# sphygmomanometer cuffs



## crash_cart (Oct 3, 2007)

To be honest, I just wanted to type sphygmomanometer.  We're beginning the more "hands on" part in our training and monday night, we were required to buy, beg, or borrow cuffs and a stethoscope to bring to class and practice with.  One practical joker even brought a digital one.rolleyes:  So when it comes to these things, are there particular models that you like or don't necessarily care for?  I bought a cheap version that has the stethoscope piece sown into the cuff.:wacko:  I evidently didn't read the box that closely.  I will invest in a cuff without the darn stethoscope attachment, though mine will suffice for another month.  So how about you?  

Yes, a thread on minor equipment, but hey, just curious here about the opinions of othes on this pressing matter.:blush:


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## Ridryder911 (Oct 3, 2007)

There are good brands out there, but personally your service as well as your school should provide you with these tools of the trade. 

Check out any EMS product sites, they range from $35 to $150 on. 

Good luck in school. 

R/r 911


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## KEVD18 (Oct 3, 2007)

the mere fact that the school doesnt have bp cuffs and scopes for you to train with would make me immediatley request a refund and seek education elsewhere.

adc makes pretty much the standard in ems v/s gear


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## Gbro (Oct 3, 2007)

You will do well with your own sphygmomanometer.

your family will be constantly seeking your new skills. 
We all need practice.

A technique i use onboard the rig in our, Not so smooth roadways when auscultating a B/P isn't going to happen unless the rig is pulled over and stopped. (This is mandatory on unstable Pt's.)

I will, when i want to obtain a palpation B/P, concentrate on the pulse, and have my partner inflate the cuff. I will indicate when to start down, and signal to "Mark" when the pulse is felt. 
This has worked much better on the road, where the frost heaves are 6" HIGH!


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## princess (Oct 3, 2007)

Another tip for auscultating a BP while riding down the road...try to rest your feet on the frame of the stretcher instead of the floor.  It helps lessen the vibrations.


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## BossyCow (Oct 4, 2007)

As for types, use as many as you can and find the one you like.  I personally like the one where the pump has the dial on it.  No having the dial slip out of sight at the wrong moment its always right there in your hand.  I catch a ton of crap for liking this one but what can I say.. it's my favorite!


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## Gbro (Oct 4, 2007)

BossyCow said:


> As for types, use as many as you can and find the one you like.  I personally like the one where the pump has the dial on it.  No having the dial slip out of sight at the wrong moment its always right there in your hand.  I catch a ton of crap for liking this one but what can I say.. it's my favorite!



By far my favorite also.

We have an Auto, Part of the series M Zoll.
I still like to use the manual cuff.
http://www.zoll.com/product_resource.aspx?id=594


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## Gbro (Oct 4, 2007)

princess said:


> Another tip for auscultating a BP while riding down the road...try to rest your feet on the frame of the stretcher instead of the floor.  It helps lessen the vibrations.



And i thought some of the attendants i work with just have better hearing.
Some of the shorter ones always have there feet on the cot frame.
Me being 5-1/2' 10" tall will have a hard time, but i will give it a try.


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## MMiz (Oct 5, 2007)

I have a cheap one that I paid $20 for, including the cuff and scope.  Our rigs have fancier ones.  I wouldn't think that investing in a good cuff would be worth it, but it really depends on the person.  I've only used mine a few times since I got it.


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## Operator 37 (Oct 5, 2007)

Keeping your feet up does diminish the amount of noise you need to deal with but also having the right stethoscope will reduce it even further. I found that a thick walled, double tubed stethoscope worked the best. (Glue the tubes together to reduce the rubbing noise.) The expensive cardio scopes used in ICU are fine in the quiet hospital setting. All you need to check is it the air and blood are doing their thing and not checking for murmurs. Also check the fit into your ear canal. Enjoy your training.


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## Meursault (Oct 5, 2007)

Good idea about making dual-tubes usable. I have one that could charitably be described as inexpensive, so I'm going to tell "professional appearance" to go :censored: itself and see what I can do with discreetly placed black duct tape.

Strangely, I have fewer problems auscultating a BP than getting a radial pulse in a moving ambulance. Any thoughts on why that happens?

Crash_cart: What everybody else said. There's no reason why your school shouldn't have gear for you. It might not be the best, but it should be there.

EDIT: Immediately after I posted this, as I was straightening and securing the tubes, the diaphragm end of one tube snapped off, revealing that it was 1. Shiny plastic, and 2. Partially plugged with something, possibly epoxy. High quality indeed.


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## DisasterMedTech (Oct 8, 2007)

*Dont make things so hard...*



Gbro said:


> You will do well with your own sphygmomanometer.
> 
> your family will be constantly seeking your new skills.
> We all need practice.
> ...



There's no reason to have two people tied up simply to get a palp pressure.  Put on the cuff. Palpate the radial pulse. Pump up the cuff until you dont feel a radial pulse any longer. Then slowly come down watching the gauge and feeling the pulse. When you feel the pulse return, note the number on the gauge and this gives you a rough palpated BP (ie systolic only) which is then noted as (for example) 140/P or verbally reported as 140-palp.


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## Gbro (Oct 8, 2007)

> DMT
> There's no reason to have two people tied up simply to get a palp pressure. Put on the cuff. Palpate the radial pulse. Pump up the cuff until you dont feel a radial pulse any longer. Then slowly come down watching the gauge and feeling the pulse. When you feel the pulse return, note the number on the gauge and this gives you a rough palpated BP (ie systolic only) which is then noted as (for example) 140/P or verbally reported as 140-palp.



You comment like i am ignorant on how to obtain a B/P by Palpation, What my post was about is obtaining an accurate one on bad roads. 
This isn't something that is done at all times, but will work when other methods are difficult.
If you have never had a hard time, you are fortunate.
But there are those who give it there best and when the results are questionable, they just make up a number. Maybe those need a new technique.


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## DisasterMedTech (Oct 8, 2007)

*well...*

Well, what I was commenting on is that you have added several useless steps to taking a palp B/P and it should never require two EMTs to take a set of vitals. It requires two hands and one set of eyes.  The "mark" call out sounds all high speed but serves no purpose. If I were your partner and you asked me to help you get a palp pressure and you did it this way, yes, I might think you a little ignorant and I would advise you that it only takes one person to get vitals. Ive taken vitals including palp'ed BPs in HUM-Vs, the backs of pick ups and while walking along side a patient who is being carried out after a SAR mission. All I was trying to say is that regardless of the terrain or noise, it doesnt take two people. Thats the whole point of it. Feel with one hand, pump with the other and watch the gauge. Its not like your listening to anything anyway so the roughness of the terrain makes absolutely no difference. Sorry if you felt insulted, its just that your process isnt very streamlined, nor is it the way I have ever seen it taught or taught it myself.


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## Gbro (Oct 9, 2007)

Thanks so much for your $0.02.
By the way, dose your cape ever slip out to reveal your true self?
Some of us mortals humble ourselves in that working together is a really neat thing.


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## Aileana (Oct 9, 2007)

anyone know where i can buy a sphygomomanometer cuff? I've had A LOT of trouble finding them around here, and when i do find a place that has, they normally just have the electronic ones.


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## Ridryder911 (Oct 9, 2007)

Aileana said:


> anyone know where i can buy a sphygomomanometer cuff? I've had A LOT of trouble finding them around here, and when i do find a place that has, they normally just have the electronic ones.



ebay... 

R/r 911


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## Aileana (Oct 9, 2007)

apparently ebay is limited to people 18+ :S tried to make an account, and was stopped by that


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## Meursault (Oct 10, 2007)

Aileana said:


> apparently ebay is limited to people 18+ :S tried to make an account, and was stopped by that



So are most online stores, AFAIK. Even if they don't have a specific age policy, most forms of online payment do. Good luck.


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## DisasterMedTech (Oct 10, 2007)

Gbro said:


> Thanks so much for your $0.02.
> By the way, dose your cape ever slip out to reveal your true self?
> Some of us mortals humble ourselves in that working together is a really neat thing.



Now youre starting with personal attacks. Im sorry if I offended you, which I have already apologized for. The thing is, there is a way to get a palp B/P that does need to tie up both responders no matter what the terrain. Working together is absolutely the way to go, but when it is at the expense of efficiency, then it goes out the window. Efficient patient care is excellent patient care and taking two people to take a BP is not efficient. As I say, I am on a team that deals with terror and other disaster events. We dont always have the luxury of putting two people on an assessment point that should only take one. Its not that I think I am a super hero, its that my agency doesnt respond to car wrecks...we respond to MCIs with tens of thousands of patients...like Katrina. I dont know how long you have been an EMT, but maybe you should tuck your bruised ego in your pocket and listen to those who have some different experiences and have developed more efficient techniques. As I say, I have taken hundreds of palp B/Ps and the way I describe always works because it relies on your sense of touch, which cant be obscured by bumpy roads or the noise in the box. Im not going to argue with you, its just that your way is akin to taking two people to do a glucose stick...its inefficient and it wastes time. Thats all. Im not attacking you as an EMT or as a person.


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## reaper (Oct 10, 2007)

The best way is--- Don't palpate a BP! On my truck you better give me a real BP, not half assed. There is hardly ever a time when you should have to palpate a BP.

On that thought. Good scope and practice is the best method


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## Ridryder911 (Oct 10, 2007)

If I was to observe a medic requiring two people to "palpate" a blood pressure, they could be assured that they would get to go to remediation classes and or have the chance to resign. The same if one has to pull a unit over to obtain a set of vital signs. 

There are a very few times that "pulling over" should be required, and one of those is not obtaining vital signs. This is why practicing on mundane calls, transfers is essential to be proficient.  Obtaining a blood pressure is a one person tasks, unless there is specific reasons such as being combatitive or obesity...

R/r 911


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## Gbro (Oct 11, 2007)

Ridryder911 said:


> If I was to observe a medic requiring two people to "palpate" a blood pressure, they could be assured that they would get to go to remediation classes and or have the chance to resign. The same if one has to pull a unit over to obtain a set of vital signs.
> 
> There are a very few times that "pulling over" should be required, and one of those is not obtaining vital signs. This is why practicing on mundane calls, transfers is essential to be proficient.  Obtaining a blood pressure is a one person tasks, unless there is specific reasons such as being combatitive or obesity...
> 
> R/r 911



Yes I do agree with you, A "MEDIC" should not ever let on that something is difficult.(i am referring to a B/P by/P enroute, thready, ruff roads,etc).
You have made a very good point, You will not see someone put themselves in a tight spot, its just going to be a simple little fabrication. And if you think that is not done, I have a few acres of prime real estate you might be interested in.


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## Ridryder911 (Oct 11, 2007)

Hopefully, a professional would "hone" their skills, especially those that are simplistic and are going to be used on * every* call. 

Are there calls where it is hard to hear, or difficult to obtain blood pressures .. you bet. That is the breaks of life, but those should be an oddity not a regular basis. As well, you would realize this before transport. 

If I catch a Paramedic "fudging" a vital sign in regards to an emergency call.. there will be problems. 

Again, the difference is I would understand perfusion levels. Realizing the numbers is not as importance as the LOC, and perfusion to distal extremities knowing that if I have a popliteal pulse I have at least a systolic of 90 or greater. 

Numbers are great, but knowing perfusion level is more important since that is really what we are after. 

R/r 911


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## Aileana (Oct 11, 2007)

Finally got myself a AMG sphygomomanometer yesterday ^^. 
Been practicing on friends and family, even teachers...whoever I can talk into letting me practice on. I find that with practice, I'm learning the amount of air to let out at once on this specific cuff, and finding ways to hear the Korotkoff sounds when theyre harder to hear. hopefully, good getting good BPs just takes a lot of practice.


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## fm_emt (Oct 11, 2007)

Those little digital ADC sphygomomanometers are pretty cool because they're self-calibrating, hard to destroy, lightweight, accurate, and have a decent warranty.

They're not too expensive either. At the rate we keep having sphygomomanometers going out of whack or getting broken where I work, it'd be a godsend.


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## crash_cart (Oct 11, 2007)

Aileana said:


> Finally got myself a AMG sphygomomanometer yesterday ^^.
> Been practicing on friends and family, even teachers...whoever I can talk into letting me practice on. I find that with practice, I'm learning the amount of air to let out at once on this specific cuff, and finding ways to hear the Korotkoff sounds when theyre harder to hear. hopefully, good getting good BPs just takes a lot of practice.



LOL-I had a good chuckle when I read this.  I was pumped too(pun not intended) and practice on everyone.  You know you're a real pro when you can get the diastolic when you palpate the radial pulse.


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## Artique (Oct 12, 2007)

That sucks that they diddent supply you with those tools. THose should be mandatory prior to even going to class. Either way, Its cool once you start doing some hands on stuff. Its awkward becuse so many EMS workers have done this time and time again, yet for me it was cool as @#%&. Hehe just like my first day on a rig will be Im sure.


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## Gbro (Oct 12, 2007)

Ridryder911 said:


> Hopefully, a professional would "hone" their skills, especially those that are simplistic and are going to be used on * every* call.
> 
> Are there calls where it is hard to hear, or difficult to obtain blood pressures .. you bet. That is the breaks of life, but those should be an oddity not a regular basis. As well, you would realize this before transport.
> 
> ...



Very good answer, I am a believer in the perfusion levels, However they don't ask for our Gut, Instinct, or any other "I know,I Know" methods that we rely on in the field. The Report has those reality boxes that need to be done or documentation as to why the boxes aren't completed has to be.
So here is where there has been some indiscretion.

Then there has been some thinking that involving another to get vitals in "Rare" situation is a wast of another attendant time. When on a 40-60 min transport, 20+ vitals might be appropriate, what is wrong with helping and learning together?
And there is many a time when stopping is done, We do try and get that done on a intersection. but that just isn't practical in some cases.


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