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Hearing is believing when it comes to training

Consider incorporating these three ways to use a digital stethoscope in your EMS training exercises and testing


Digital stethoscope technology that affords students and preceptors the ability to relisten to a patient’s lung sounds after the initial assessment is an invaluable learning tool that no YouTube video or sound clip can reproduce.


Sponsored by Eko Health

By Tim Nowak for EMS1 BrandFocus

If only your entire paramedic class could hear the same lung sounds that last week’s clinical group heard ... Well, there’s a tool for that.

The technology behind noise canceling, high-fidelity recording and Bluetooth-enabled stethoscopes has improved dramatically over the years, now available in products like Eko’s CORE Digital Attachment.

So, where does this technology advancement fit into EMS education? Here are three examples of how hearing is believing both in the classroom and in the field.


Last week’s clinical group heard something interesting while assessing a 3-year-old male who came to the emergency department with a “rough cough.” He presented as active in appearance, breathing with normal rates and effort, and otherwise seemed hemodynamically stable – but he did have a slightly elevated temperature.

His parents reported that their child had begun to get this “rough cough” overnight, which led to him having a hard time sleeping. The child doesn’t complain of any pain, and a cooperative physical exam of his throat doesn’t reveal any swelling or irritation. Shortly thereafter, the patient lets out his “rough cough” in a coughing fit that lasted a few seconds. Listening to his lung sounds after this resulted in seemingly clear sounds, but still a bit more resonant than what we would all come to expect as compared to “normal.”

Keeping a close eye on the patient, with your digital stethoscope in place on his chest, you’re able to experience the patient’s cough return and hear a rough, “seal-like,” resonant lung sound in result. This lung sound – although a result of irritation of the upper airway that resonated into the lungs – was recorded and can now be played back to the attending physician and the rest of the class. This sound – which didn’t seem the same as traditional rales or rhonchi – was unique and intermittent, and your device’s digital recording function caught the sound in action.


Hearing rales or crackles for the first time on a “live” patient – outside of the sterile hospital clinical setting – sounds “different” than in a patient’s home or in the back of an ambulance. Being able to recap on what you heard as a student, or as an instructor to recap on what your student heard, is a valuable teaching tool for a field preceptor.

“Why did we go straight to CPAP?” the student may ask. “The patient was sick and working to breathe. We needed something powerful to open up his lungs – they sounded very congested,” replies the preceptor. “Here, let’s listen.”

It’s invaluable to be able to relisten to a patient’s lung sounds 30 or 60 minutes after you initially heard them on scene. Digital stethoscope technology that affords students and preceptors this ability is an invaluable learning tool that no YouTube video or sound clip can reproduce.

eko-core-attachment-closeup-horizontal - 1000x crop.jpg

Install the Eko CORE Digital Attachment onto the stethoscope you already own to eliminate noise distractions, enhance auscultation and enable more options for how you listen.

Eko Health


Come examination day, everything you’ve been studying for in your respiratory chapter has come to its peak. Now, it’s time to verify and validate what you’ve been learning.

Question 1: “Which expiratory lung sound is characterized by ...?”

We’ve all had that static test question. How about an interactive hearing exam to go along with it? Spice up your classroom and your students’ exams with some “live” lung sounds! We’re accustomed to testing students in a “dynamic cardiology” environment (with a “live” rhythm strip scrolling across a cardiac monitor’s screen showing one of the 12 often-repeated rhythms clearly displayed). How about a “dynamic respiratory” exam?

With the ability to record lung sounds throughout the year, replay them to the class, save them in an archive and then revisit them in a testing environment, your test bank of opportunities as an instructor just expanded tenfold as the year progresses (and with the ability to throw in a trick question bowel or heart sound for good measure).


It’s fair to presume that nearly every EMS educator has at least a handful of sound clips buried on their hard drive somewhere for training purposes. Wheezing, stridor, rales/crackles, rhonchi or Rice Krispies going “snap, crackle, pop” in a bowl of milk ... we’ve all got them somewhere. How about an update with some high-quality sound clarity that came from a real patient, saved from your digital stethoscope?

The digital assessment tool world has expanded, and that means the pool of digital training tools has grown with it. Before, we were hindered by access to technology. Today, we can use these tools to facilitate more dynamic learning opportunities.

Visit Eko Health for more information.

Read Next: Why the traditional stethoscope is no longer sufficient in EMS

Tim is the founder and CEO of Emergency Medical Solutions, LLC, an EMS training and consulting company that he developed in 2010. He has nearly two decades of experience in the emergency services industry, having worked as a career firefighter, paramedic and critical care paramedic in a variety of urban, suburban, rural and in-hospital environments. His background includes nearly a decade of company officer and chief officer level experience, in addition to training content delivery and program development spanning his entire career. He is experienced in EMS operations, community paramedicine, quality assurance, data management, training, special operations and administration disciplines, and holds credentials as both a supervising and managing paramedic officer.

Tim also has active experience as a columnist and content developer with over 200 published works and over 100 hours of education content available online, and is a social media influencer on LinkedIn within the EMS industry. Connect with him on LinkedIn or at