Amplified Stethoscopes Paired with Hearing Aids

Are you a medical professional who performs auscultation as part of your routine job? 

For those who are not in the medical field, auscultation is the process of using a stethoscope in order to listen to the internal sounds of the body. This method allows medical professionals to examine sounds of the heart and lungs in order to make a diagnosis. For hearing aid users in these medical fields, a frequent concern is how their hearing aids can connect to the stethoscope. 

The difficulty with auscultation and hearing loss is that the heart rhythms and breaths from the lungs are faint, low frequency sounds. Using an amplified stethoscope will help make up for the hearing loss by amplifying bodily sounds. Please be aware that there is a hearing limitation when hearing aids are used. The low frequency levels that are needed for auscultation are far below the frequency region that is needed for speech comprehension. The frequency range of lung sounds is between 70 hertz (Hz) to 4000 Hz. The greatest signal detection is below 2000 Hz. The range of frequencies for the heart beats is between 20 Hz to 650 Hz. Sometimes auscultation is carried out in busy environments.

Deciding on the solution that works best requires you to work closely with your hearing aid provider. Be sure that you are informed and given guidance on the fact that heart and lung sounds may not be heard in the same way when listening to them with hearing aids. Make sure you select the right stethoscope that complements your personal listening needs, the severity of your hearing loss, your style of hearing aids and the accessories that you use.      

Programming suggestions for Phonak Marvel Hearing Aids

Use amplified stethoscopes with headphones and hearing aids. The earpieces on stethoscopes were developed for unoccluded ear canals. As a result, the earpieces have to share space that is occupied by hearing aids. One suggestion is to wear an amplified stethoscope that has over-the-ear or on-ear headphones. The hearing aids can stay inside the ears while conducting auscultation.    

Structures for amplified stethoscopes with headphones: 

• On-ear headphones with hearing aids that feature open or large venting (in hearing aid domes), which will permit auscultation signals to be transferred through direct sound. This works best for hearing aid users who have normal or near-normal low frequency hearing.
• Over-the-ear or on-ear headphones paired with customized hearing aids. Hearing instrument specialists can create a separate manual program that has more low frequency gain. 
• Over-the-ear headphones paired with behind-the-ear (BTE) or receiver-in-canal (RIC) and customized earmolds, can be used to protect the hearing aid microphones. A separate manual program with additional frequency gain should be created.  

Hearing Aid Streaming and Amplified Stethoscopes

Signals from a stethoscope can be streamed through Phonak’s Marvel hearing aids. There are different programming options based on the chosen stethoscope. 

These options include: 

• Bluetooth® streaming through a Bluetooth® transmitter that is connected to the stethoscope.
• Direct Bluetooth® connectivity using a Bluetooth®-enabled stethoscope.
• RogerDirect™ Streaming via Roger microphone plugged into the stethoscope.

No matter what type of stethoscope you choose, take these factors into consideration when choosing a hearing aid:

• The more occluded the coupling of your stethoscope and hearing aid, the lower risk you will have of low frequency leaking out. When choosing a hearing aid to pair with your stethoscope, select a custom earmold that has little to no ventilation.
• The ability to hear low frequencies is vital in order to recognize sounds from a patient’s heart and lungs. Phonak’s Marvel hearing aids have a default streaming program that features a low frequency boost. The amount of gain and range of frequencies that are affected is based on the acoustic vent and receiver power of the hearing aid.
• Think about how you want to hear patients when performing auscultation. The streaming program allows the hearing aid microphones to be fine-tuned based on your personal needs and preferences. 
• If you are experiencing distortion when streaming and performing auscultation, lower the maximum power output (MPO). This would mainly apply to hearing aid users who have an earmold vent. The larger the vent is, the more likely there will be distortion.

Streaming Factors to Consider

• If you are dealing with distorted sounds in the streaming signal, you might need to lower the volume level on the stethoscope. Raising the volume too high on the stethoscope might cause the stream signals in the hearing aids to cut off.  
• If the streaming device features external microphones, like the Roger Select, verify that they are muted during auscultation in order to decrease any ambient noise in the background.
• Hearing aids can automatically shift to the streaming program when Bluetooth® or a signal from a Roger device is detected. This automatic identification makes it easier to use when switching in and out of the streaming program.    

There are many amplified stethoscopes that are available on the market. Each patient has different ranges of hearing loss, so a strong bond between a hearing aid provider and a client is important in order to find the best solution. Clients in the medical field might need to practice and figure out what they need to listen for in regards to bodily sounds that are heard differently with hearing aids and without hearing aids. Recommend that the clients test out the stethoscope with their hearing aids to make sure that all of the devices are suitable for their hearing needs.

If you, or a loved one, are in need of hearing aids, contact us at Pure Sound Hearing for a free hearing test and consultation. 

Please be aware that Pure Sound services will only be available by appointment and for essential visits at this time. Essential visits include all appointments that require new hearing aid fittings, repairs and re-fittings. We ask that you please wait in your car, while wearing your mask, and place your hearing aids in a clean zip lock bag.  We will come to your car to get them. If you are having any problems with your hearing aids, or need supplies for your hearing aids, please call us before visiting one of our offices.

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