b/p question

[occipudding]

so im at my mom's apt in bk tonight. figured i'd bring my b/p cuff and stethoscope for practice. tried twice on the right arm, couldn't get a pulse. tried 3 times on the left arm and finally i was able to auscultate a pulse but it was very thready. i think i got a systolic at 110 but i was even less sure about diastolic. possibly at 60 but as i said, the pulse was very weak. i checked her radial pulses as well and those were thready also. carotid i barely felt a thing. she says that even for doctors and nurses, finding a pulse has always been an adventure. so my question is: am i doing something wrong or is my mother just a challenging pt? also, my mother's going through chemo and taking a lot of morphine. could this have anything to do with this? i mean, she says her pulse is always difficult to find but for a few minutes there, i thought "wow, i think my mom is dead." so... what's the deal? am i missing something? am i doing something wrong?

 

[BBFDMedic28]

The strength of the pulse differs from pt to pt. Some have a pounding pulse, some have a very weak one. I have personally noticed that a weak pulse is a more frequent occurance in older pts.

 

[occipudding]

she's in her mid-50s but seriously, it was like nothing was there. i really had to strain to hear anything at all and i still wasn't completely sure of it. any tips?

 

[BBFDMedic28]

There really is nothing that I have found to make it stronger. The only thing I can think of is a good stethoscope. I bought a cheapo when I started and then graduated to a Littman. It has made a big difference.

 

[occipudding]

that's probably it. my stethoscope came as part of a kit i got for 40 bucks (bp cuff, pen light, o2 key, stethoscope, and those big ol' scissor thingies). cheap stuff but good to practice with i guess.

 

[BBFDMedic28]

Cheap is good to get you started, especially for practice purposes. I am in no way saying go buy a littman to check your moms bp, but if you decide to buy one at a later date then it will help you in the field dramatically. But i lasted with a cheapo for 2 yrs.

 

[occipudding]

nah man, i already told my mom to get me a littman after i graduate this course. el cheapo is good for practice but once i get on the streets, i want top of the line dude

 

[BBFDMedic28]

They help alot. Especially during xpt. Also going back to your original question about the pulse-if you cant get a pulse, use a pulse ox that is what i do.

 

[Ridryder911]

Remember peripheral pulses are formed by feeling the pulsation of the artery over the bone, as in the carotid over muscle tissue. True, peripheral pulses vary in strength, (thus the reason for grade +1-4 weak-bounding), I have found many are using their thumbs, and either attempting to push too hard or not enough.

Like blood pressures, pulses get easier to detect with time and repeated practice.

God luck & keep practicing!

R/r 911