Taking Vitals in the Rig--Training

I hope my instructor has us taking blood pressure in the ambulance. So far, we're not at that stage yet, but I'm addicted to reading everyone's comments and stories about life on the street...
 
I think instead of jumping to defend your auto BP, you could for a minute just listen to what is being said. Other threads have discussed this at length and the consensus is that they do have a place. Monitoring a BP that has already been established through manual detection on a stable pt is a perfectly acceptable use of the auto/BP.

I use a lot of technology in the back of the rig. But my SPO2 monitor is always used in conjunction with my observation of the pt. When the SPO2 gives me a HR of 110 and my palp of the pressure is 82, I'm going to go with what my fingers told me, since I know my SPO2 tends to run fast in the HR. Machines are great, but we have to know their shortcomings as well as their expertise.

About the double earred scopes.... awesome.. a bit pricey though.. but nothing beats them in teaching newbies.
 
Pratice Pratice Pratice....... Always!

What I have done in the past with students and learning how to listen for vital signs.

As a student you will be able to pratice with your other classmates in the classroom, but what else is needed is to be able to do vital signs in areas with noises. first get a group of you together and just be on the side walk with street noise. This is a way to start getting your ears and eyes tuned up for the real world. Second, pratice in a moving car getting vital signs, ( a few of you together, and not the driver lol!) this can be done on your off time and also helps with getting more hands on pratice.

Any willing friends and family members that offer take them up on it!! The more body types to work with the better.

And always remember to use the proper size BP cuff and proper placement of the bp cuff. "you must use the right size equipment for the right job!! Good luck, I hope this helps! :):):)
 
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Airwaygoddess said:
And always remember to use the proper size BP cuff and proper placement of the bp cuff. "you must use the right size equipment for the right job!! Good luck, I hope this helps! :):):)
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That is the biggest thing to learn. Whether you are obtaining a manual or NIBP, you must make sure you have the right cuff for the Pt. A wrong size cuff will give false readings. This is most true when using a NIBP machine.
 
BossyCow said:
I think instead of jumping to defend your auto BP, you could for a minute just listen to what is being said...but we have to know their shortcomings as well as their expertise.
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I have listened to what is being said and no offense to anyone, I simply don't agree with the "consensus" so far You are assuming that I don't know about the pros and cons. I am aware of the shortcomings of autocufffs however, I am aware of the shortcomings of manuals which noone wishes to discuss. The consensus so far that I have heard on this thread is that all autocuffs are inaccurate and that manuals are the only way to go. This is simply not the case. I say take advantage of both. Some technology (autocuffs or otherwise) is constantly improving: (SunTech Medical OEM NIBP Technology For EMS Patient Transport Excels Against Recognized Standard Link) I say embrace it.

I am not saying rely ONLY on tech...but why not use both? :)


BossyCow said:
About the double earred scopes.... awesome.. a bit pricey though.. but nothing beats them in teaching newbies.
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Agree :) :) Most EMT classes should have them already and many of the instructors are generally always willing to help...submitter may be able to borrow one from his/her old instructor ? and use it on his ride alongs in the field. If he/she is past this stage (ride alongs) already then perhaps he can ask his supervisor for some more ride along time so that there are 3 people in the ambulance. I'm assuming however that submitters agency only has 2 per :)
 
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I wish we could've practiced this way when I took my class. It's harder than people think to take vitals in the back of the rig.Another thing I've found that helps with taking a bp is to keep your feet off of the floor, I usually put mine up on the bottom part of the stretcher. That helps get rid of some of the noise of the moving ambulance.
 
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skyemt said:
hi all...

i'm putting together a training for our emt-b's, involving taking groups of four out at a time in the rigs to practice taking vitals...

has anyone had experience doing drills involving taking vitals?

any suggestions on how to make the best use of the time would be appreciated.

thanks.
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if your an emt and need practice taking vitals you shouldnt be an EMT...
 
Mercy4Angels said:
if your an emt and need practice taking vitals you shouldnt be an EMT...
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Not everybody that touches a stethoscope are magically infused with the ultimate power of 100% accuracy in taking vitals.

Some needs practice to learn to hear past artifact, some must be taught that a "lub-dub" is counted as one beat when feeling a pulse. Continuing education is part of EMS.

Otherwise every Main EMS forum here should be locked with a sticky that basically says "If your in EMS and need any information or further education you shouldn't be in EMS"
 
Great Idea. I agree that repete skills are critical to newcommers into the busniess. I would add another senerio into the mix, ie: taking vitals on a critical pt and have the pt have a onset of another problem. Kudos to you for doing what should be done
 
Mercy4Angels said:
if your an emt and need practice taking vitals you shouldnt be an EMT...
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I agree with you very little, mabee the EMT-b's have a very low call volume and cannot pratice all the time. Or the pts that they do run have bounding pulses, normal bps. they need practice with thready pulses and no palp bp. the way i set up stuff for my cc medics is practice pratice and more pratice
 
NRCCEMTP26 said:
I agree with you very little, mabee the EMT-b's have a very low call volume and cannot pratice all the time. Or the pts that they do run have bounding pulses, normal bps. they need practice with thready pulses and no palp bp. the way i set up stuff for my cc medics is practice pratice and more pratice
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I have been doing ok taking vitals during my clinicals. There was one rather large woman that I couldn't get her pulse, but the medic could. I guess I needed to place my stethoscope harder against the artery. Anyhow I did successfully take a pulse on 2 out of 4 patients. Its harder in the back of the rig bouncing around. Also the medic recommended taking them before you get underway, unless they are in bad shape. I am going to get me a stethoscope with squishy ear pieces to help drown out the background noise, now I have the ones with the hard ear pieces.
 
something i was told and works well is lift your feet off the bus floor. put your toes on cot rail. works well for obtaining manual blood pressure
 
The OP referred to skill training involving vital signs inside a unit. Absent a few diversions regarding auto/manual devices and an interesting idea involving thick socks, how about the idea of training your folks on using sites other than the left arm? If your -I or -P partner is trying to get a line in the left A/C, can you work around them to get a B/P on the right side? Could you restrict them to the C/C area and make them work "upside down"? How about the fact that you can successfully get a B/P on the foot? If it's in the scope of their practice (assuming these are new folks), have they ever spiked a bag while moving, without being told ahead of time that their partner was going to need one? Are they allowed to do BGL's? Do they know that it's less painful for the patient to use the side of the finger rather than the fingertip, and how to do one in the back without polkadotting the floor with those pretty red drops? These are all things that I've seen new people fumble with from time to time, and I hope that they spawn some further ideas for you.
 
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