Blood Pressure - Even Numbers or Any Number?

[reaper]

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.

That's going a little to far! Considering that there is a +/-2 on any cuff, I don't think you have to much to worry about with that.

 

[Code 3]

Yes, I know. I was going for the technicality

 

[Sasha]

A little off topic, but.... Since I've started working in the field, I have been absolutely amazed by the number of new EMTs who get throguh EMT school with out actually being able to take an accurate BP and falsify their BP readings.

 

[aidan]

A little off topic, but.... Since I've started working in the field, I have been absolutely amazed by the number of new EMTs who get throguh EMT school with out actually being able to take an accurate BP and falsify their BP readings.

Seriously? I honestly taught myself, a month before my EMT class even started, by watching Youtube videos hahaha

 

[Sasha]

Seriously? I honestly taught myself, a month before my EMT class even started, by watching Youtube videos hahaha

Seriously. I've taught one, and a couple others have told me so and so yelled at them and re-taught them blood pressures. Simply astounding.

I learned how to in a health science class in high school, but we used the palpation and watching for needle jump. Needle jump is far less accurate than asculatating, but I practiced ausculatating that since I started EMT school on anyone who could and would sit still long enough.

The sound of velcro strikes fear into my grandpa's heart!

 

[aidan]

Seriously. I've taught one, and a couple others have told me so and so yelled at them and re-taught them blood pressures. Simply astounding.

I learned how to in a health science class in high school, but we used the palpation and watching for needle jump. Needle jump is far less accurate than asculatating, but I practiced ausculatating that since I started EMT school on anyone who could and would sit still long enough.

The sound of velcro strikes fear into my grandpa's heart!

I "practiced" too. All my family members had bruises by the end of my EMT class. I've learned the palpation method, but I was under the impression one can't take diastolic BP with just palpation.. it's possible to take diastolic with the needle jump method though, right? Just whenever the needle stops jumping?

 

[Sasha]

I "practiced" too. All my family members had bruises by the end of my EMT class. I've learned the palpation method, but I was under the impression one can't take diastolic BP with just palpation.. it's possible to take diastolic with the needle jump method though, right? Just whenever the needle stops jumping?

That's what I was told. but I notice in the ambulance the needle jumps all the way down And no diastolic by palp, it's whatever/palp

 

[medicdan]

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.

I would think that any medic worth their cert would retake the BP after a few seconds or on the other arm before giving NTG for a baseline BP like that.

 

[aidan]

That's what I was told. but I notice in the ambulance the needle jumps all the way down And no diastolic by palp, it's whatever/palp

Haha, maybe its the shakiness of the road moving the needle (if you mean you were moving) or else maybe the ambulance cuff is more sensitive? :unsure:

 

[Sasha]

I would think that any medic worth their cert would retake the BP after a few seconds or on the other arm before giving NTG for a baseline BP like that.

Or establish a line for the "OH crap! Squeeze the bag!" moment. The protocols where I work are a minimum of 100mmHg systolic, I've seen medics give it at 95-90mmHg with a line popped in case they bottom out.

 

[Code 3]

I would think that any medic worth their cert would retake the BP after a few seconds or on the other arm before giving NTG for a baseline BP like that.

Okay, okay people I wasn't talking real-world application. Just playing devil's advocate for the argument of reading "in between" measurements and whether or not it would make a difference. Case in point, when you take the NR exam and the question is regarding administration of NTG and you select a systolic B/P of 88 or 89 instead of 90 or 92 then technically you got the question wrong.

 

[SES4]

BP Numbers.

Okay. So.... I work as a CNA (Certified Nursing Assistant) in both the hospital and nursing home settings. That said, I have taken my fair share of BP's and I agree with RidRyder that it is GENERALLY chart ettiquecy to record even numbers. Also, regarding what Sasha said about new EMT's inability to take BP and having to be trained on the job, it must be an epidemic in the healthcare industry. Seriously, I am constantly amazed at the number of supposedly trained professionals who are inept in accurately taking BP's.

Thank god for the automatic cuffs and machines that calculate everything for us (makes my life and job A LOT easier HAHA) but I think occasionally everyone should take a manual BP just to keep that skill because basically if you do not use it consistently you lose it or get VERY rusty.

 

[aidan]

Okay. So.... I work as a CNA (Certified Nursing Assistant) in both the hospital and nursing home settings. That said, I have taken my fair share of BP's and I agree with RidRyder that it is GENERALLY chart ettiquecy to record even numbers. Also, regarding what Sasha said about new EMT's inability to take BP and having to be trained on the job, it must be an epidemic in the healthcare industry. Seriously, I am constantly amazed at the number of supposedly trained professionals who are inept in accurately taking BP's.

Thank god for the automatic cuffs and machines that calculate everything for us (makes my life and job A LOT easier HAHA) but I think occasionally everyone should take a manual BP just to keep that skill because basically if you do not use it consistently you lose it or get VERY rusty.

Geez, it's not thoracic surgery!
listen for brachial pulse.
listen for brachial pulse to go buh-bye.
done!

 

[SES4]

Geez, it's not thoracic surgery!
listen for radial pulse.
listen for radial pulse to go buh-bye.
done!

Oh Aidan for some it is akin to thoracic surgery it seems!

 

[BossyCow]

DO NOT USE NEEDLE JUMP FOR B/P.. LEARN THE SKILL!

Kev.. I need the head banging jpg.. please!

 

[SES4]

Indeed.

DO NOT USE NEEDLE JUMP FOR B/P.. LEARN THE SKILL!

Kev.. I need the head banging jpg.. please!

Indeed. Agreed.

 

[aidan]

DO NOT USE NEEDLE JUMP FOR B/P.. LEARN THE SKILL!

Kev.. I need the head banging jpg.. please!

^_^.
It's harder for me to get my needle to jump than it is to auscultate

 

[Sasha]

DO NOT USE NEEDLE JUMP FOR B/P.. LEARN THE SKILL!

Kev.. I need the head banging jpg.. please!

I don't use the needle jump method, it was just my observation in the ambulance it tends to bounce alllll the way down. I said that's how we were taught in high school health science class, probably because we didn't have stethescopes. I asculatate!

 

[Scout]

A little off topic, but.... Since I've started working in the field, I have been absolutely amazed by the number of new EMTs who get throguh EMT school with out actually being able to take an accurate BP and falsify their BP readings.

120/palp, times 3 on a record sheet. always a crowd pleaser

 

[WuLabsWuTecH]

I'm surprised no one has mentioned significant figures!!!

I have always been taught to estimate to one more place than is difinitively marked. Learned it in high school chemistry, and have used it ever since in any science setting where measurements are required. I have and will continue to use odd numbers when taking a bp reading. If the number falls in such a range that an odd number is required when using 3 significant figures (2 sigfigs for under 100 torr) then I will report that odd number.