Digital and AI stethoscopes for nurses are no longer a niche product. Between the growth of telemedicine nursing, the demand for amplified auscultation by nurses with hearing loss, and the increasing deployment of AI cardiac screening tools in primary care settings, demand for electronic stethoscopes has grown significantly since 2023. The question nurses are asking in 2026 is no longer "should I buy a digital stethoscope" but "which one is worth $250–500, and what does the AI actually do?"
This article answers that question for nurses specifically — not for cardiologists or primary care physicians, but for ICU nurses, med-surg nurses, telehealth nurses, and nurses considering upgrading from a traditional acoustic Littmann or other analog stethoscope.
The term "AI stethoscope" is used loosely. There are three distinct things manufacturers mean by AI in this context, and they produce very different clinical tools:
1. AI-powered murmur and cardiac anomaly detection — the stethoscope uses a machine learning algorithm to analyze recorded heart sounds and flag potential murmurs, valve abnormalities, or rhythm irregularities. This is the most clinically significant application, and it is what Eko's platform does. The AI runs either on the device or in the companion app.
2. AI-enhanced noise cancellation and amplification — the stethoscope uses signal processing (sometimes called AI but more accurately described as adaptive filtering) to suppress ambient noise, amplify low-frequency sounds, and produce a cleaner audio signal than a traditional acoustic stethoscope. The 3M Littmann CORE and Thinklabs One primarily compete in this category.
3. AI integration for documentation and remote transmission — the stethoscope connects to a telehealth platform or EHR and routes recorded audio to a remote provider or to an AI documentation tool. Eko's platform supports this, and several telehealth-specific stethoscopes (Eko Core + Eko App + Epic integration) are now used in virtual care models.
Understanding which category a stethoscope falls into determines whether it's the right tool for your clinical workflow.
The Eko DUO is the most clinically sophisticated nursing-accessible AI stethoscope available in 2026. It combines a digital stethoscope with a single-lead ECG — meaning a nurse can record both heart sounds and a rhythm strip simultaneously using the same device. The FDA has cleared the Eko DUO's AI algorithm for detection of atrial fibrillation, normal sinus rhythm detection, and structural heart disease screening (murmur detection).
When a nurse records a cardiac assessment, the Eko app runs the recording through its murmur detection algorithm and the ECG strip through its atrial fibrillation detection algorithm. Eko's published validation study found 94% sensitivity and 70% specificity for detecting cardiac murmurs across a multi-site evaluation. The AFib detection algorithm, cleared by the FDA, performs comparably to validated single-lead ECG screening tools.
The practical nursing use case: a patient on a telemetry unit complains of palpitations. The nurse performs a quick DUO assessment — records heart sounds and a 30-second ECG strip — and the Eko app flags a murmur finding and irregular rhythm. The nurse has structured, time-stamped data to include in a SBAR to the provider rather than documenting "murmur noted on auscultation — provider notified."
The DUO requires the Eko app (iOS and Android) to access AI features. The base Bluetooth recording function works without the app. Battery life is approximately 10 hours of continuous use. The DUO is compatible with Epic, and several health systems have integrated Eko recordings directly into patient charts via the EHR integration.
For infection control: Eko sells stethoscope covers compatible with the DUO. The device body and ear tips can be wiped with approved disinfectants — review the current Eko cleaning protocol guide for the specific approved agents, as this has been updated several times since 2023.
The Eko CORE 500 is the stethoscope-only version of Eko's platform — no built-in ECG, but the same high-fidelity digital auscultation and murmur detection AI available through the app. It is Eko's most widely purchased product for general nursing use.
The CORE 500 is best suited for nurses who primarily want: (1) significantly amplified auscultation — up to 40x amplification, making it useful for nurses with mild-to-moderate hearing loss or for auscultation through thick clothing or in high-ambient-noise environments; (2) AI-assisted cardiac screening without the added cost and complexity of the built-in ECG; or (3) telehealth nursing applications where high-quality audio recording and remote transmission are priorities.
The CORE 500 can wirelessly transmit auscultation recordings to a remote provider during a telehealth encounter, making it the standard of care tool for telehealth nursing stethoscope assessments. Several major telehealth platforms have direct integrations with the Eko CORE 500.
The 3M Littmann CORE is Littmann's entry into the digital stethoscope market, and it occupies a specific niche: nurses who want a high-quality digital stethoscope from a brand they trust (Littmann is the dominant traditional stethoscope brand in nursing), with superior amplification and noise cancellation, but without the full AI diagnostic platform of Eko.
The Littmann CORE does not have built-in AI cardiac screening. What it does have is 40x amplification, adaptive noise reduction (Littmann calls this "intelligent noise reduction"), and Bluetooth audio streaming to the companion app or to third-party telehealth platforms. Some third-party apps (eKuore Pro, Eko via Bluetooth) can be paired with CORE audio streams to add AI analysis to CORE recordings, but this is not the stethoscope's native function.
The CORE excels in environments where noise is the primary problem: noisy ICUs, ED settings, and any auscultation being performed through thick clothing or dressings. The noise cancellation is technically excellent. For nurses who simply want a dramatically better acoustic experience — clearer heart sounds, clearer lung sounds, without the full AI platform — the CORE is a well-engineered choice at a lower price point than Eko.
The Thinklabs One is the highest-amplification digital stethoscope on the market — it can amplify heart and lung sounds by up to 100x. It is primarily targeted at providers with hearing impairment and at situations requiring extreme amplification (patients with significant obesity, heavy clothing, or poor acoustic windows). It does not have built-in AI features; it is a pure amplification and digital recording device.
For most nurses, the Thinklabs One is overkill at its price point. Nurses with significant hearing loss who find even 40x amplification insufficient may benefit from the Thinklabs, but the lack of AI features and its higher price make it a specialist purchase rather than a general nursing upgrade.
| Feature | Eko DUO ($349) | Eko CORE 500 ($299) | 3M Littmann CORE ($259) | Thinklabs One ($459) |
|---|---|---|---|---|
| AI murmur detection | ✅ FDA-cleared | ✅ Via app | ❌ No | ❌ No |
| AFib detection | ✅ FDA-cleared (ECG) | ❌ No ECG | ❌ No | ❌ No |
| Single-lead ECG | ✅ Built-in | ❌ No | ❌ No | ❌ No |
| Amplification | 40x | 40x | 40x | 100x |
| Bluetooth / app | ✅ iOS/Android | ✅ iOS/Android | ✅ iOS/Android | ✅ 3.5mm + Bluetooth |
| EHR integration | ✅ Epic, others | ✅ Epic, others | Limited | None native |
| Best for | Full AI cardiac screening | Telehealth, general AI screening | Amplified auscultation, Littmann loyalists | Hearing impairment, extreme amplification |
ICU nurses: The Eko CORE 500 is the strongest choice for most ICU nurses. The AI murmur detection adds a documentation and screening layer to your existing monitoring-heavy workflow. The high-fidelity audio recordings are useful for capturing subtle changes in breath sounds or murmur character over time. The DUO adds value if your ICU sees step-down or transitioning patients in whom rhythm monitoring adds clinical value beyond the continuous telemetry.
Telehealth and remote nurses: Eko CORE 500 or Eko DUO — both have first-class telehealth platform integrations and are specifically designed for remote auscultation workflows. The DUO's rhythm assessment adds significant value in remote patient monitoring settings where the nurse cannot initiate a standard ECG.
Med-surg and floor nurses: The Eko CORE 500 at $299 is the best value for general nursing use. The AI murmur detection flag gives floor nurses structured data to escalate cardiac concerns. It significantly outperforms traditional acoustic stethoscopes in high-noise hospital environments.
Nurses with hearing loss: The Thinklabs One for severe hearing impairment. The Eko CORE 500 or 3M Littmann CORE for mild-to-moderate hearing loss — both provide 40x amplification which covers the majority of auscultation accessibility needs.
Nurses who prefer Littmann brand: The 3M Littmann CORE Digital is the logical upgrade path from a traditional acoustic Littmann. Accept that you're paying for amplification quality and brand familiarity, not AI clinical decision support.
For additional AI tools nurses are using in clinical settings, see AI tools ICU nurses are actually using in 2026 | Best AI tools for nurses 2026 | AI charting tools for nurses compared
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