BP Question

[Linuss]

Except pulse pressure doesn't only have to do with the hearts condition and the blood vessels. You can have a widening pulse pressure because of Cushings Triad with ICP.

[trevor1189]

Originally Posted by Linuss

Except pulse pressure doesn't only have to do with the hearts condition and the blood vessels. You can have a widening pulse pressure because of Cushings Triad with ICP.

Yet another thing that was not covered in my class, but I had to learn on my own.

(irregular resps, widened pulse pressure, bradycardia = Cushing's triad = possible ^ ICP)

^ ICP may have you thinking brain hemorrhage (possibly from trauma), stroke and many other things.

[EMT.Hart]

Interesting. Thanks for your input!

[juxtin1987]

The other important thing to remember (especially for testing purposes) is Hypertension or Hypotension (as well as tachycardia, bradycardia, tachypnea, bradypnea etc.) are meaningless terms if the patient isn't symptomatic. By definition the average adult BP is NOW 130/90 up from the previous 120/80 (due to a rising obese population in the US) Again, based off the national average of BP Hypertension begins at a systolic of 140 and Hypotension at a systolic of 110. But as i stated above hypotension and hypertension don't mean anything to a patient who's asymptomatic, it's simply their baseline BP.

Hope That Helps

[Linuss]

Not so true, juxtin.

Most VS can be put in 2 categories: relative(asymptomatic) and absolute(symptomatic). Absolute = absolutely not right, hence symptomatic.

I'm relatively bradycardic. I have a heart rate of 52. That's brady no matter how you spin it. But it's not absolutely bradycardic, meaning it's asymptomatic. I have no negative effects at 52bpm as my BP is 120/80, my norm.

[juxtin1987]

Linuss,

I agree with you 110%, but for NREMT-B purposes, you're bradycardic below 60 Tachycardic above 100 etc. Let him pass registry before he learns how to treat patients.

[CountryEMT-bGurl]

I am pretty sure it is Age + 100 for males up to age of 50, then Age + 80 for females up to age 50. And this is there systolic number. The normal disystolic for both males and females for the normal range are the same for this formula. Can't remeber what range they gave for it though...hmmm.

[EMSLaw]

Originally Posted by Linuss

Not so true, juxtin.

Most VS can be put in 2 categories: relative(asymptomatic) and absolute(symptomatic). Absolute = absolutely not right, hence symptomatic.

I'm relatively bradycardic. I have a heart rate of 52. That's brady no matter how you spin it. But it's not absolutely bradycardic, meaning it's asymptomatic. I have no negative effects at 52bpm as my BP is 120/80, my norm.

Even if we've already taken the patient history, if I get an abnormal reading from a patient (well, abnormal in my eyes), then I will... ask the patient!

BP is high, "Sir, do you have high blood pressure normally?" If their pulse is 52, but they've mentioned how well they did in the last NYC marathon, I'll probably be less concerned than if it was someone like me who hasn't run a mile recently.

[RESQ_5_1]

Normal is relative to the pt. I have had Pts with Diastoilic pressures hovering just above 90 and Asymptomatic. However, I keep a close eye on that BP and my pt for any changes.

And, just for the record, I am 5'6" and 195 lbs. I smoke just under a pack a day and live for the next bacon fix. And, before any non-smoker's automatically triple that number, trust me on the accuracy. I'm not in any denial. I have been a smoker for 20+ years. My average BP is around 136/80. And, my average resting pulse is around 72 S/R.

When I was 24, I had my wisdom teeth removed under IV sedation. When I was in recovery, I was awakened by an alrm on the vitals machine. It seems my HR dropped to 42. The nurse that came over to silence the alarm never even stopped the conversation she was having with the other nurse and didn't even look at me. But, since the alarm woke me up, and I was concious enough to see that my HR was 42, I guess it wasn't a problem.

Normal for textbook is whatever is in your textbook. IE; 120/80. Normal for your pt is whatever is normal for your pt. Take at least 3 sets of vitals if possible, and get as accurate a history as possible.

[Melclin]

Originally Posted by EMT.Hart

Pulse Pressure... Never heard of it. Care to elaborate?

Learn to google man

On the topic of triads and pulse pressures, beck's triad (depending on how you phrase it I suppose) involves a lowered pulse pressure (and generally lowered arterial pressure), muffled heart sounds and Jugular Venous Distension = Cardiac tamponade.