Again, this item requires additional purchase of a stethoscope. Seller does say they will provide it at no cost if you write a survey. How can you write a survey without actually testing the device??!!! I don't think it's possible to test it without the stethoscope..... Anyway, I did take a look at the item and the hand pump rubber seems thin and fragile. That made me return the item even though I had to pay 7.4$ for return shipment. Definietly not an item I would recommend to anyone.