Checking ALS equipment on a BLS truck

[medicdan]

Why do people hate NIBP so much? How often do you see someone taking a manual BP in the hospital?

I can count on one hand in a touch over two years how many times I've seen it happen, that's including during paramedic clinicals. Just like any tool, calibrated, maintained, applied and used properly they're just fine.

The first pressure any patient gets in the trauma rooms (major trauma or medical) around here is a manual pressure. From there NIBPs are trended. I content that the hospital equipment is more calibrated, accurate and consistent than my monitor. Manual BP is the gold standard, and I use NIBP as a trending tool from that baseline.

This thread boils down to responsibility and accountability.

 

[EMT B]

Why do people hate NIBP so much?

Its not that I hate it, I guess I just have a bias because I like it much better than using the LP. When I am on the beach, I don't keep an LP on the ATV; it is not necessary. I do all my vitals by hand, except for SPO2. I have a little finger dohickey for that.

 

[usalsfyre]

Why do people hate NIBP so much? How often do you see someone taking a manual BP in the hospital?

I can count on one hand in a touch over two years how many times I've seen it happen, that's including during paramedic clinicals. Just like any tool, calibrated, maintained, applied and used properly they're just fine.

Usually because the NIBP has made them look foolish at some point. But that goes back to clinical correlation. In my anecdotal experience ascultated pressures with crap scopes (the kind NIBP haters usually seem to have) are more inaccurate than NIBP.

 

[NomadicMedic]

I think common sense is a good thing. If your patient looks like they're going to have an abnormal BP, yet the NIBP is dead normal... Or vice versa, get a manual.

Or, if your normal trending NIBP is suddenly wonky, a manual BO may be indicated.

In most cases, the NIBP works just fine.

But, let's get back on topic. This is about BLS providers checking ALS gear. (And I still feel it's the medics responsibility to check his own stuff..)

 

[unleashedfury]

Its a paramedics responsibility to check his/her own gear.

I worked for a 911/IFT company that had their trucks setup as a BLS/ALS

all they did was add an extra cabinet that was locked. If you were on that truck as a paramedic you got the keys to unlock the cabinet along with a assigned set of narcotics to go into your locked cabinet where the LP and ALS gear was placed.

If it was a BLS truck that day the cabinet was locked and stayed locked. Narcs were removed at the end of the shift by the paramedic coming off duty signed into the lockbox placed in the supervisors office.

 

[Mariemt]

Why do people hate NIBP so much? How often do you see someone taking a manual BP in the hospital?

I can count on one hand in a touch over two years how many times I've seen it happen, that's including during paramedic clinicals. Just like any tool, calibrated, maintained, applied and used properly they're just fine.

I have seen them wrong. I have taken a manual bp , then used the machine and have gotten a very different reading due to bumps and jolts of the ambulance. We have a well maintained and calibrated machine.

When we get one that is completely off, I will go to palpation of a bp unless it is a pt I am worried about the blood pressure, then I will try to aulsutate it if I can hear it in a moving ambulance. If I can't, I may ask the driver to stop a second