Obtaining pulse. - EMTLife.com - The #1 Online Forum for EMS-Related Discussion

atlasD · 10-04-2009, 12:27 AM

This might be a silly question but they pop up soon after class...

When counting the pulse, why is it we count until 30 seconds then double instead of counting to 15 then quadruple. I understand if its to determine regularity, but if the pt is stable - Why not?

Is doubling typically protocol or is it just how it is taught in EMTB Brady?

7.5 = 11
15 = 20
30 = 42

Hell, if just playing stable frequent flyer medical taxi - why not 7.5(approx)?

Akulahawk · 10-04-2009, 12:38 AM

30 seconds will get you a fairly accurate number for pulse and breathing rate. If you note any irregularity, you can then extend another 30 for a full 1 min count. You can be "off" by quite a bit if you use a quicker count than that... The shortest amount of time I'll use (ever) is 15 seconds, but I usually go 30.

As far as doing 15 seconds or 30 seconds... doubling is easy math... Double it if you're doing 30 seconds, double again if you're counting for 15... Do note that if you're off by just one beat @ 15 seconds, your math will be "off" by 8 for an actual per/min pulse rate. At 30 seconds... that's just two beats/min.

Another way to look at it is:

If I'm counting for 15 seconds, all I really am looking for is fast/slow, regular/irregular. Nothing more definitive than that. If I'm counting for 30 seconds, I'm going for accuracy. At a first pulse check (couple seconds), all I'm looking for is presence of a pulse, and way too fast/way too slow.

VCEMT · 10-04-2009, 12:44 AM

Who is EMTB Brady?

Why not 20x3? Or 5x12? Maybe 1x60?

When you're working in the field, you'll learn real fast what needs to be done. If you spend your time finding a pulse or BP, you'll find yourself at the ER and nothing on your assessment.

Akulahawk · 10-04-2009, 12:46 AM

Quote:

Originally Posted by VCEMT

Who is EMTB Brady?

Why not 20x3? Or 5x12? Maybe 1x60?

When you're working in the field, you'll learn real fast what needs to be done. If you spend your time finding a pulse or BP, you'll find yourself at the ER and nothing on your assessment.

Field experience is a wonderful teacher for what needs to be done in the moment...

ngbacon · 10-04-2009, 01:53 AM

Quote:

Originally Posted by VCEMT

Who is EMTB Brady?

Why not 20x3? Or 5x12? Maybe 1x60?

When you're working in the field, you'll learn real fast what needs to be done. If you spend your time finding a pulse or BP, you'll find yourself at the ER and nothing on your assessment.

Are you suggesting that we don't need accurate counts of pulse, breaths and BP as long as they appear normal on first look?

dewd09 · 10-04-2009, 05:00 AM

On myself.. At rest, I have a fever, so it's going to be higher than normal.

10 x 6 - 102

15 x 4 - 102

20 x 3 - 102

30 x 2 - 104

60 x 1 - 106

---

On a patient, if they're with in a realm of what I consider stable, I count for 30 x 2 on the pulse; and one minute on respiration. On a patient that I consider unstable, I count both for one minute. It's not absolute, something x something will most always be a little higher or lower than a full minute.

VCEMT · 10-04-2009, 02:02 PM

Quote:

Originally Posted by ngbacon

Are you suggesting that we don't need accurate counts of pulse, breaths and BP as long as they appear normal on first look?

Negative Ghostrider, that is what you are suggesting. I am stating that, if you spend too much time on vitals, you're going to be at the ER with no info to give.

Second · 10-04-2009, 02:33 PM

I just count to 6 and put a 0 behind it, so if I count 8 beats in a six second time frame there's 80 beats per min.

or just stick a pulse ox on them and there ya go

dewd09 · 10-04-2009, 02:47 PM

Quote:

Originally Posted by Second

just stick a pulse ox on them

Fail.

Second · 10-04-2009, 03:11 PM

what, I said OR

10-04-2009, 12:38 AM	#2
Akulahawk Forum Deputy Chief Join Date: Aug 2009 Location: Unincorporated Sacramento County Posts: 2,230 Training: EMT-Paramedic	30 seconds will get you a fairly accurate number for pulse and breathing rate. If you note any irregularity, you can then extend another 30 for a full 1 min count. You can be "off" by quite a bit if you use a quicker count than that... The shortest amount of time I'll use (ever) is 15 seconds, but I usually go 30. As far as doing 15 seconds or 30 seconds... doubling is easy math... Double it if you're doing 30 seconds, double again if you're counting for 15... Do note that if you're off by just one beat @ 15 seconds, your math will be "off" by 8 for an actual per/min pulse rate. At 30 seconds... that's just two beats/min. Another way to look at it is: If I'm counting for 15 seconds, all I really am looking for is fast/slow, regular/irregular. Nothing more definitive than that. If I'm counting for 30 seconds, I'm going for accuracy. At a first pulse check (couple seconds), all I'm looking for is presence of a pulse, and way too fast/way too slow. Last edited by Akulahawk; 10-04-2009 at 12:45 AM.

10-04-2009, 05:00 AM	#6
dewd09 Forum Crew Member Join Date: Sep 2009 Posts: 57 Training: Mentally Unstable	On myself.. At rest, I have a fever, so it's going to be higher than normal. 10 x 6 - 102 15 x 4 - 102 20 x 3 - 102 30 x 2 - 104 60 x 1 - 106 --- On a patient, if they're with in a realm of what I consider stable, I count for 30 x 2 on the pulse; and one minute on respiration. On a patient that I consider unstable, I count both for one minute. It's not absolute, something x something will most always be a little higher or lower than a full minute. Last edited by dewd09; 10-04-2009 at 05:01 AM.

10-04-2009, 02:33 PM	#8
Second Forum Lieutenant Join Date: Oct 2008 Location: the corrner of a dark padded room Posts: 131 Training: NREMT-I	I just count to 6 and put a 0 behind it, so if I count 8 beats in a six second time frame there's 80 beats per min. or just stick a pulse ox on them and there ya go __________________ Have you ever danced with the devil by the pale moon light?

10-04-2009, 03:11 PM	#10
Second Forum Lieutenant Join Date: Oct 2008 Location: the corrner of a dark padded room Posts: 131 Training: NREMT-I	what, I said OR __________________ Have you ever danced with the devil by the pale moon light?

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10-04-2009, 12:27 AM	#1
atlasD Forum Probie Join Date: Sep 2009 Posts: 20	Obtaining pulse. This might be a silly question but they pop up soon after class... When counting the pulse, why is it we count until 30 seconds then double instead of counting to 15 then quadruple. I understand if its to determine regularity, but if the pt is stable - Why not? Is doubling typically protocol or is it just how it is taught in EMTB Brady? 7.5 = 11 15 = 20 30 = 42 Hell, if just playing stable frequent flyer medical taxi - why not 7.5(approx)?

10-04-2009, 12:44 AM	#3
VCEMT Forum Captain Join Date: Jun 2009 Location: Ventura County Posts: 277 Training: Paramedic	Who is EMTB Brady? Why not 20x3? Or 5x12? Maybe 1x60? When you're working in the field, you'll learn real fast what needs to be done. If you spend your time finding a pulse or BP, you'll find yourself at the ER and nothing on your assessment.

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