...barely. I am very new as an EMT. I went to a hospital to pick up a patient and I went to take his blood pressure, and as I put the cuff on his arm, a nurse said, "No, not on that arm! He has a dialysis shunt on that arm! You could have killed him!"
Needless to say I was horrified. There was nothing posted in the area, no tags on his arm, saying not to take a BP on that arm; what he had on that arm was a bandaid over a cotton ball. (As a matter of fact there WAS a tag on his arm saying no known drug allergies, even though his chart said penicillin allergy, but we'll just let that one go. I took the NKDA tag off his arm.)
Now, I'm going to be honest - I did not know that you can't take a BP on the arm where a patient has a dialysis shunt. It's not in my textbook, and no teacher ever told me that, and no-one at my job ever told me that.
As soon as I got home I did a bunch of research on the internet to find out what else I should avoid, but I want to make sure I didn't miss anything. I already know that if a patient had a mastectomy you don't take the BP reading on that side.
So - three questions:
1.) From now on I am going to ask the patient's nurse which arm I can take a BP on before I take a BP, and I will always ask if the patient has a dialysis shunt, AND check their chart, before I take a BP; is there anything else I can do to ensure this doesn't happen again?
2.) What other conditions would prevent me from taking a BP? (Other than the obvious - fractured arm, gushing blood from that arm, etc.) I have heard conflicting opinions on what to do if they have a pacemaker implanted.
3.) Any other advice for a new EMT on not making potentially lifethreatening mistakes?
Needless to say I was horrified. There was nothing posted in the area, no tags on his arm, saying not to take a BP on that arm; what he had on that arm was a bandaid over a cotton ball. (As a matter of fact there WAS a tag on his arm saying no known drug allergies, even though his chart said penicillin allergy, but we'll just let that one go. I took the NKDA tag off his arm.)
Now, I'm going to be honest - I did not know that you can't take a BP on the arm where a patient has a dialysis shunt. It's not in my textbook, and no teacher ever told me that, and no-one at my job ever told me that.
As soon as I got home I did a bunch of research on the internet to find out what else I should avoid, but I want to make sure I didn't miss anything. I already know that if a patient had a mastectomy you don't take the BP reading on that side.
So - three questions:
1.) From now on I am going to ask the patient's nurse which arm I can take a BP on before I take a BP, and I will always ask if the patient has a dialysis shunt, AND check their chart, before I take a BP; is there anything else I can do to ensure this doesn't happen again?
2.) What other conditions would prevent me from taking a BP? (Other than the obvious - fractured arm, gushing blood from that arm, etc.) I have heard conflicting opinions on what to do if they have a pacemaker implanted.
3.) Any other advice for a new EMT on not making potentially lifethreatening mistakes?