Trick to hear BP Better in the Moving Rig???

[EMSslick536]

Hey Guys,

Was told by an RN and a few of my buddies a way to hear BP's more loudly for all of that annoying background noise in the rig.

1.) Assess the BP, if heard correctly the following steps are not needed. If not heard, or heard incorrectly, continue with the following steps.

2.) Ask the pt. to clench his/her fists in a ball and then retract them again (aprox. 3 - 4 times)

3.) Reposition the BP cuff.

4.) Assess BP again, you will hear the pulse a lot louder.

Just a little tip for all of the frustrated crew that can't hear BP's with background noise very well...

 

[HotelCo]

Hey Guys,

Was told by an RN and a few of my buddies a way to hear BP's more loudly for all of that annoying background noise in the rig.

1.) Assess the BP, if heard correctly the following steps are not needed. If not heard, or heard incorrectly, continue with the following steps.

2.) Ask the pt. to clench his/her fists in a ball and then retract them again (aprox. 3 - 4 times)

3.) Reposition the BP cuff.

4.) Assess BP again, you will hear the pulse a lot louder.

Just a little tip for all of the frustrated crew that can't hear BP's with background noise very well...

How are you going to know if you hear it "incorrectly"?

Side note: Once had a partner tell me the pt's BP was 64/93. I asked if he mean 93/64, and he was convinced that not only could he hear the bottom number first, but that he could read between the lines on the BP cuff.

 

[EMSslick536]

How are you going to know if you hear it "incorrectly"?

I'd guess by not hearing it or it being very faint.

 

[EMSslick536]

How are you going to know if you hear it "incorrectly"?

Side note: Once had a partner tell me the pt's BP was 64/93. I asked if he mean 93/64, and he was convinced that not only could he hear the bottom number first, but that he could read between the lines on the BP cuff.

Haha, yea that's what they told us at CFR class.. If you get a odd number reading.. you probably need more help than the pt. sitting in front of you. haha

 

[18G]

I get the concept of the fist pumping but highly doubt that would make much difference. The best method is practice. The more blood pressures you take the more you will be able to pick out the sounds in amidst the mix of other ambient noises.

And sometimes you just can't hear it in the ambulance. I personally love NiBP

 

[usalsfyre]

Ultrascope. I got mine a month ago and I think I'm in love :wub:.

 

[TransportJockey]

Glad to see more people drinking the koolaid I can't wait to get mine back from Ultrascope

Ultrascope. I got mine a month ago and I think I'm in love :wub:.

 

[94H]

Palp?

Especially in BLS if the systolic number is in a normal range it should be fine

 

[exodus]

Palp?

Especially in BLS if the systolic number is in a normal range it should be fine

Erhm, no...

But the BP cuff on as normal, palp the brachail, search for it until you feel it, and put the center of your Steth bell there it will be loud every time. Also, make sure your steth is tight enough. Very little outside noise should come through.

This is assuming the BP is decent as far as palping it to find the artery, otherwise just guess by looking at anatomy...

 

[HotelCo]

Erhm, no...

You beat me to it!

 

[Wyoming Medic]

Just remember that taking a BP (or hearing anything through a stethoscope) is like listening through a drum. Excess skin/fat or anything that prevents a flat and solid physical connection with the stethoscope will hamper the sound conduction.

Remember the 2 soup cans and string phones we made as kids. If the line was REALLY tight, you could kind of hear each other. But if it was sloppy and saggy, then no sound conduction.

The other trick that helped me in a rig was where my knees were. If I was kneeling beside the gurney, my knees would be on the floor and I would get more ground vibrations which would make it harder. My bony knees conducted vibrations throughout my skeletal system.

WM

 

[exodus]

Just remember that taking a BP (or hearing anything through a stethoscope) is like listening through a drum. Excess skin/fat or anything that prevents a flat and solid physical connection with the stethoscope will hamper the sound conduction.

Remember the 2 soup cans and string phones we made as kids. If the line was REALLY tight, you could kind of hear each other. But if it was sloppy and saggy, then no sound conduction.

The other trick that helped me in a rig was where my knees were. If I was kneeling beside the gurney, my knees would be on the floor and I would get more ground vibrations which would make it harder. My bony knees conducted vibrations throughout my skeletal system.

WM

Another one, put the balls of your feet on the gurney foot rail, and lift your heels off the floor, and keep the tubes of the steth from touching anything. All reduces vibration.

Honestly.... To me, taking a pulse is much harder XD

 

[bigbaldguy]

I'm still a little confused by the no odd number thing. It seems to me our job is to be as accurate as possible when taking vitals but I've been told by "old hands" that we never report a odd reading, but if the needle is sitting right between two numbers when you hear it then why would you round up or down, why wouldn't you put down the actual number it was at?

 

[HotelCo]

I'm still a little confused by the no odd number thing. It seems to me our job is to be as accurate as possible when taking vitals but I've been told by "old hands" that we never report a odd reading, but if the needle is sitting right between two numbers when you hear it then why would you round up or down, why wouldn't you put down the actual number it was at?

You can tell when the needle is exactly in the middle of the lines when doing a blood pressure?

 

[exodus]

http://184.72.239.143/mu/aefcfb8f-285e-3a08.jpg

You can tell when the needle is exactly in the middle of the lines when doing a blood pressure?

Almost time for a new sphyg, or to re-calib

 

[18G]

It's way too difficult to see in a bouncy ambulance when the needle is between two narrow lines which is why its always an even number reading unless using NiBP (automatic BP).

 

[usalsfyre]

How are you going to know if you hear it "incorrectly"?

Side note: Once had a partner tell me the pt's BP was 64/93. I asked if he mean 93/64, and he was convinced that not only could he hear the bottom number first, but that he could read between the lines on the BP cuff.

Haha, yea that's what they told us at CFR class.. If you get a odd number reading.. you probably need more help than the pt. sitting in front of you. haha

Palp?

Especially in BLS if the systolic number is in a normal range it should be fine

It's way too difficult to see in a bouncy ambulance when the needle is between two narrow lines which is why its always an even number reading unless using NiBP (automatic BP).

This kinda stuff is also why I laugh when people start ranting about how bad NIBP is. The honest fact is I trust NIBP FAR, FAR more than a lot of partners I've had. The insistence that "my ears are better than a machine" when said parties ears have been assaulted by sirens and diesel engines for years makes me smile....

 

[usalsfyre]

You can tell when the needle is exactly in the middle of the lines when doing a blood pressure?

How easy is it to read a very accurate B/P period? The only pressure you should trust to be completely accurate is off of a properly transduced a-line with a good waveform. Everything else is really some level of guess.

 

[HotelCo]

How easy is it to read a very accurate B/P period? The only pressure you should trust to be completely accurate is off of a properly transduced a-line with a good waveform. Everything else is really some level of guess.

No argument here...

 

[clibb]

You were told by an RN?

-Position the patients arm with palm up
-Straighten the arm
-Put forearm on your knee. Don't touch cot with your knee or you'll still hear background noise.

If you can't hear BP then palp.