Lowest BP with patient asymptomatic?

[Kevinf]

Just a quick question to anyone reading... what is the lowest BP reading you've gotten in which the patient was in no apparent outward distress?

I had an older pt (late 70's) today that was 68/40 (normal BP ~130/80) laying down, and he said everything was perfectly normal, no complaints at all (negative to nausea, dizziness, lethargy, pain) and alert and oriented. That said, his extremity circulation was abysmal and he was somewhat tachycardic. He had a history of a GI bleed from one month prior and palpation of the abdomen was unremarkable (normal temp and firmness, no pain). Took him to the ED, I may hear if they found anything at some point in the future.

 

[Mariemt]

If he had no symptoms of anything, why was an ambulance called?

 

[rescue1]

My mom has a resting BP of 80-90/60. She's never had symptomatic hypotension, but I imagine that it would have to get pretty low before she started showing symptoms.

 

[CriticalCareIFT]

Just a quick question to anyone reading... what is the lowest BP reading you've gotten in which the patient was in no apparent outward distress?

I had an older pt (late 70's) today that was 68/40 (normal BP ~130/80) laying down, and he said everything was perfectly normal, no complaints at all (negative to nausea, dizziness, lethargy, pain) and alert and oriented. That said, his extremity circulation was abysmal and he was somewhat tachycardic. He had a history of a GI bleed from one month prior and palpation of the abdomen was unremarkable (normal temp and firmness, no pain). Took him to the ED, I may hear if they found anything at some point in the future.

Late 70s, Tachycardia along with hypotension with history of GI bleed, warrents a better assesment, staying he is assymtomatic is not accurate, numbers need to accoomany through assesment.

 

[VFlutter]

Sit him up and see if he is asymptomatic :unsure:

 

[EMT B]

My mom frequently does IronMan length races...she is baseline hypotensive/bradycardic. I'm a distance swimmer so I am as well, but I am not as low as her.

 

[DesertMedic66]

Sit him up and see if he is asymptomatic :unsure:

This. My guess is that you would be laying that patient down really quickly.

 

[STXmedic]

My mom frequently does IronMan length races...she is baseline hypotensive/bradycardic. I'm a distance swimmer so I am as well, but I am not as low as her.

My HR usually sits around 40, but my blood pressure never gets that low. I can understand 90s systolic being normal for some adult patients. Much lower than that and I start to really think pathology- unless they can show me some trending, consistently low and asymptotic BPs. Like Chase said, sit that patient up and he'll probably show you his symptoms.

 

[CriticalCareIFT]

This. My guess is that you would be laying that patient down really quickly.

He will lay himself by syncope.

 

[DesertMedic66]

He will lay himself by syncope.

I wouldn't consider it "laying down". More like a rapid transition from fowlers to supine

 

[Kevinf]

To answer some questions, we had the patient for a scheduled transport to a nephrologist from an ECF. The patient was bed confined, but was in a semi-fowlers position due to sacral wounds that were exacerbated by laying flat or sitting high-fowlers.

 

[abckidsmom]

I wouldn't consider it "laying down". More like a rapid transition from fowlers to supine

Random acts of gravity.

 

[Brandon O]

I have had numerous unconscious patients who expressed no symptoms to me despite their hypotension.

 

[Kevinf]

So I've gotten one actual reply to the question asked... I think I won't give background information next time. :lol:

I asked one of the medics in our company the same question and the lowest he's seen that was asymptomatic was about the same, high 60's over 40.

If he had no symptoms of anything, why was an ambulance called?

We had him for a scheduled transport to his nephrologist. He couldn't go by wheelchair due to bed confinement status and location of decubitus ulcers among other issues.

Late 70s, Tachycardia along with hypotension with history of GI bleed, warrents a better assesment, staying he is assymtomatic is not accurate, numbers need to accoomany through assesment.

He was assessed by a physician and transport to the ED was literally across the street (about ~1 minute transport time), not much time for trending there. We all agreed that his vitals warranted an examination at the ED, but there were no outward signs apparent that his blood pressure was in the tank. Granted it may have been different were he standing or in a high-fowlers position, but that wasn't going to happen due his bed confinement and decubitus ulcers.

 

[mycrofft]

Had a friend , not hypothyroid, who had a regular temp around 97.9, pulse regular at about 50plus, ate two meals a day, and was fine. Went on to become a mother and successful professional. Said he BP was always "low", no idea what it was as I was not yet trained and equipped.

 

[Kevinf]

Some of the smaller women in our company run around ~90 systolic as baseline, so that's probably around what she meant. Not sure if your friend was on the tiny side or not

 

[Hunter]

I know someone that runs an average if 80/40ish blood pressures are very patient specific, I hate using the phrase but; treat your patient, not your monitor.

 

[Uclabruin103]

Had a pt during internship that had a by of 60/40. She was walking, talking, and adamant about not going to the hospital. Spent over an hour trying to get her to let us treat and transport.

 

[johnrsemt]

I normally run 80/50 to 90/50: I went into the Blood Center one day to donated, and after 4 people took it with 3 machines, and 5 manual cuffs they finally told me my pressure was 72/26. Asked all the questions you could think of; Then EMS showed up (blood center called them). They asked even more.

I felt fine, was tired, the end of a 30 hour shift, but didn't feel any tireder (more tired) than I should, not dizzy, HR was 72. Didn't go to the hospital