Why do we trust Auto-NIBP?

So our expensive well tested equipment gets rough treatment, rode hard and put away wet. What a shock! We don't trust our LP12s etc. to take a b/p but the same machine is trusted to take an accurate ECG which we use to drive our tx of STEMIs etc. Hmmmmm! Do I detect a double std?
 
exodus said:
Why do we actually trust Auto-NIBP? It's perfect for us as long as the BP comes up as somewhat normal. But as soon as it goes out of a range we deem as normal, then I see people bust out the manual NIBP..

So why is that we only consider the "normal" pressures accurate" but very often treat the "abnormal" pressures as inaccurate and then manually check those? If we need to recheck the abnormal pressures, why do we not recheck the normal ones?

I've been *****ed at before for taking a manual BP on a pt before putting them on a zoll. But that's the only way to verify the BP on the monitor...
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Sorry haven't read the whole thread. here's my gutshot response before i read everyone else's.

If you haven't learned anything in class yet, your instructors should have told you to take the first two sets manually. Then you know whether to trust your ANIBP
 
Because we are lazy and it gives us more time to sit and ignore the patient, duh!
 
spoken to in harsh voices.
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My stuff works better if you talk a little dirty to it.
 
Outbac1 said:
So our expensive well tested equipment gets rough treatment, rode hard and put away wet. What a shock! We don't trust our LP12s etc. to take a b/p but the same machine is trusted to take an accurate ECG which we use to drive our tx of STEMIs etc. Hmmmmm! Do I detect a double std?
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The monitor doesn't detect a stemi, the medic interpreting it does...
 
We don't have the option, yet. Hopefully when we upgrade our monitors we will have that feature.
 
Like what usalsfyre said, my clinical impression determines how well I trust a BP from the automated cuff. The exact numbers are unimportant, what matters is how well it correlates with my clinical impression/exam of the patient.

If I get some number that doesn't correlate I do a manual check.
 
The ART of EMS, an ongoing series

Sasha said:
Because we are lazy and it gives us more time to sit and ignore the patient, duh!
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Bingo! Sasha

The evolution of Emergency Medical CARE and Transportation of the Sick and Injured into Emergency Medical SERVICES has relegated human beings into objects into which machines are plugged. Sure, it looks really cool and clean to just plug in this and then that and then respond to the monitor or whatever, but as Sasha observes, the patient gets ignored.

Arguments for or against the stability or accuracy of the tools should come secondary to the presence that you have with your patients. For the unconscious, even though it's good to be somewhat aware that there's still a human being there, ACTION is the word and any tool is a good tool if used properly.

But while the patient is still conscious, I say half your function is about working with who he or she IS to help them mobilize their own healing abilities.

Didn't think that was in the job description did ya?

But please consider this: The tools you chose to use AND the ways you choose to use them are in large part vehicles that convey to the patient that there is hope and they are secure in your hands. Do not minimize the power of this in healing.

Yes, healing! That is what you signed up for; to be a part -- often the first, most crucial part -- of that process.

A patient in crisis often spends the most important 20 minutes of the rest of his or her life with you in the back of that ambulance. If you don't integrate that understanding into EVERYTHING you do, you may be depriving a lot of people of a lot of healing!

How you use tools is equally important as using them.
 
exodus said:
The monitor doesn't detect a stemi, the medic interpreting it does...
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But the monitor has to correctly read and print the electrical currents in the body so we can read it. We also "Interpret" the b/p numbers the machine gives us. It is ultimately up to us to interpret all the info we gather, both from machines and the MK1 eyeball. Feed it to the human computer and come up with a solution.
 
Firetender,
Auto-BP does precisely the opposite for me, I can now hold a hand, continue a conversation, ect while only having to glance at the monitor every few minutes instead of interupt to take a pressure.

Furthermore, if I run into a patient who it's more therapeutic for me NOT to communicate with I am free to ignore them at will :D.
 
usalsfyre said:
Firetender,
Auto-BP does precisely the opposite for me, I can now hold a hand, continue a conversation, ect while only having to glance at the monitor every few minutes instead of interupt to take a pressure.

Furthermore, if I run into a patient who it's more therapeutic for me NOT to communicate with I am free to ignore them at will :D.
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It is that very consciousness that I was talking about; so thank you! Tools are always interchangeable; the ways you use them is what counts.
 
Outbac1 said:
So our expensive well tested equipment gets rough treatment, rode hard and put away wet. What a shock! We don't trust our LP12s etc. to take a b/p but the same machine is trusted to take an accurate ECG which we use to drive our tx of STEMIs etc. Hmmmmm! Do I detect a double std?
Click to expand...

Do you have a manual alternative for getting a 12 lead? If not, then we have to trust what's available. There is a better alternative to auto BPs, manual BPs. Preferably from someone you trust not to be an idiot.
 
Im in the group that trusts NiBp. Verify as necessary but overall I have found them to be very accurate.
 
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I try to take a manual blood pressure first, after that I use the NIBP unless it's a code green. If I think it's wrong, I'll double check it. But I can't help but think this is more of a pride/old dog debate than anything else.

How about this, anybody got some studies that describe the clinical accuracy of NIBPs?
 
I am sure there are studies by companies that manufacture them, I can not imagine any have been done on actual in the field units.
 
I personally believe anyone who doesn't take a manual BP first is just lazy, honestly. It takes a minute, and it gives you something to compare to the NIBP. Yeah, you trust it but it only takes one time for it to be incredibly off in an emergency to possibly harm your patients and bite you in the bum.
 
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