Need Help Doing Trip Sheet

[Veneficus]

Originally Posted by Screwby

If you palpate the BP you find pulse in radial or femoral artery it's at least an 80 systolic, Brachial is at least a 70 systolic, and a carotid is at least a 60 systolic. So you take a radial pulse then you know the patient is at least 80/palp and so on. This is the way I was taught to at least have a base line on hard to get vitals on an emergent patient in the field. Am I not remembering this correctly? And I always note in narrative what the situation was...

Just so you know, this was an EMS myth that was busted years ago by numerous sources as I recall.

I would never use it, encourage others not to use it, and certainly would not make or support a clinical decision based from it.

I know for billing, 2 sets of vitals signs are required. I also know that employers really get mad when they cannot easily bill. But it is the nature of psych. The call will probably be audited and payment may or may not be made.

But it is the responsibility of the organization to work out billing for transporting psych patients in advance.

From a 911 standpoint, it is probably a loss. Hopefully your organization doesn't actually depend on 911 billing alone. If it does, they should expect a certain level of nonpayment.

[Screwby]

I wasn't saying to lie...perhaps I misunderstood the way I was taught? My cert isn't worth faking vitals, I'm saying that worst case scenario you at least had a radial pulse, so BP was at least 80 systol and in narrative and at hospital I explain EXACTLY what and how I arrived at that vital. Maybe I need to dig out my old book because your saying that this method in a worst case scenario is not accurate in the least? Or is it once a great while that this method is way off?
No arguing from me here, I'm a newby open to any criticism! Which is why I joined the forum!

Originally Posted by Medic Tim

It is a bad idea to chart something you did when you never did it. PCRs are legal documents. . I have had pts with a bp less than 80 sys have a radial pulse and pts with a high bp and no or faint radial pulse.

[Medic Tim]

Originally Posted by Screwby

I wasn't saying to lie...perhaps I misunderstood the way I was taught? My cert isn't worth faking vitals, I'm saying that worst case scenario you at least had a radial pulse, so BP was at least 80 systol and in narrative and at hospital I explain EXACTLY what and how I arrived at that vital. Maybe I need to dig out my old book because your saying that this method in a worst case scenario is not accurate in the least? Or is it once a great while that this method is way off?
No arguing from me here, I'm a newby open to any criticism! Which is why I joined the forum!

I understand where you are coming from. I was taught the same thing back when I did my EMT. When I did Medic school I was told not to put any faith in it. In cases when you dont get a bp chart you didn't get one and why. I will reiterate that it is a bad idea to chat a bp if you didn't take one. I may be wrong but I believe the radial pulse = 90sys came from a trauma study in healthy pts(besides the trauma)

[PoeticInjustice]

Originally Posted by Screwby

I wasn't saying to lie...perhaps I misunderstood the way I was taught? My cert isn't worth faking vitals, I'm saying that worst case scenario you at least had a radial pulse, so BP was at least 80 systol and in narrative and at hospital I explain EXACTLY what and how I arrived at that vital. Maybe I need to dig out my old book because your saying that this method in a worst case scenario is not accurate in the least? Or is it once a great while that this method is way off?
No arguing from me here, I'm a newby open to any criticism! Which is why I joined the forum!

That method has been proven inaccurate. I sat in on a lecture given by an Army trauma surgeon recently who tore this myth apart, citing numerous sources. The radial pulse being at least 80sys is bogus. We were shown a scatter chart with radials palpated with BPs as low as the mid 50s systolic (obtained by art line).

[Screwby]

Thanks for the feedback! Just more knowledge to chart away in my ever expanding and still frighteningly empty EMS brain

[usalsfyre]

From a management standpoint there's also an issue of a non-biomedical certified device (personal pulse-ox) being used for patient care.