Blood Pressure after a workout

[Captn' Tuddle]

Quick question:

Someone at the gym (43 y/o male) has a resting heart rate of 60 bpm and a BP of 120/70. Right after they finished working out their heart rate was 120 bpm and the BP was at 105/65. They are also on cholesterol and high blood pressure medication(I don't know the details on the meds). Is that normal or should they go and see the doctor about it?

 

[alphatrauma]

Unless he is symptomatic in some way, that BP/P does not bother me. What is a little concerning is that target heart rate seems a little low... tell him to turn it up a notch

 

[LucidResq]

Yeah, no one on this forum is qualified to dole out medical advice, but there's I don't see anything too remarkable in that relatively small drop in BP.

 

[FLEMTP]

Yeah, no one on this forum is qualified to dole out medical advice,

Speak for yourself. You have no idea on the medical qualifications of people on this forum.

YOU are not qualified to give medical advice would be the more appropriate answer

 

[LucidResq]

Ok, perhaps I worded that wrong.


OP - It would be wise to take medical advice from ANYONE over the internet with a hardcore grain of salt, as I could start a new account right now and start calling myself Soandso, certified rocket surgeon, MD, FACEP, MPH, NREMT-P, BSN.

Furthermore, those of us claiming to be EMS professionals, it would be also be unwise to dole out straight medical advice via the internet.

 

[adamjh3]

I think what she was getting at is that giving medical advice to someone with a very small snippet of medical Hx and no assessment via an anonymous internet forum is irresponsible. But please correct me if I'm wrong, Lucid.

Edit: You beat me by a minute

 

[LucidResq]

Exactly, I'm wary of giving medical advice out when I can see the person and assess them.... I almost always still advise them to see their doctor, and if not practical, I forewarn them of my low level of training, still hint at seeing the doc, and give the "well, if you were my mother.... I'd tell you to RICE this for the next couple of days... and if it's not better...." kinda speech.

Not going to have random people coming back at me with "well you said that I was fine, but they amputated my leg!" even if they don't sue me.

 

[Veneficus]

Quick question:

Someone at the gym (43 y/o male) has a resting heart rate of 60 bpm and a BP of 120/70. Right after they finished working out their heart rate was 120 bpm and the BP was at 105/65. They are also on cholesterol and high blood pressure medication(I don't know the details on the meds). Is that normal or should they go and see the doctor about it?

Hopefully the person spoke to his doctor about his workout plans prior to starting with this limited medical history, but if not, now is as good a time as any.

 

[reaper]

Speak for yourself. You have no idea on the medical qualifications of people on this forum.

YOU are not qualified to give medical advice would be the more appropriate answer

As far as we know, No one on this site is qualified to give any medical advice!

 

[medichopeful]

As far as we know, No one on this site is qualified to give any medical advice!

Especially Veneficus and JPINFV

I kidd

 

[JPINFV]

Yeah, no one on this forum is qualified to dole out medical advice, but there's I don't see anything too remarkable in that relatively small drop in BP.

Although I'm almost 25% capable of providing medical advice, providing specific medical advice through the limited information provided in a forum post isn't necessarily the best of plans.

 

[mycrofft]

Also, the BP was oblvikously done by machine (odd-numbered value in BP)

Do it manually. 120/min for a healthy person with a resting rate of 60 may indicate a delay in measurement, a bad monitor, or not working hard enogh for cardiopulmonat improvement.
Usually, if the person feels ok and looks ok, other than cases of hidden hypertenson, they are probably ok at that point in time.

And as for giving specific medical advice, doing it through this forum or any other is like wearing a blindfold and relying on someone else to describe the case.
"Your Honor, it was like this....).

 

[GhostEMT627]

When I did the CPAT for the fire department, they took my vitals before and after. Before I was 80p 128/86, after I was 120p and 110/76. One of the ff's asked me if I had a history of hypotension and I told him no. He told me that that was abnormal and I should see my doctor. Doc said everything looks good B)

 

[Akulahawk]

When I did the CPAT for the fire department, they took my vitals before and after. Before I was 80p 128/86, after I was 120p and 110/76. One of the ff's asked me if I had a history of hypotension and I told him no. He told me that that was abnormal and I should see my doctor. Doc said everything looks good B)

Sounds like a normal response to exercise. Your heart rate increased to increase blood flow and your capillary beds were probably still wide open, thus increasing "the container", leading to lower BP, which might actually be compensated for by the increased HR. Given a few minutes more rest, those capillary beds will start closing back down as the area they supply blood do no longer has a high demand for oxygen/nutrients. That makes the "container" smaller, and your BP should return back up to normal.

 

[clibb]

Exactly, I'm wary of giving medical advice out when I can see the person and assess them.... I almost always still advise them to see their doctor, and if not practical, I forewarn them of my low level of training, still hint at seeing the doc, and give the "well, if you were my mother.... I'd tell you to RICE this for the next couple of days... and if it's not better...." kinda speech.

Not going to have random people coming back at me with "well you said that I was fine, but they amputated my leg!" even if they don't sue me.

When people that I'm not related to ask me for help when I'm not on the bus, I tell them "If I'm going to check you out, then you have to promise me you'll go to the hospital anyway." Usually that's when I get the "Okay, never mind."

 

[clibb]

When I did the CPAT for the fire department, they took my vitals before and after. Before I was 80p 128/86, after I was 120p and 110/76. One of the ff's asked me if I had a history of hypotension and I told him no. He told me that that was abnormal and I should see my doctor. Doc said everything looks good B)

Doctors have so much more knowledge and education.
When we had a patient who was decerebrating. My teacher said that he knew for sure that my patient had to have a problem with his Cerebellum.
An ER doc that I talked to told me that it could be many different problems and you'd have to do tests to check it out.

Paramedics and Basics aren't supposed to diagnose, they are supposed to prevent. Diagnosing is the doctor's job.

 

[Veneficus]

Paramedics and Basics aren't supposed to diagnose, they are supposed to prevent. Diagnosing is the doctor's job.

I'm not sure I understand what you mean by this. What are paramedics and basics preventing?

I think there may be some confusion as to what exactly a diagnosis is and how it comes about.

di·ag·no·sis (dg-nss)
n. pl. di·ag·no·ses (-sz) Abbr. dx
1. The act or process of identifying or determining the nature and cause of a disease or injury through evaluation of patient history, examination, and review of laboratory data.

"Laboratory data" isn't exclusive to hematology or other biochemical tests. It also incorperates EKG analysis and the correlation of other forms of quantitative data. (like a blood glucose check)

Sometimes a physician has the benefit of large amounts of data from the latest facilities available. Sometimes they do not. Some of the biological samples sent for testing will be determined long after decisions need to be made. But you use what data you have.

There are also several levels of diagnosis. For example, the diagnosis of Acute Coronary Syndrome is rather vague. As are other pathologies such as nephrotic syndrome or closed head injury.

An accurate diagnosis is not always possible. The clinician can only narrow the list of potential pathology and start treating for more specific ones by trial and error and the patient finds relief and the most accurate dx is never discovered or some other therapy is initiated to treat another.

Even among physicians there are different levels of diagnosis. An emergency physician doesn't operate at the same level of accuracy and precision that a pathologist does, or even an internal medicine physician.

Likewise a paramedic does not always operate at the same level as a physician as a basic does not operate at the same level as a medic. But some level of diagnosis is required in order to treat any patient.

"treating signs and symptoms" and all the other catch phrases used to avoid the word "diagnosis" just demonstrates misunderstanding of what "diagnosis" actually is or is a very poor attempt to escape the responsibility associated with clinical decision making.

The language can be argued ad nausum, but in order to treat a patient without some level of diagnosis a provider would have to omit any level of physical exam, history including the chief complaint, and perform no quantitative testing like checking vital signs, blood glucose, EKG, etc.

I can't imagine how anyone could possible do that without initiating every treatment avialable to the provider on every patient they see.

Even at the Paramedic level some treatments oppose others.

 

[JPINFV]

but in order to treat a patient without some level of diagnosis a provider would have to omit any level of physical exam, history including the chief complaint, and perform no quantitative testing like checking vital signs, blood glucose, EKG, etc.

Quoted for emphasis. I'd also like to add that if EMS providers didn't diagnosis, then there's no reason for anything other than pure (and strictly enforced) cook book treatments, all levels are over educated (after all, why know the pathophys of, well, anything if EMS wishes to abdicate all clinical decision making), and there really is no reason to pay anything above minimum wage for all levels.

 

[Delando]

Hopefully the person spoke to his doctor about his workout plans prior to starting with this limited medical history, but if not, now is as good a time as any.

Wait, this is a real case? if he actually call you guys in, what was his chief complaint?

 

[Veneficus]

Wait, this is a real case? if he actually call you guys in, what was his chief complaint?

There was no chief complaint th question was whether the changes in the measured vitals of a person were physiologic or pathologic enough to warrent immediate care.

The only reliable answer is:

"have the person go see a doctor."

Offering speculation as to whether or not the person should seek medical care or screening based on an unseen patient, with such limited information, on an internet forum is not the best idea.