouts, juices, soups, raw vegetables, and fruits. Water is a great detoxifier, hence drink plenty of water. This will prevent the growth of acne and other scars on your skin. No acne, no picking!

Aromatherapy
Who doesn’t like the sweet fragrance of flowers? So does your skin. Aromatherapy has emerged as a great way to revitalize your skin and open the blocked pores, thus cleansing your skin.
▶ Take a vessel filled with hot, boiling water and add 2-3 tablespoons of aromatic herbs or oil in it.
▶ Place a wide towel over your head, covering the bowl and create a steam tent.
▶ Inhale the fragrant steam for about 5-10 minutes.
▶ Finish the process by washing your face with cold water.

Tip: Use lavender oil, lemon oil, or apricot oil. For herbs, you may choose chamomile, basil, mint, lavender, or rose petals.

Peer Counseling
One is always motivated to attain more when the inspiration comes from an alter ego. Try to be friends with fellow chronic skin pickers, and both of you can take it as a challenge to get rid of the disease. Competition, this way, is a healthy practice. Or you can use the social network to join forums where you can interact with people who have overcome a similar condition. Direct motivation from a veteran would do wonders.

Keep a track of your progress
Make a habit to log and register every bit of your growth as an anti-skin picker/peeler. Starting from day one, note down the frequency of your picking, the most susceptible areas where your pick on, and what ways are you trying to cope up with the urge. After every week, take stock. You will really feel happy and motivated by your progress. Plus, this documentation might come handy for others when you turn a ‘Once-a-Picker’.