Blood Pressure: ALS v. BLS
- Thread starter sirengirl
- Start date
OK so we have an old lady with known hypertension and she is .... hypertensive, Brown is gobsmacked.
Did we actually ask this lady what her blood pressure is normally? Could it be that such numbers are usual for this patient? Did the nursing home have any more history on her?
In the absence of any sort of symptoms that she is having a stroke Brown cannot help but wonder if we are getting our knickers in a twist over .... nothing.
For example, Brown and Black picked up a bloke from a medical centre whose primary problem was asthma, but his blood pressure was 240 systolic, but, that was normal for him and he had no headache, visual or other sensory abnormality or neuro symptoms and he was on a bag of blood pressure lollies so we didn't think of it as clinically significant.
Did we actually ask this lady what her blood pressure is normally? Could it be that such numbers are usual for this patient? Did the nursing home have any more history on her?
In the absence of any sort of symptoms that she is having a stroke Brown cannot help but wonder if we are getting our knickers in a twist over .... nothing.
For example, Brown and Black picked up a bloke from a medical centre whose primary problem was asthma, but his blood pressure was 240 systolic, but, that was normal for him and he had no headache, visual or other sensory abnormality or neuro symptoms and he was on a bag of blood pressure lollies so we didn't think of it as clinically significant.
18G
Paramedic
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Brown makes a great point.
I had a patient once who was being treated for hypertension and was walking around with a BP of low 200's over 100 something. She was on a few anti-HTN meds and her doctor couldn't get the pressure down. She was undergoing more testing and what not but at the time she was baseline hypertensive with medication.
From my experience most nursing home staff have no clue what a patient's baselines are when you ask. Yesterday I had a call that was a perfect example of that.
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18G
Paramedic
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I never said BLS couldn't.
OP
OP
sirengirl
Forum Lieutenant
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Pt stated normal for her on her home NiBP was 136/90s. Had recently moved into the home, nursing staff was typically clueless and didn't even know if pt takes meds as religiously as the pt says she does.
slb862
Forum Lieutenant
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When I get called into a Basic's area, allowing them to give me a good report, and I ask questions if needed, I will then make a decision as to whether it is ALS or BLS.
Also, sidenote about taking blood pressures, when I take a BP via machine, and I think it is abnormal (high or low), I will follow it with a manual BP. And then if time allows, I have one of my partners take a manual BP.
Also, sidenote about taking blood pressures, when I take a BP via machine, and I think it is abnormal (high or low), I will follow it with a manual BP. And then if time allows, I have one of my partners take a manual BP.
AnneHathaway
Forum Ride Along
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good post I like it
tom.watkins
Forum Probie
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As a good rule of thumb you should try to start taking your first pressure manually, and then use your machine for trending. Also, HTN is something that typically kills you over 10 years, not 10 minutes. Still, a basic should never be afraid to tell a medic that they aren't comfortable with certain situations; I have a real aversion to sending my partners with anything that could use ANY kind of ALS treatment.