
Why Are Stethoscopes Still a Thing? - dsr12
http://motherboard.vice.com/read/why-are-stethoscopes-still-a-thing
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ackfoo
Idiotic article.

The value of a stethoscope comes not from the low-tech, lo-fi sounds that it
picks up, but from the enormous knowledge base built up over hundreds of years
and billions of examinations that allows a doctor to diagnose, say, mitral
valve insufficiency, or pleural effusion, instantly.

By themselves, a muffled "whoosh" at a particular point in the cardiac cycle,
or a particular kind of "rub" while breathing, mean nothing whatsoever. Any
modern imaging technology could outperform the glorified tube of the
stethoscope easily.

However, since we have built up an enormous database of clinical experience,
it gives us a powerful ability to interpret otherwise useless sounds in a way
that outperforms newer technologies for speed, efficiency, accessibility, and
reliability.

If you arrive in ER with a pneumothorax, for example, you had better hope that
there is someone waiting for you with a stethoscope to confirm the absence of
breath sounds on the affected side. Even a handheld ultrasound may not be fast
enough to get you a chest tube before you are irreversibly dead.

~~~
digi_owl
I can't shake the feeling that modern humanity is ignoring all but its ability
to see.

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skywhopper
The amount a doctor can learn about the functioning of one's heart and lungs
via a cheap and simple tool like a stethoscope is amazing, and certainly
nothing to look down on. Ultrasound tools may well one day be as commonly used
but while ultrasound and other imaging tech can provide images and details
stethoscopes cannot, they in turn cannot give the doctor any information about
how ones breathing sounds, and cannot provide the instant and visceral
connection of hearing your heartbeat directly.

Simple tools like stethoscopes are critical to medical care precisely because
they are so cheap, easy to use, flexible, reliable, portable, quick to deploy,
and give a direct human connection between doctor and patient. Why would you
ever want to replace it? Supplement, sure. Improve, absolutely.

~~~
dbbolton
Medical student here- I completely agree. Auscultation is an important
component of physical examination, and most of this article's arguments
_against_ it just seem silly. Ignoring the obvious etymological fallacy, it's
just not cost effective to replace stethoscopes with imaging tools.

A "cheap" portable ultrasound machine is going to be in the thousands of
dollars, and there's just no way that hospitals and clinics would be able to
purchase enough of them so that one was available for every ongoing PE- not to
mention the fact that US is billed separately, and could easily double the
patient's cost for a brief office visit.

Plain film x-rays and CT scans expose the patient to ionizing radiation, so
that's not a practical option either.

MRI is expensive, time-consuming, and a lot of rural hospitals might not have
a machine, or if they do, it's very, very unlikely that they're going to have
staff available to operate it 24 hours a day.

All of these tools, including the stethoscope, have their own separate uses
and applications- they are not competitors.

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douche
MRIs also have issues if you happen to have ferrous metals in your body.
Ignoring obvious things like surgical pins, plates and screws used in
orthopedics, and piercings, people in certain occupations have a high
likelihood of picking up things like metal filings in their eyes, which can be
catastrophic for them in a MRI.

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iofj
Funny : "yet doctors cling to a tool that was invented at a time when medical
practitioners still regularly used leeches as a form of treatment."

They still do "cling" to leeches for some treatments as well. Leeches are hard
to beat for a few conditions. It's got a name : hirudotherapy, and sees
application in skin related conditions and wound cleaning, and saves hundreds
of legs and arms from amputation on a yearly basis and even sees use in
cosmetic medicine. Cleaning skin and wounds the way leeches do is not
impossible but takes experts hours or days and introduces risks that treatment
with leeches does not.

[https://en.wikipedia.org/wiki/Hirudo_medicinalis#Today](https://en.wikipedia.org/wiki/Hirudo_medicinalis#Today)

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radiorental
In other news, why are construction workers still using this 1000 year old
tool what with all the modern advances in construction technology

[https://en.wikipedia.org/wiki/Hammer](https://en.wikipedia.org/wiki/Hammer)

~~~
anexprogrammer
There's probably a startup somewhere working on an IoT connected version. With
an app to keep track of number of hits, thumbs and misses...

~~~
pavel_lishin
Error: The Samsung Naildriver™ is not compatible with this brand of wood
fastening device.

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0xcde4c3db
I'm only vaguely familiar with either technology, but I don't understand how a
handheld ultrasound scanner can possibly substitute for a stethoscope.

I know this is a flawed analogy, but I imagine somebody walking up to an
electronics tech and saying "Hey, you don't need that oscilloscope anymore
because we bought this thermal camera. Don't you know that oscilloscopes are
old technology from the 19th century? Why, they didn't even know what
electrons were back then!".

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ape4
Why do doctors still use their eyes when looking at an injury.

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newday
This is literally the dumbest thing I've read on vice.com. And I just read an
article about a girl that drank a bottle of marijuana personal lubricant.

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dekhn
What a strange article. It ends up damning the stethoscope with faint praise.

