mycrofft
Still crazy but elsewhere
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O2 stat!
Right past the "Lare-Nix"
Right past the "Lare-Nix"
For the love of God...
- Thread starter Veneficus
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Commonsavage
Forum Crew Member
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...which is just past the fare-Nix!
In medic school, I finally snapped and stopped my instructor's lecture to correct her. I was teacher's pet...up until that moment.:unsure:
Pavehawk
Forum Lieutenant
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Well our lab guy loved to talk about the Compy-Tube, even while spelling it right!
Remeber343
Forum Lieutenant
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OMG the o2 stats are at 92% 15 LPM NRB NOW!!!!! THIS PERSON NEEDS O2!!!
jjesusfreak01
Forum Deputy Chief
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You get over that urge really quick when you work convalescence, primarily because the company would run out of NRBs in five minutes.
Remeber343
Forum Lieutenant
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I.... I was kidding... Nevermind....
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mycrofft
Still crazy but elsewhere
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Naw, naw...card laid is a card played.But if it's a convo, make sure the flow is 2 or lower to save oxygen costs. (And please return masks to the central supply closet)
mycrofft
Still crazy but elsewhere
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Over the oropharnicks
Pavehawk
Forum Lieutenant
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Wait, is the patient alert and or -ee-en-TAY-ted??
Remeber343
Forum Lieutenant
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The pressure is 110 over palp. Really? Over palp?
Have you never heard it said this way before?
Anjel
Forum Angel
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Ya I dont get it
Aidey
Community Leader Emeritus
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Over palp vs by palp. Technically it is by palpation.
Mountain Res-Q
Forum Deputy Chief
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NO, it is lazy and is a disservice to the patient. 110/P could mean 110/40 or 110/90; BIG DIF! The one reason why an EMT really needs a stethoscope and instead of using it to get a vital sign that is kind of a big deal they hang it around their neck? Not acceptable for any student I am testing or any person working for me.
The only time it is acceptable to take a BP by palpation is when you are in an environment which will not allow a BP by auscultation. This could be that it is simply too loud, or your stethoscope got shut in the door. (The latter incident could be reprimand-able)
It is totally acceptable to take a BP over Palp, especially from a first responders point of view. Scenes are often louder than the ambulance!
It is totally acceptable to take a BP over Palp, especially from a first responders point of view. Scenes are often louder than the ambulance!
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Loud environments can make it downright impossible to ascultate a BP...Palpated BP isn't preferred but sometimes you just have to work the the cards that are dealt to you.
Sure during transport you should have time to ascultate a pressure but again that doesn't always happen if you're working the whole way to the hospital.
Profoundly hypotensive patients can be difficult to ascultate as well and at that point just be thankful you can get something to go off of.
Also I've used it before when we were working on a critical trauma pt. We were both working and our NIBP was being finnicky so the manual cuff stayed on and I palpated a few pressures. It can be done a pretty rapidly in a pinch, especially if the cuff has just been left in place.
It's like the "assumed" BP by presence of a radial/femoral/carotid pulse. Not exact but in a pinch I'll take it.
If I got ripped by my clinical director for palpating a pressure I'd be a bit on the grumpy side seeing as it is a technique that is taught throughout healthcare although, as you pointed out, not the preferred method.
By no means was this an attack towards you, just pointing out some situations where palpated pressures happen.
edit: How is a stethoscope getting shut in a door a reprimandable event? Mistakes happen...
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Agree with you there!
Just the stethoscopes in the door may lead to reprimand if it means you arent equipped properly for patient care. I know some medical directors who would eat you out for that, which is why most services around me keep the personal stethoscope on the neck and another in a bag somewhere.
Of course the stethoscope is primarily diagnostic, and not as important at my level as say an ALS provider. For instance, what if a medic lost their stethoscope and didnt notice rales indicating pulmonary edema, but still infused 1000 ml NS? Entirely hypothetical of course
Just the stethoscopes in the door may lead to reprimand if it means you arent equipped properly for patient care. I know some medical directors who would eat you out for that, which is why most services around me keep the personal stethoscope on the neck and another in a bag somewhere.
Of course the stethoscope is primarily diagnostic, and not as important at my level as say an ALS provider. For instance, what if a medic lost their stethoscope and didnt notice rales indicating pulmonary edema, but still infused 1000 ml NS? Entirely hypothetical of course
Mountain Res-Q
Forum Deputy Chief
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11 Years of Ambulance, First Response, and SAR, and I can say that I have only been forced to take a BP by palpation a handful of times (inside the helo, windstorm, etc.). What irritates me is when palpation is the habit and not the exception used only when you have no other choice. "Acceptable" only under certain circumstances; not the equivalent!
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Agreed on that.
Like I said, I wasn't attacking just pointing out that every now and again it's a necessary skill.