Blood Pressure - Even Numbers or Any Number?

Jon

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So... the question was asked by an EMT Student at the volunteer squad:

Why do we only measure blood pressure in even numbers.

My answer was simply "thats the way it is done"... and I hate giving that answer, so I said I'd look into it... and so I come here.


To take it a step further - all the lovely electronic machines we have now measure "exact" numbers... I.E. 119/81 vs. 120/80 - Do/Should you round up/down to get an even number when documenting those pressures.
 

KEVD18

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manual guages are marked in even numbers. its not feasible to have an odd number in your answer.

automatic machines have a computer to process the results and are fairly well unlimited.

if it is within your services policies to obtain v/s with auto machines, then i see no reason to change the result. quite the opposite in fact. that would be falsifying a treatment record, wouldnt it? you would be writing down that you got a pressure of 116/64 when in fact you got 115/63. to me, thats no different legally than plain making it up
 

MMiz

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On the rig/on scene if I were to report an odd numbered blood pressure reading it would be considered falsifying a patient's record, as I've yet to find a manual sphygmomanometer with markings for odd numbers.

In the clinical/hospital setting with electric/automated machines it's possible to get an odd number for a reading.
 

Jon

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On the rig/on scene if I were to report an odd numbered blood pressure reading it would be considered falsifying a patient's record, as I've yet to find a manual sphygmomanometer with markings for odd numbers...
But... But.... what if it IN BETWEEN the markings?
 

traumateam1

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Like others have said.. the manual ones are only marked with even numbers. 0, 10, 20, 30, 40 etc. Where as the electrical/monitoring ones have a computer in them to interpret the data and get near exact numbers, thus you get even and odd numbers.
 

MMiz

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Jon, I'm a highly calibrated numbers-reporting machine that would never take a reading that was even a point off.

I really don't think it's a big deal either way, but I'm sure someone will burst into this thread with a five page response as to why you've broken EMS code 8675.309. I won't be that person :)
 

traumateam1

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But... But.... what if it IN BETWEEN the markings?
I dunno about you.. but a difference of 1 mmHg isn't going to make that big of a difference pre hospital. So, if something falls on 131, writing 130 or 132 isn't going to make a difference.. besides, can you honestly catch it in between the two even numbers?
 

MSDeltaFlt

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But... But.... what if it IN BETWEEN the markings?
Who cares? NIBP's are not accurate. Never have been. Never shall be. Even their specs say they aren't. The most accurate blood pressures are:

1. A properly zeroed arterial line, and

2. A manual BP.

Manual cuffs are marked in even numbers, true. But even if you have a one digit margin of error, it will matter about as much as the price of milk. Which is absolutely none.
 

Jon

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Thanks MMiz and MSDeltaFlt... I was just playing devil's advocate.
 

Ridryder911

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Agreed, even numbers. It is part of "chart" etiquettecy.

R/r 911
 

Jon

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aidan

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We were told that if we take it manually (with stethoscope/sphygmomanometer) it has to be an even number, but if we take it with an electronic sphygmomanometer, we can write down an odd number as long as we also write that it was taken electronically.
 

tydek07

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We were told that if we take it manually (with stethoscope/sphygmomanometer) it has to be an even number, but if we take it with an electronic sphygmomanometer, we can write down an odd number as long as we also write that it was taken electronically.
Not to steal the thread... but your signature made me laugh "aidan" haha, love it

Palin, Palin, Palin... **shakes head**
 

aidan

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Not to steal the thread... but your signature made me laugh "aidan" haha, love it

Palin, Palin, Palin... **shakes head**
Thanks! B) hahaha.. yeah..*shakes head in agreement!*
 

Code 3

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I dunno about you.. but a difference of 1 mmHg isn't going to make that big of a difference pre hospital. So, if something falls on 131, writing 130 or 132 isn't going to make a difference.. besides, can you honestly catch it in between the two even numbers?
1mmHG can mean the difference between whether or not you administer NTG 0.4mg SL along with 1" NTG ointment for a cardiac C/P pt.
 

aidan

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1mmHG can mean the difference between whether or not you administer NTG 0.4mg SL along with 1" NTG ointment for a cardiac C/P pt.
Really? Could you elaborate a little? I didn't even think it was possible to get a BP down to the exact mmHg. If it is possible, I sure doubt my ability to do it! Even releasing 2-3mmHg/second, it still goes too fast for me to see the EXACT spot where the radial pulse returns or goes away..
 

Code 3

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Really? Could you elaborate a little? I didn't even think it was possible to get a BP down to the exact mmHg. If it is possible, I sure doubt my ability to do it! Even releasing 2-3mmHg/second, it still goes too fast for me to see the EXACT spot where the radial pulse returns or goes away..
What's there to elaborate? You should have a protocol for NTG with a set B/P reading of greater than or equal to a number. The post I quoted was regarding rounding up the number if you catch it in between readings and how it does make a difference.
 

aidan

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What's there to elaborate? You should have a protocol for NTG with a set B/P reading of greater than or equal to a number. The post I quoted was regarding rounding up the number if you catch it in between readings and how it does make a difference.
Ah okay. I can't picture a medic being so 100% confident in the BP cuff to not administer NTG based on 1 mmHg, though.
 

VentMedic

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We were told that if we take it manually (with stethoscope/sphygmomanometer) it has to be an even number, but if we take it with an electronic sphygmomanometer, we can write down an odd number as long as we also write that it was taken electronically.
Exactly. That way other professionals don't have to guess whether you are using an electronic device or don't know how to read the sphygmomanometer which is commonly in even number increments.
 

aidan

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Exactly. That way other professionals don't have to guess whether you are using an electronic device or don't know how to read the sphygmomanometer which is commonly in even number increments.
Ahh ok..yeah.. if someone were to assume you used a manual cuff and wrote down an odd number, it'd definitely hurt your credibility :p. I hadn't thought of that, thanks.
 
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