Fam Pract Manag. 2011;18(4):39
Obtaining compensation and coding data
Eliminate stethoscope background noise
I always listen to patients' chests with the stethoscope on bare skin and not through layers of clothes. Oftentimes, though, when the patient is wearing a shirt, the stethoscope bell underneath it rubs against the shirt creating background noise that could be misrepresented as crackles or rhonchi.
To eliminate this problem, I simply place my palm over the bell of the stethoscope beneath the shirt while I am listening. This also saves the patient from having to change into a gown for most visits that require a cardiorespiratory exam.