Urgent Care PA-C Overcomes Challenging Environments

Littmann CORE's Noise Cancellation and Wireless Functionality Increases Confidence in Urgent Care Scenarios.

Los Angeles Physician Assistant (PA-C) Melody Reyes is on the front lines of the COVID-19 pandemic in a city battling a persistent surge in infections. Most of her grueling 12-hours shifts are spent running the COVID isolation tent area for her hospital’s urgent care department. Auscultating outdoors, in the middle of loud and often chaotic conditions, Reyes needed a device that would allow her to cut through the noise and hear crucial vital sounds.

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“It was so hard to listen to the heart and lungs,” Reyes said. “Sometimes I questioned whether I was really hearing abnormal sounds or whether it was the background noise. Sometimes I was with a patient for a very long time and that caused an increase in wait time for my other patients. Or sometimes I would order X-rays because I thought I heard something.”

She had heard about Eko’s CORE stethoscope attachment and decided to try one. The first day she used the CORE in combination with her Littmann Cardiology IV stethoscope, Reyes felt like she had found the missing piece.

Melody Reyes in a COVID isolation tent

“It was phenomenal in terms of my clinical practice,” Reyes said. “I thought wow, I can hear again perfectly. It was almost like listening for the first time back in school, where I could use the senses I’d been trained to use.”

The difference helped Reyes get an unstable patient the help she needed quickly and confidently, whereas before, triage would have taken much longer.

“An older woman was having a lot of difficulty breathing. I quickly put on my upgraded scope and I could instantly hear all of the congestion that was going on in the lungs. Then, because I was also able to connect through my phone app, I could see how fast the heart rate was going. This patient was in tachycardia and really unstable. I knew right away that I had to admit her, and she needed to be intubated pretty quickly. If I would have had a standard stethoscope, it would have taken longer to get her where she needed to be.”

The first day of using the Eko CORE attachment with her Littmann stethoscope has stuck with Reyes because it made such an impression. A few months later, she was among the first providers to use the new 3M™ Littmann® CORE Digital Stethoscope, what the company calls its most advanced stethoscope yet. In essence, the top cardiology stethoscope is now equipped with powerful Eko technology, including up to 40x amplification, noise cancellation, sound wave visualization, and wireless listening capabilities, which are especially useful when COVID exposure is a top concern for health care professionals.

Melody Reyes in full PPE with the Littmann CORE stethoscope


“No matter what, I’m in full PPE all day,” said Reyes. “I love the fact that you can connect to the CORE with AirPods.”

Using the Bluetooth feature means that frontline providers don’t have to reach under their PPE to put stethoscope ear pieces in to auscultate each patient, and then reach under their PPE a second time to take them out. They simply place the stethoscope chestpiece on the patient’s chest, and the sound transmits through the Eko app and arrives in the earbuds.

Wireless workflow with the Littmann CORE using the Eko app and headphones


“It actually worked really well, but because my shifts are so long, the AirPods run out of charge. So now I'm usually using the Littmann CORE stethoscope with amplification and noise cancellation, unless I have to do visits with a patient in their car.”

That’s right, the car. If a patient comes to the hospital for a COVID swab but they are stable enough to be discharged home, the car becomes a makeshift exam room.

“For those visits I use Bluetooth because it’s so simple to connect and then do recordings or listen wirelessly. The patient just takes their seat belt off and I’m reaching in through the window.”

Recordings Reyes makes using the Eko app come in handy when staff is on the move and spread over a large area. Sometimes a supervising physician is on the other side of the hospital.

“I don't always have the time to call over the radio, so sometimes I'm able to record sounds and my nurse is able to play that for my supervising physician. Or if I'm hearing an abnormal vital sign, which happens a lot with COVID, I use the app to track the heart rate, track the actual rhythm.”

Reyes found herself on the forefront of the coronavirus fight in a roundabout way. Not long ago, she was a public health researcher at the Centers for Disease Control and Prevention (CDC). The switch to clinical practice was largely inspired by her roots. The daughter of South American immigrants, Reyes grew up in a low-income community that was medically underserved.

“Not really having any clinicians or doctors that looked like me, who spoke my native language, thrust me toward this path. I wanted to be that person and come back into my community and speak to my patients in Spanish.”

The goal has become a reality, and also inspired a blog. Reyes shares her insights online through www.stethoscopesandyoga.com.

“I wanted to share my experience as a Latina, as a person who changed careers, and now working in the pandemic. There is a mental health component with it too, with meditation and yoga. I'm kind of amazed at how many people have reached out to say, ‘this is great.’”

Being mindful and practicing meditation has long been a part of Reyes’ routine. Yoga came into the mix about seven years ago. Today, in the middle of extraordinary circumstances and chronic stress, it’s something Reyes relies on to get through the day.

"Tree pose: COVID-y edition"


“Whenever I have to gown up and head over to the COVID area, I often do a yoga pose or just take the time to reflect and prepare to see some pretty scary things, some really sad things. Some of my patients haven't made it, and being able to rely on my yoga and meditation training has really helped.”

Reyes will often post a daily mantra for her followers and hold that mantra in her mind throughout her difficult shifts. Meanwhile, in her hands, she uses the Littmann CORE digital stethoscope to cut through the city traffic, the beeping monitors and all the activity that goes along with evaluating patients in need of urgent care. Eko is proud to provide a tool frontline clinicians like Reyes have come to rely on.
Find out more about Melody by visiting her website, or by connecting with her on Instagram.

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