Automatic blood pressure cuffs...

[mikeylikesit]

I think those life packs are about the most worthless things out there. unless, my patient did really have a SPO2 of 86 yesterday? no they do have the benifits but i still prefer my ears and a good steth.B)

 

[Mercy4Angels]

thoughts on auto bp cuff

ive seen the small automatic wrist bp cuffs are they any good ? looks small enough to carry around. thoughts ?

 

[CFRBryan347768]

Im pretty sure their was a thread on this allready, but i find my BP's to be difrent when the auto one is used compared to some one taking it.

 

[kayrules5340]

No...we have one because my dad has hypertension, but they give you completely different readings.....It makes no sense, it was a waste of like 30 bucks. I would get like 100/60, then like 75/35 then like 150/90 all like on the same day, like 10 minutes apart.

 

[fma08]

buy a decent manual and steth if you are gonna carry somethin around

 

[NJN]

Don't get an auto bp cuff. Especially those wrist ones. Got one for my mother (hypertension) first time i tried it i got a reading that i thought was odd, i forget what the exact numbers were but they were high enough that i was about to call medics. Went again with a manual, it was within normal limits. Now i just use my littman and a manual.

 

[KEVD18]

try a search. it will do wonders for your posture.

 

[BossyCow]

The ones that are affordable aren't worth it. They are notorious for inaccurate readings.

 

[mikeylikesit]

worthless pieces of crap. i could get a more accurate BP with the ones at the pharmacy mounted to the wall then those stupid things. they don't make things easier trust me. i can do a manual BP just as fast. practice.

 

[Mercy4Angels]

i got ya ill just get a finger pulse ox and use my manual cuff..

 

[KEVD18]

i got ya ill just get a finger pulse ox

here we go again. round two: ding ding ding

 

[ffemt8978]

Why do you even need a finger pulse ox? What treatment modalities are you going to implement based upon a pulse ox reading, or how is it going to change your treatment of the patient?

 

[Jon]

Also.. why do YOU need to buy one? doesn't your service have one, if you need it?

 

[BossyCow]

My favorite pulse ox is my eyes! I took in a pt the other day with a pulse ox of 86. She was talking in full sentences, had good color and nice cap refill. No edema to extremeties, no hx of cardiac or respiratory compromise. I put I put her on a n/c at 4lpm.

The pulse ox was wrong and the doc in the ER agreed with me.

 

[CAOX3]

Ok, I havent been here long enough to draw any conclusions about anyone. I am sure you are all wonderful providers. If I could Bossy.

If she was pink, warm and dry, speaking in full sentences with no hx, why the O2?

Not being an *** here just wondering what your thoughts were.

How about lung sounds?

Do they still teach EMTs to assess cap refill in adults? CRT is age/temperature dependent.

 

[Hastings]

Ok, I havent been here long enough to draw any conclusions about anyone. I am sure you are all wonderful providers. If I could Bossy.

If she was pink, warm and dry, speaking in full sentences with no hx, why the O2?

Not being an *** here just wondering what your thoughts were.

How about lung sounds?

Do they still teach EMTs to assess cap refill in adults? CRT is age/temperature dependent.

Because oxygen is a wonderful drug that is beneficial even when given to a healthy individual.

And yes, they still teach EMTs to assess cap refill in adults. However, when you get to paramedic level, they tell you that cap refill is only really a significant finding / vital sign in young children.

Why do you even need a finger pulse ox? What treatment modalities are you going to implement based upon a pulse ox reading, or how is it going to change your treatment of the patient?

As one example, PE. One of the most telling signs of a PE is a pulse ox reading that does not improve with the administration of O2 (depending on the type of PE, of course). I know that there are other signs, but personally, any clues that will cause the EMS provider to realize that this is an IMMEDIATE emergency quickly is okay with me. In this case, it's the difference between trying to convince a patient to calm down and stop hyperventilating and hauling to the hospital so the patient can get into the OR immediately.

 

[KEVD18]

except for the problem that multiple reasons can cause completely erroneous readings and should never be used to unilaterally determine treatment.

and if a provider(of any level) waits for a pulse ox reading to determine they need to scoop and screw with a pe, they need to turn their ticket in. any of the prevailing symptoms of a pe by themselves scream for immediate transport. add them all up and you can call that one with no electronics whatsoever.

 

[Hastings]

except for the problem that multiple reasons can cause completely erroneous readings and should never be used to unilaterally determine treatment.

Absolutely not. That's the point I was getting at. It's simply one more diagnostic tool which, when added to the list of other diagnostic procedures done, can nail in a (dare I say) diagnosis quickly. It takes 5 seconds to put on, and it can be one more step to finding out what's wrong and getting to treatment quickly. Why pass it up?

 

[VentMedic]

As one example, PE. One of the most telling signs of a PE is a pulse ox reading that does not improve with the administration of O2 (depending on the type of PE, of course). I know that there are other signs, but personally, any clues that will cause the EMS provider to realize that this is an IMMEDIATE emergency quickly is okay with me. In this case, it's the difference between trying to convince a patient to calm down and stop hyperventilating and hauling to the hospital so the patient can get into the OR immediately.

Shunting and heart defects in the newborn and in rare cases in the adult do not respond to O2 therapy. Pts with severe pulmonary hypertension may also appear to be nonresponsive to O2 therapy but is a very different treatment pathway from PE. O2, however, will stil be the administered.

A PE is not a good example either since oxygen can improve oxygenation. One would not know the A-a gradient in the field to actually know the degree of hypoxia. Clinical correlation, pt hx and what they are telling you will still dictate care.

In the ED, we will often get strange looks from the EMS providers who bring in a patient with an SpO2 of 100% on a NRBM and we will immediately intubate after the ABG based on an A-a gradient. Likewise, if the person's SpO2 is 100% on room air but a severe metabolic acidosis that can not be contributed to DKA there may be an ETT in their future.

The assessment of the patient can be skewed by seeing that 100% on a pulse ox and a true emergency can be missed.

"Hyperventilating" is another over used and misunderstood term in EMS. Again good assessment, reassurance and a little oxygen may improve that situation. Many patients with a variety of disease processes (DKA, sepsis, renal failure) "hyperventilate" in the truest sense of reducing their PaCO2 to maintain a pH compatible with life. Other patients are "tachypneic" without hyperventilating because respiratory failure is setting in and they no longer can blow off their CO2 no matter how hard they try.

 

[CAOX3]

"Because oxygen is a wonderful drug that is beneficial even when given to a healthy individual." :unsure:

Interesting......

Hastings, I guess we can just disagree on this.

After assessment a healthy oxygenating patient would not require nor would they recieve oxygen in my care.