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For Medical Students
You want to start as early as possible perfecting your clinical assessment skills.
The physical exam is key in every patient encounter
Your responsibility to physically assess a patient, will be a major characteristic differentiating yourself
from others in the healthcare field. In addition, insurance companies billed require appropriate
documentation of your clinical observations, and the medical necessity of the procedures performed.
Many clinicians believe over 80% of diagnoses come from the history and physical assessment of the patientThere will be increasing pressure on physicians to pay close attention to the high cost of healthcare, and payers will insist on well-documented evidence that advanced care or testing is required. Although great advances have been made in medicine, approximately 80% of your diagnoses will still come from basic history and physical assessment.
So why invest with Welch Allyn? When purchasing your first diagnostic instruments, it's important to understand this is an investment for your future. The medical equipment presented here will be critical tools to your success when gaining physical diagnosis skills that are fundamental to clinical practice. Invest in Welch Allyn diagnostic equipment, and get a head start on the opportunities it will provide you to practice and perfect these skills on your peers, family members and friends. From our beginnings in 1915 with the invention of the world's first hand-held direct illuminating ophthalmoscope to our latest innovations like the PanOptic™ Ophthalmoscope and the MacroView™ Otoscope, Welch Allyn has long been the leader in diagnostic instruments. Want proof? Ninety-five out of 100 physicians in the United States own Welch Allyn instruments—and count on them daily to help diagnose and treat patients.
TABLE OF CONTENTS
Table of Contents
3.5 V PanOptic™ Ophthalmoscope 3.5 V Coaxial Ophthalmoscope 3.5 V MacroView™ Otoscope
Revolutionary technology for a difference you can see 3.5 V PanOptic™ OphthalmoscopeThe fundamental challenge in ophthalmoscopy is to get a good view of the fundus in order to make a sufficient assessment. Let the Welch Allyn PanOptic Ophthalmoscope help you meet this challenge.
Patented Glare Extinguishment System:
Prevents interference from unwanted
glare and reflections
Patient eyecup: Establishes
and maintains proper viewing
Welch Allyn PanOptic distance, provides image stability, Ophthalmoscope Head shown serves as a pivoting point for with Lithium Ion Handle panning around the retina, helps with orientation, and screens out ambient light. The eyecup is cleanable and reusable Soft grip handle: Ergonomically
Lens dynamic focusing
designed for maximum comfort, wheel: Continuous, smooth
balance, and access to controls action for more precise control and optimum view. Focusing range is -20 to +20 diopters Aperture dial: Allows you to
select from micro, small, and
large spot sizes, slit aperture,
red-free and cobalt blue filters
What is the ophthalmoscope and what can be seen with it? The ophthalmoscope is used to view the Why ophthalmoscopy is an important diagnostic skill back of the eye, commonly called the fun-dus. This is the only place where arteries, veins, and nerves can be seen without Help to Detect Prevalent Disease States surgically entering the patient. Diabetic Retinopathy Internal Medicine A good view of the fundus will not only > nearly 40% of patients with diabetes do not receive their recommended give an indica tion as to the health of the eye, but can also tell you a lot about the patient's overall health.
Hypertensive Retinopathy Internal Medicine > useful in finding undetected hypertension > helps monitor control and management of disease Internal Medicine Papilledema/Head Trauma > patient complains of headaches Emergency Medicine Central Nervous System Problems > manifestation commonly seen in retina Shaken Baby Syndrome > can visualize retinal hemorrhages consistent with syndrome Emergency MedicineInternal Medicine Foreign Bodies/Corneal Abrasions Emergency Medicine Revolutionary technology for a difference you can see 5X larger view
*in an undilated eye Advantages When Using the PanOptic Ophthalmoscope> Fast, easy entry into undilated pupils—the entire optic disc and surrounding vessles should be visible> 25° field of view vs. the standard 5° field of view> Greater working distance improves comfort for both practitioner and patient What You See—Clinical Applications Direct viewing of the fundus through the PanOptic can reveal valuable clinical observations. Systemic diseases such as diabetes mellitus and hypertension leave footprints in the retina and aid the practitioner in the evaluation of these and many other diseases.
Innovative Axial PointSource™ Optics c The practitioner is actually viewing the fundus through the mirror that directs illumination into the eye, maximizing the alignment of the viewing axis with the illuminated areas.
How it worksa. Converges the illumination to a point at the patient's cornea, allowing easy entry into small pupils b. Then diverges the illumination pathway to the patient's retina, illuminating a very wide area of the fundus c. Simultaneously enables the practitioner to view the illuminated area on virtually the same axis, creating the widest field of view attainable Traditional quality, reliability 3.5 V Coaxial Ophthalmoscope Welch Allyn Coaxial Ophthalmoscopes provide benefits over standard ophthalmoscopes including easier entry into the eye, a larger field of view, reduced glare, and bright, long-lasting LED light.
Welch Allyn Coaxial Ophthal- moscope Head shown with Triple-sealed ophthalmoscope:
Aperture selection dial: Offers six
Lithium Ion Handle Keeps dust from reaching optics apertures, including the micro-spot Cross-linear polarizing red-free filter:
Eliminates unwanted reflections
Compact head design: For ease of use;
convenient access to all controls
Lens selection disc: Offers easy, fast,
one-hand selection of 28 focusing lenses
Apertures (programs of light) The Welch Allyn Coaxial Vision System: makes learning easier commonly used during a patient exam The majority of the time you will use the • Virtually eliminates shadowing, allowing you to see a much larger portion small aperture as the standard aperture for the examination of an undilated eye. The of the fundus when compared to a standard flat-mirror optical system. other two apertures you will use most often • Brings the lines of vision and illumination closer for easier entry of are the micro-spot and the large.
light into the pupil and a larger field of view.
Small Aperture: Provides easy view of
the fundus through an undilated pupil.
Always start the examination with this
aperture and proceed to micro-spot
aperture if pupil is particularly small
More readily enter even the and/or sensitive to light.
Micro-Spot Aperture: Allows easy
entry into very small, undilated pupils,
and light-sensitive eyes.
The doctor looks through the notch in the mirror directly along the pathway of the light, Large Aperture: For dilated pupil
seeing a larger area of the retina examination of the eye.
Red-Free Filter: Excludes red rays
from examination field for easy
identification of veins, arteries, The exclusive curved-filament lamp and and nerve fibers.
notch in the mirror are the patented enabling Cobalt Filter: Used with fluorescein
features of the Coaxial Vision System dye to view small lesions, abrasions, and foreign objects on the cornea.
Bigger, better, sharper view of the tympanic membrane MacroView™ OtoscopeThis instrument is a significant advance in hand-held otoscopy, to provide an improved view for enhanced learning and decision making.
Tip grip: Ensures ear specula are
fastened securely and easily
Adjustable focus: Ability to zoom
in or out to fine-tune the view
Choose between disposable or reusable ear specula made of the highest quality construction for an unobstructed, glare-free view Welch Allyn MacroView Otoscope Head with Throat Illuminator shown with Lithium Ion Handle Insufflation port: Creates closed system for
pneumatic otoscopy to assess middle ear disor-
ders. Apply positive and negative air pressure and
view tympanic membrane using an insufflator bulb
Default focus: Optimal setting for most
2-in-1 Throat illuminator: Provides light with
a handy built-in penlight
Field of viewDelivers almost twice the field of view at higher magnification compared to standard otoscopes, making it easier to visualize the auditory canal and tympanic membrane. Standard Otoscope MacroView™ Otoscope 3.5 V Lithium Ion Power HandleThe Welch Allyn Lithium Ion Handle powers any 3.5 V instrument head for 110 minutes — twice as long as a conventional handle. This "Smarter" lithium-ion battery technology also means no memory effect, often found with NiCad batteries. Soft grip rheostat for intensity control section Textured handle made of durable Welch Allyn 3.5 V CYCOLOY® blend construction Lithium Ion Handle Removable pull-out AC charging module with retractable AC prongs, can be plugged into any 110 V outlet Low-battery indicator light 3.5 V Convertible HandleTraditional chrome-plated brass construction for durability and long life.
ETL/UL Recognized Rheostat control: Sets light intensity Recyclable battery.
Well-balanced handle with knurled Please return expended rechargeable finish evenly distributes weight, rests batteries to Welch Allyn for recycling.
comfortably in hand ® CYCOLOY is a registered trademark of General Electric Company ETL/UL Recognized Bivalve Nasal Speculum Disposable Universal Adjustable speculum facilitates KleenSpec® Specula removal of foreign bodies, 2.75 mm and 4.25 mm autoclavable for complete disposable specula to help eliminate 26035 Bivalve Nasal Speculum
52432-U, 52434-U Disposable
Only—for use with the diagnostic KleenSpec Specula otoscope/throat illuminator
26038 Bivalve Nasal Speculum—
complete with illuminator base
Corneal Viewing Lens LED Replacement Lamps Replaces the patient eyecup on the PanOptic Ophthalmoscope to provide extra magnification for exams Attaches to port for of the cornea.
Not made with natural 11875 Corneal Viewing Lens
23804 Insufflator Bulb
Fiber-Optic Nasal IlluminatorProvides superb view of nasal passages.
Pneumatic Otoscope 26535 Fiber-Optic Nasal Illuminator
Includes powerful Halogen Section— for use with diagnostic TM lamp and rotating lens with ultra-seal for pneumatic 26538 Fiber-Optic Nasal Illuminator
—complete with illuminator base 20200 Pneumatic Otoscope
Fiber-Optic Finnoff Transilluminator Operating Otoscope Helps to reduce patient discomfort in transillumination of frontal and Features powerful Halogen HPX maxillary sinuses.
lamp and convenient open system.
41100 Fiber-Optic Finnoff
21700 Operating Otoscope
LED Replacement Lamps Upgrade to LED lamps for longer Package of 5 reusable eyecups life, high efficiency, and SureColor™ for PanOptic ophthalmoscope.
LED technology that reduces glare while preserving the color and clarity of the view.
11870 Patient Eyecup
03100-LED Traditional Diagnostic Otoscopes
30X the Lamp Life of a traditional 06500-LED MacroView Diagnostic Otoscopes
halogen lamp in just one LED lamp.
Traditional Ophthalmoscopes 03800-LED PanOptic™ Ophthalmoscopes
• 7-year guarantee • 80% cost savings over the life Traditional quality, reliability and performance 3.5 V Diagnostic Set ComponentsAll Welch Allyn student diagnostic sets come with the following components: Welch Allyn 3.5 V SureColor™ LEDs What is a diagnostic set? A basic diagnostic set consists of an oph thal mo scope for examination of the eye, an oto scope for examination of the ear, and a battery handle to power these instruments.
Why should I consider purchasing a Welch Allyn diagnostic set? Owning your own diagnostic instruments will ultimately support your ability to be proficient. And, your proficiency with these diagnostic tools is essential for your goal of becoming a licensed practitioner.
Welch Allyn has the features, optics, and durability that make your job of learning how to examine the eyes and ears easier. This is important because you are investing in equipment that represents the fundamen-tals of your profession, and which will serve you throughout your education and career.
Service is always local and prompt; Welch Allyn has the most extensive distributor network, and your equipment is unconditionally guaranteed while you are a student or resident.
Leather-grained black vinyl with molded inserts, Made of durable corduroy with interior pockets for lays flat displaying instruments for easy access.
instruments, this smaller profile case fits right in your lab coat.
Traditional quality, reliability and performance SureColor™ LEDs SET CONTENTS & ORDER NUMBERS Cases/Part Number When selecting the set that is right for you, consider which of these diagnostic components best fit your needs: Lithium Ion Handle, Tycos® DS58 Classic Hand AneroidWith gear-free DuraShock™ technology, you can count on the classic aneroid to remain in calibration longer than traditional aneroids, providing more accurate readings over time.
Gear-free design withstands a 60" drop for more accurate readings Laser-engraved dial face is computer-matched and calibrated to the movement inside for accuracy Thumbscrew air-release Lifetime calibration warranty valve provides con stant deflation and is posi tioned Jeweled movement to reduce for use in either hand friction, ensur ing long life Tycos DS58 Classic Multi-cuff Kits available separately for DS58 and * Not made with natural DS66 models.
Welch Allyn DS66 Trigger Hand AneroidThe Trigger Hand Aneroid features a modern, ergonomic design to fit perfectly in theright or left hand. This aneroid makes taking accurate blood pressure measurementseasy and comfortable.
Large, easy-to-read dial face 15-year calibration warranty Gear-free design withstands a 30" drop for more accurate Why is it important to invest in a blood pressure readings over time sphygmomanometer (aneroid)?Taking a patient's blood pressure is one of the most frequent diagnostic tasks you'll Trigger deflation valve:
perform throughout your medical career. Provides smooth and easy control of pressure deflation High blood pressure (hypertension) affects nearly one in three Americans and plays a * Not made with natural major role in deaths due to cardiovascular disease. The sphygmomanometer is your tool for early detection of this silent killer and will be used on nearly all of your patients. It is vitally important to be well trained in Welch Allyn DS45 Integrated Aneroid blood pressure measurement technique and to have an accurate, reliable instrument Welch Allyn's DuraShock™ Model DS45 offers quality and accuracy in an easily affordable system. It features a traditional to properly diagnose and determine treat- thumbscrew design, and the gauge clips onto the cuff and bladder. It is also shock-resistant to 30 inches, lightweight and is ment options. Owning your own sphygmo- backed by a 10-year calibration warranty. manometer will allow you to practice and gain competency in blood pressure mea-surement.
Harvey™ Cardiology StethoscopesHarvey DLX and Elite stethoscopes were developed during a 30-year association with the preeminent Dr. W. Proctor Harvey, MD—the first and only "Master" of cardiology bestowed by the American College of Cardiology. He designed these stethoscopes to accentuate important high-frequency heart sounds like clicks, murmurs and ejection sounds.
Harvey™ DLX Double-head Stethoscopes Comfort sealing eartips:
Allow you to effectively seal the ear,
while also providing sufficient comfort
Rotatable binaurals Adjustable triple-leaf spring for optimum comfort Harvey DLX Stethoscope Dual-lumen, 28" latex-free
tube: provides sufficient reach
* Not made with natural Low-frequency bell:
sounds and murmurs at
Detects higher-frequency heart and lung sounds at 100-1,000 Hz Multihead brass chestpiece:
Includes bell and flat diaphragm
What should I look for in a stethoscope? Harvey™ Elite® Stethoscopes Comfort sealing eartips You want to be sure that the stethoscope fits correctly. If you can't get sound past the eartip Rotatable binaurals to your tympanic membrane, all other features are unimportant. The more custom the fit, the easier the sounds travel to your ear. As a student, you must consider the versatility of the scope. Remember you will be doing rotations, including pediatrics and cardiology. The Harvey DLX and Elite, for example, adapt Dual-lumen, latex-free tube easily for pediatrics, and the bell is essential for cardiology.
Adjustable triple-leaf Low-frequency bell spring for optimum Every Harvey DLX and Elite stethoscope comes with a free copy of Harvey Heart Sounds Sampler, an interactive CD for learning heart sounds and a Cardiology Accessory Kit.
Stainless steel chestpiece Cardiology Accessory Kit Includes: Pediatric Diaphragm Assembly non-chill rim for One Pair Medium Soft Eartips * Not made with natural One Pair Large Hard Eartips One Pair Extra Large Hard Eartips Easy to change diaphragm Dual-bore, one-piece PVC tubing For Medical Students Our diagnostic instruments are rugged, durable, and dependable. We are so confident of the quality of our products, that no matter what you buy—whether it's a stethoscope, ophthalmoscope, otoscope, or even the lamp inside—we give you an enhanced warranty for the time you're a student through your first two years of residency. The only thing we do not cover is loss or theft.
If it breaks, we'll repair or replace it. That's our guarantee, plain and simple.
4341 State Street Road, P.O. Box 220, Skaneateles Falls, NY 13153-0220 USA (p) 800.535.6663 ext.3 (f) 315.685.3361 www.welchallyn.com 2014 Welch Allyn SM1943 Rev H Please use this sheet as a guide as you make decisions on the
Equipment you'll invest in for your career.
Every diagnostic set starts with our exclusive MacroView™ Otoscope For Medical Students Pick your Ophthalmoscope (please check one box in each step) 11820 PanOptic™ Ophthalmoscope— 11720 Coaxial 3.5V Ophthalmoscope — 5X field of view for textbook image of fundus Full-featured traditional ophthalmoscope.
and fast easy entry into small undilated pupils.
Pick your Power Source 3 71900 Lithium Ion Handle—
71000-C Convertible Handle— Lightweight & portable with twice Accepts rechargeable or alkaline C-cell batteries. the on time of our NiCad handle. No Useful for overseas travel when it's difficult to memory—cell phone battery technology.
Pick your Carrying Case 4 Hard Case—
Keeps your instruments in place, Lightweight, portable and durable protection.
organized, and protected.
SET CONTENTS & ORDER NUMBERS Cases/Part Number Now ships standard with SureColor™ LEDs for 30X the lamp life of traditional halogen lamps.Guaranteed 7 years.
Not an order form. Product selection, availability varies by sale. Please check with your local distributor or Welch Allyn on-site representative to place an order.
5 Pick your Stethoscope
Harvey DLX Premium Cardiology Stethoscope—
Brass chest piece for superior sound transmission, student bonus accessory kit (additional ear tips & pediatric diaphragm), 10-year warranty.
Harvey Elite Cardiology Grade Stethoscope—
Stainless steel chest piece, student bonus accessory kit (additional ear tips & pediatric diaphragm), 10-year warranty.
CARDIOLOGY GRADE STETHOSCOPES Harvey DLX (Brass) Colors: Black (325), Burgundy (328), Green (327), Navy (326) STETHO SCOPES Harvey Elite (Stainless)
Colors: Black (125), Burgundy (270), Green (284), Navy (271) 6 Pick your Blood Pressure Device
DS58 Hand Aneroid—
Traditional thumbscrew style air release valve, adult & child cuff or family practice set available, lifetime calibration warranty.
DS66 Hand Aneroid—
Trigger air release valve, adult cuff or family practice set available, 15-year calibration warranty.
DS45 or DS44 Integrated Aneroid—
Integrated design with inflation system, adult cuff, 5-year calibration Hand Aneroid, Cuff Kits warranty (DS44) or 10-year calibration warranty (DS45).
for DS66 and DS58 * All models above are shock-resistant.
With child print, adult, and large adult inflation systems in a dual-compartment zippered case. BL PRESSURE DS66 Trigger
DS45 Integrated Aneriod 4341 State Street Road, P.O. Box 220, Skaneateles Falls, NY 13153-0220 USA (p) 800.535.6663 ext.3 (f) 315.685.3361 www.welchallyn.com 2014 Welch Allyn SM1943 Rev H EYE IMAGING ON YOUR iPhone®*COMPATIBLE WITH IPHONE 4 AND IPHONE 4S Our innovative iExaminer facilitates education, allowing you to document and study fundus images as you perfect ophthalmoscopy.
The complete iExaminer system consists of three core components: Take a peek atthis amazing medical breakthrough in action.
EYE IMAGING ON YOUR iPhone® • iExaminer adapter works with the Welch Allyn PanOptic Ophthalmoscope, and through your iPhone,* and the iExaminer app to create a mobile digital imaging device • Rapid capture of fundus images on your iPhone for easy eyeground documentation • Document and study images in any clinical • Share and consult with peers across the continuum of care at a moment's notice
Menopause Heidi D Nelson Lancet 2008; 371: 760–70 Menopause is the time of life when menstrual cycles cease, and is caused by reduced secretion of the ovarian Oregon Evidence-based hormones oestrogen and progesterone. Although menopause is a normal event for women, individual experiences