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April 20, 2020How to pair Phonak Marvel hearing aids and amplified stethoscopes
If you are a medical professional living with hearing loss, what do you need to consider when using an amplified stethoscope?
As an audiologist with hearing loss, I have learned many tips for finding the right amplified stethoscope that works well with hearing aids.
Auscultation with hearing aids
If you are working in the medical field, you may have run into the challenge of using a stethoscope with your hearing aids, particularly when performing auscultation.
Auscultation is the act of using a stethoscope to listen to the internal sounds of the body. Through auscultation, medical professionals can analyze heart and lung sounds for differential diagnosis, according to A.U. Bankaitis Smith’s article “20Q: Amplified stethoscopes for medical practitioners.”
A question often asked by hearing aid wearers is, “how should my hearing aids interface with the stethoscope?”
The challenge with auscultation and hearing loss
The challenge with auscultation and hearing loss is that heart and lung signals are very soft, low-frequency sounds. An amplified stethoscope helps compensate for hearing loss by amplifying bodily sounds. However, there is a limitation when coupled with hearing aids. For instance, the frequency bandwidth needed for auscultation extends well below the frequency region necessary for speech understanding. As an added challenge, auscultation is sometimes performed in noisy environments.
“The challenge with auscultation and hearing loss is that heart and lung signals are very soft, low frequency sounds.”
To determine a solution that best fits your needs, it is important that you and your audiologist work together. It is also important to be aware that heart and lung sounds might not be perceived the same when listening through hearing aids. Choosing the right stethoscope is dependent on your listening needs, the severity of your hearing loss, the type of hearing aids worn, and wireless accessories used.
Below are recommendations for set up with Phonak Marvel hearing aids.
Amplified stethoscopes with headphones and hearing aids
Stethoscope earpieces are designed with an unoccluded ear canal in mind. Thus, the earpieces are competing for space occupied by hearing aids, according to Smith. One consideration is to use an amplified stethoscope with over-the-ear or on-ear headphones. This allows the hearing aids to remain in the ears during auscultation.
The configurations for an amplified stethoscope with headphones include:
- On-ear headphones with hearing aids that have open or large venting in the earmold. This allows auscultation signals to be travel naturally through the vent. This is ideal for someone with normal or near-normal low-frequency hearing.
- Over-the-ear or on-ear headphones with custom hearing aids. An audiologist can create a manual hearing aid program with more low-frequency gain.
- Over-the-ear headphones with a behind-the-ear or receiver-in-the-canal hearing aid and custom earmolds. Over-the-ear headphones are recommended to cover the hearing aid microphones. An audiologist can create a manual hearing aid program with more low-frequency gain.
Read more: What it’s like to become a nurse with hearing loss
Amplified stethoscopes and hearing aid streaming
It is possible to stream signals from a stethoscope to Phonak Marvel hearing aids. There are different setup options depending on the chosen stethoscope.
These include:
- Direct Bluetooth connectivity via a Bluetooth-enabled stethoscope
- Bluetooth streaming via a Bluetooth transmitter plugged into the stethoscope
- Roger Direct streaming via a Roger microphone plugged into the stethoscope
Hearing aid factors to consider
Regardless of the chosen stethoscope, consider these hearing aid factors:
- When selecting the earmold, discuss with your audiologist if a custom earmold with minimal or no venting or a power dome would be suitable for you.
- Low-frequency information is important for detecting heart and lung sounds. In Phonak Marvel’s streaming program, a low-frequency boost is provided by default.
- Consider how you would like to hear your patients when performing auscultation. Within the streaming program, the balance between the acoustic signal from the hearing aid microphones and the streaming signal can be adjusted according to your needs.
Streaming factors to consider
In addition, consider these streaming factors:
- If you experience distortion in the streamed signal, you may need to reduce the volume on the stethoscope. Increasing the volume too much on the stethoscope may lead to clipping of the hearing aids’ streaming signals.
- If the streaming device has external microphones such as the Roger Select, make sure they are muted while performing auscultation to reduce the surrounding ambient noise.
- The hearing aids can automatically switch into the streaming program upon detection of the Bluetooth or Roger signal. This automatic detection allows for greater ease of use when switching in and out of the streaming program.
There are multiple amplified stethoscopes on the market and each individual has unique listening needs. Therefore, a partnership between you and the audiologist is crucial in determining the right solution. You may need to practice and learn what to listen for. Bodily sounds may be perceived differently via the hearing aids than without them. If available, demo a stethoscope beforehand to ensure it meets your needs.
Disclaimer: The information provided is a general recommendation only. Phonak does not warrant, endorse, guarantee or assume responsibility for the accuracy or reliability for any information offered within this presentation. The use of any information contained within this presentation is solely at your own risk.
