BP Cuffs?

hocomedic said:
When im on scene, like in someones house we generally dont take our lifpak 12 unless its a cardiac call. I get a manual bp first, then proced with the call then i get the NIBP in the ambulance once we get in and once when we reach the ER.
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Howard County's policy is the first is always manual.
 
Manual has its place to build and retain the skill of getting a pressure however if the patient is really sick or you have a lot of things to do then I will go with the NIBP.
 
We only take manuals, though our monitors have the funtionality of an automated one. I like to hear my BP if I'm basing a treatment off of it.
 
Running on a vollie BLS truck, We exclusively carry normal old-fashioned BP cuffs as we don't have a cardiac monitor with the built in NIBP cuff. However, when we rendezvous with ALS, I usually try to have at least one or two manual pressures before we rendezvous and attach the NIBP cuff.
 
JJR512 said:
Howard County's policy is the first is always manual.
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It is a County Policy that all BP's must be obtained manually for San Joaquin County as well. This includes ALS, BLS as well as any Inter-facility transfer.

Being on a Medic Unit for the past 5 years, I have seen countless mis-readings by the NIBP by +or- at least 10 points. + or - 10 points can make a huge difference in examing a Pt for orthostatics as well as other procedures. In the end, we try to stay away from the NIBP when examing Pt Vitals.

What's also sad is, I was a FTO (Field Training Officer) and I couldn't believe how many new hires could not conduct a Manual Blood Pressure. When I asked why, many stated, "Oh, we just used the Automatic One" in our EMT class. Makes me think what the heck kind of school did you go to???
 
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i have seen the nibp give a bp of 200/70 when the manual was 114/60 you be the judge
 
I instructed a preceptor to always get a manual B.P. and pulse first. It teaches them to feel for irregularities in the pulse, and they can also hear some abnormal rythyms through ausculating the B.P.
 
My dept has a NIBP and Manuals.

I like to get my first with a NIBP just so I can be doing other things when it is thinking and if I have time to do a manual I do so I can stay fresh with it.

NIBP is nice to have it cuts down on the time it takes to get initial vitals.

I have also come to learn that when the NIBP does not read the first time that the second time it tries and reads and gets a number it is usually wrong, in that case I just do manual.
 
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Unless it's a crazy scene I'll get the first one manually and then see what the monitor gives me. If it's close (+/- up to 5 points) I'll go with it for the call
 
I will take a manual on scene, then one or two during transport depending on ETA.
If I can't get a BP, then I'll use the NIBP.
 
For my initial B/P I ALWAYS take it manually, just more accurate than an electronic/automated. However, after I take my manual, I place the automated cuff on (from the heart monitor)...and keep a constant check on their B/P throughout transport.
 
izmedaemt said:
i have seen the nibp give a bp of 200/70 when the manual was 114/60 you be the judge
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something like this would be disputed with the first manual BP, and being so off the wall, would be verified with another manual.
 
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