Medical doctor's penlight

[justin]

Don't you love the Internet. I got online looking for a flashlight to meet my needs, thinking I would have only a few options. Well, well, well.

I saw a recent post about medical lights. I liked the post, but it didn't apply to my situation.

I don't look in people's eyes with lights, so I will not blind anyone. But don't want to make looking closely at the object difficulty due to its brightness. I do work from 1-2 feet away.
I also don't mind the size of a 2xAA maglight, although too heavy is not good. I don't want a penlight.
I need good color rendition, and some LEDs with a blue tint make good visualization difficult.
I need a tight, bright beam at two feet.
It usually is easy for me to get my hands on AAA, AA batteries. I would like the rechargeable option too. I wouldn't use the light for more than a couple of minutes at a time. I would like to be able to rely on the light being consistent, however, as I can't be fiddling with the light during a procedure.

My buddy just picked up the Super-Lux flashlight from Brookstone. It seemed pretty bright. It seems to be about the right size. It uses CR-123, which is a bit annoying. I guess if reliable rechargeables could be had, then that would be ok. The light seems a bit blue to me.

I use bright Welch Allyn Xenon headlights in the OR, and that is a good white. It is at 5500K. I am not opposed to LED if color is good.

I would probably like to fasten it to a headband to I could use it handsfree from time to time, but don't want a dedicated headlight.

So, I need a bright beam right where I shine it that doesn't blind me from 1-2 feet away, and shows accurate colors. I am a resident doctor, so any recommendations in the <$50 range? Thanks in advance.

 

[joema]

Re: medical light recommendations

There's always the Welch-Allyn penlights:

http://www.allheart.com/wa76600.html

Accurate color rendition can be difficult for LED flashlights. However it is possible. There was a thread where an army medical corpsman described what LED lights he used in Iraq, but I can't find it right now.

 

[cratz2]

Re: medical light recommendations

Hrmm... Well, in my opinion, even a Lux I is out as most that are reasonably well-focused are just too bright for close up work.

A Maglite or Maglite clone (if you prefer a clickie tail cap to a twist-on head) with an MJLED is very nice... My two most recent ones are very white, much whiter than the River Rock 2xAAA light which would otherwise probably be my first recommendation.

I build a lot of lights for nurses, mostly Minimags and Minimag clones with 26k, 35k, Nichia CS and MJLEDs but for general use, the River Rock has made me rethink that... It's even smaller, throws a nice usable beam with good runtime. But they are decidedly blue-tinted.

 

[Jumpmaster]

Re: medical light recommendations

I also don't mind the size of a 2xAA maglight, although too heavy is not good. I don't want a penlight.

There's always the Welch-Allyn penlights:

:huh2:

 

[igabo]

Re: medical light recommendations

There's the Nuwai Q-III which is an LED with decent color; though it does use CR123's, it is capable of using a Rechargeable CR123 that runs at a higher voltage, without destroying anything. Only problem is the Q-III and a pair of Rechargeable CR123 will probably run you about $60; but it is worth it.

Another option is the Fenix L1; uses 1AA (can take rechargeable), small, bright (for it's size) durable, and $42.

Just my 2 cents.

 

[UVvis]

Re: medical light recommendations

I've been in the same situation.

The beam shapers like what surefire offers, are great for this type of use. Normally you want a close range flood to light everything up. I found that a Surefire E2e with the longer runtime lamp and the beamshaper were ideally suited for this task.

A cheaper substitute is to take about any regular flashlight, and put some of the matte looking scotch tape over the lens, it gives you a similar and easily removed trial method.

 

[Hookd_On_Photons]

Re: medical light recommendations

What exactly are you going to be using the light for? Illumination for minor procedures? Peering into people's throats (or other orifices)? If you're going to be using it for procedures, you need a headlight.

An Inova X1 sounds like it has the beam pattern you describe (tightly focused, no flood), but it's not very bright and the stock "white" LED is rather blue-tinted. You might have it modded with a "Snow" LED.

You could go with a Peak Matterhorn or Kilimanjaro with multiple Snow LEDs.

It's going to be difficult to match the performance of a coaxial halogen headlight with a handheld LED light.

 

[WinstonSmith]

Re: medical light recommendations

The Inova X1 throws a small, precise beam. At two feet, mine threw about a five inch spot. At a foot, that shrank to three inches. Almost nothing outside the spot.

Not real useful around the house, but might be good in this application.

 

[nethiker]

Re: medical light recommendations

Fenix. 1xAA or there is now the 2xAA version. The beam might not be as tight as you were looking for, but a fantastic light for the money.

__________

Greg

 

[justin]

Re: medical light recommendations

Great replies. Thanks.
Most of what I need is good light to peer down holes in peoples' necks, and into mouths. Occasionally I might need to wear it on a headband for some hands free work for five minutes at a time.
I definitely like the coaxial halogen headlights, but I am looking for a portable unit that I can stash in a pocket/bag for rounding in the hospital, or in the ER when I can't easily swipe a headlight from the OR.
I currently have a Petzl Xenon 4xAA camping headlight, the Myo. I didn't get one with the LEDs, as they didn't focus. The headlight is focusable, but the spot is more like a blur than any tight light. It sort of does the trick. With fresh batts, it lights OK, but not great. It doesn't work as a flashlight to store in a pocket, though.
Do any Xenon incandescents light up well and throw a tight beam?
I am new to this forum, so I really appreciate this input. When I started searching for flashlights, I thought I would run out of options in about ten minutes. It took ten minutes to figure out I had barely scratched the surface!
Actually, now that I think of it, the Myo is difficult for me to use as I always seem to get a dark spot in my beam at 1-2 feet, no matter how tightly I focus. Originally I said I wanted a real tight beam. I guess if the light were uniformly bright over its projection at 2 feet, then it would be great. I certainly don't need a wide flood, but I also don't need a laser. Imagine trying to get the best look as possible in someone's mouth, under their tongue, and in the back of the throat without having to aquint or wonder if you are seeing everything there is to see.
Ideally I would like to be able to do what it shows at this site with this light. http://www.dysphonia.certec.lth.se/examtech_detail_uk.lasso@ID=10006.html
This requires a bright light this is fairly well focused as it must bounce off the mirror held behind someone's tongue and reflect down their throat. So, again, it doesn't have to be a laser. The website shows a bright halogen lamp used as a light source that is focused by a 3.5" mirror with a small hole in the middle to look through. I think it has a focal length of 18", which is about right to look in someone mouth and use the mirror as described.
This is not the only thing I do with it. But, if it could do that, then it would easily do everything else I would need.
Quick update. Welch Allyn sells a headlight designed for what I would want, except that it's a $250 headlight. specs here: http://www.welchallyn.com/medical/support/manuals/Portable%20Solid%20State%20Light.pdf

 

[Mike Painter]

Re: medical light recommendations

How about a Thor?
Failing that you might try something like this
I have a similar one which lives in my car. It's a "bit" smaller than the Thor, can focus fairly well, and might work for you. If not it comes with a couple bucks worth of batteries and can live in your glovebox for a long time.

 

[cy]

Re: medical light recommendations

you want a fenix L1-P with a two stage mod. cost is is $45 + 10 ohm resisters from ratshak.

dial in how bright you want low beam by experimenting with resister value.

here's my EZ 15min two stage fenix mod
http://candlepowerforums.com/vb/showthread.php?t=100142

for headlamp purchase a $15 river rock from Target. gives nice tight beam, but not as powerful as fenix. uses 2x AAA. beam is regulated on both.

you can also find a maglite headband to use fenix as headlamp for $6.

 

[AndrewL]

Re: medical light recommendations

I use the QIII for first aid use and it's good for checking wounds to see if there's grit in there etc but I'm not sure how good it would be at looking down someones throat. It's small enough to be ok on a headband and can fit in a pocket very well.
you'll find a use it if you get one

 

[cognitivefun]

Re: medical light recommendations

I think you need something incandescent for better color spectrum than current LED technologies allow.

 

[Hookd_On_Photons]

Re: medical light recommendations

With any LED light, there is the potential for tint issues. The River Rock 0.5W lights tend to be blue. Luxeon lights are subject to the "Luxeon lottery".

You could try a Mini-Mag ($10-15) with the Nite-Ize LED drop-in (about $4-5 at Wal-Mart). The LED upgrade supposedly uses Snow29 LEDs, so the output should be close enough to white for your purposes. Nite-Ize also sells a headband accessory you could use for the ER and on rounds, but in my experience a dedicated headlight is much more useful. You want the light to be mounted in the midline, between your eyes. If the light is mounted laterally, you might have to **** your head and look sideways if you want to put the hotspot on a particular site of interest.

Here's a list of Nite-Ize upgrades and accessories:

http://www.niteize.com/category.php?category_id=28

You could give the upgraded Minimag a try. Even if it doesn't work out for clinical purposes, you still have a decent light for the glove compartment, or for household usage. It uses AA batteries which are readily available in any hospital or clinic (some of the disposable pulse lavage devices used in the OR contain 6 or 8 carbon-zinc AA batteries... the nurses crack them open after the case is done to salvage the batteries). And the setup is inexpensive enough that it won't be a great loss if you lose it or it gets stolen.

You might also want to try the Peak Matterhorn. It uses AAA batteries, which might be a little more difficult to find than AAs (many pagers use AAA batteries, so there might be a readily available source of spares for you). It uses the Snow29 LEDs. It is smaller than the Minimag, so it would be unobtrusive in a pocket or carried on a lanyard on your neck.

It is of much higher quality than a Minimag. It is also much more expensive, about $45-50. You'll definitely be mad if it gets lost or stolen. The other factor is that the LEDs are recessed in the head, which creates nooks and crannies where... um... biomaterial could get lodged. The lights are supposed to be water resistant, so if somebody coughs up a loogie or some blood on your light you could wash it off. The fingernail picks at the scrub sink could be used to dig out stuff that gets lodged between the LEDs.

I'd recommend getting the lug or key chain body, as you'll probably want an attachment point to carry it on a keychain or lanyard.

The HAIII finish is durable, but my personal preference would be for stainless steel. I also prefer the aesthetic appearance of the lug style body over the keychain style body. However, the stainless steel lug body doesn't exist...

Anyway, I'd try the 3 LED Snow Hi-Power configuration. Ultra Power is probably overkill for short-range applications, and will significantly reduce the lifespan of the LEDs.

http://www.peakledsolutions.net/aaa.html

Peak is hopefully going to release a Luxeon AAA light in the next week or two. You might want to wait a bit and see what people think about that model.

I'm going to get one for a friend who's an ENT. I'm not sure how much he'll actually use it, because he specializes in oncologic surgery and doesn't see general ENT problems much, but it's an excuse to buy another flashlight! :naughty:

 

[justin]

Re: medical light recommendations

Again, thanks.
I have been looking at mods as I do have a minimag. My concern is over focusability, or rather, focus and tight beam at all. I am concerned that a general though bright flood might not work. I may be wrong, but we always seem to focus our lights into a tight circle, maybe inches across to aim it where we want it.

What about the L2P? I was looking at some Mods that were way more than this little lamp. I actually think the 2AA size is a better fit for me. I like the feel of the Minimag for exams. It is not too small, which some of the single battery units seem to be. I know some particulars are not known, but based on what seems to be nearly universal awe at the L1P, can its brother be worse?

More importantly, would it do the trick?

On the other hand, $5 for a Walmart add-on sure is not a bad way to go. I just don't know if the local walmarts will have it, and I am not keen on driving all over town to get it, or ordering it on-line and paying $8 to ship it. Then, I might as well get a new X1.

Cognitivefun suggested incandescents. Does anyone have a good recommendation? My only experience with them is that they are great for general purpose. I have a 3D mag that does fine for most activities when I want to wield a small club. However, they have a hole in the middle of the light and they focus poorly. Also, they never seem to actually be that bright. I imagine I would have trouble getting something bright enough in a 2AA or smaller form factor. Any more suggestions? Or rather, any more witnesses for or against anything already posted?

The difficult thing is that I can't walk in to a store, check out ten different lights, and decide. No one has these locally, that I know, and certainly, no one has multiple high quality torches.

I can see why this becomes addicting. I spent four hours last night, after midnight, looking at charts, reviews, product info, etc.

 

[cognitivefun]

Re: medical light recommendations

justin, I would suggest a SureFire A2 Aviator. It runs on lithium batteries, which you said you don't want. But it is regulated. That means it will go for about 45 minutes on incandescent at a very focused, even brightness, with excellent color rendition.

The trouble with so many small incandescent lights is that they dim and yellow a few minutes into the battery life. They may have a 60 minute runtime, but only the first few minutes has bright, white light.

Not so for the A2.

I used mine recently to see when I needed to remove a tick from my dog. It is great for this type of work if you are already in a lighted facility anyway. It would be blinding if you are working in the dark.

If you only use it a few minutes every day anyway, what would be the cost of operation? Peanuts. You can buy the batteries on the web for $1.25 each, so you are looking at $2.50 per month or less. The lamps never seem to blow out.

The A2 is waterproof down to 33 feet so it can be washed off. And it has LEDs that you can use if you want that kind of light.

 

[Hookd_On_Photons]

Re: medical light recommendations

For small lights, I think LEDs are going to beat incandescents for efficiency and runtime.

For looking waaaay back into the nasopharynx, you'll need a specialized illumination instrument.

http://www.welchallyn.com/medical/products/catalog/type.asp?ID=24311

For procedures, you definitely need a headlamp. It's hard to be a one-handed surgeon.

To supplement the crappy lighting in the ER, I use a Princeton Tec Eos. It's not mine, somebody got it for general shared use in the ER. It's available at ****'s Sporting Goods for $39.99.

It's a bit yellow, compared to the pure white output of a Welch-Allyn Luxeon surgical headlamp. However, individual emitters will vary in tint so that doesn't mean all PT Eos lights are going to be yellowish.

http://www.welchallyn.com/medical/products/catalog/type.asp?ID=33995

However, the Welch-Allyn lights cost $275 for the "basic" LuxI model and $685 for the "premium" LuxV model. The cost probably reflects how picky they are about tint, as they no doubt select only the whitest emitters for their products. (Like the HDS "GT" models.) For the same amount of money, you could buy a lot of Eos headlights and pick the whitest one.

For looking at the oral cavity and throats, and for examinations at the bedside during 5 AM rounds, the Fenix L1P or L2P should be more than adequate. Be aware that there will be a "donut hole" in the center of the beam when the Fenix is used to illuminate an object about an inch away. That's not a defect, that's a property of the reflector/emitter setup.

FWIW, the Fenix L1P works fine for me for general purpose illumination. My pager takes an AA battery, so I always have a backup battery on hand. It's small and unobtrusive for pocket carry in the office. It's a PITA to carry with scrubs, but a pocket clip would fix that. I use mine for surface illumination and to backlight radiographs when there's no light box available. I don't need to peer into any cavities, crevices, orifices, or yucky places. It's not *perfectly* white compared to the searing beam of the OR coaxial halogen headlights or fixed OR lights, but it's more than adequate for the office and making rounds in dark rooms.

 

[cratz2]

Re: medical light recommendations

It seems odd that with as popular as the Minimag is, no one has come up with a beamshaper type product that allows only a very small centered bit of light to escape... seems like that would be just the ticket for justin. With a little effort, you could probably fashion something useful out of a piece of opaque plastic cut to proper diameter and drilled with a small drill...

As far as LED tints... W0 and X0s are very white and would generally suffice for this use, I would think. I recently bought and resold a TLE-5 module and I think it had either a W0 or an X0 tint. If you step up to a custom pill or sandwich with some sort of shaper, you can dictate what bin is used but this will likely put you in the over $50 range. A Lux I will be more than adequate for looking into someones throat, but all the work seems to center around the Lux IIIs and I think their binning is a bit more accurate overall.

So... not to ask a stupid question, but is there an ebay-ish outlet for used medical lights? Are you trying to put something together for off-duty use or are you just not happy with the equipment you have at work or are there just not enough lights at your work?

 

[springnr]

Re: medical light recommendations

http://www.brightguy.com/detail.php?Sku=UND14201.