Old school

[VentMedic]

Well, I'm sorry I ever got into this discussion. If you never did anything similarly silly early on in your career, then you're a better man than I am.

I don't recall whether the numbers were upside down like 60/80. I just remember once or twice reading the numbers off the machine only to immediately realize that they couldn't possibly be true. And that is how I learned not to trust the machine.

The lessons learned from our mistakes. It only took me one time to forget to switch the nasal cannula from the ambulance tank to the portable when unloading a sweet 85 y/o grandmotherly patient. That was probably the worst cussin' out I have still to this day taken from a patient and it was well deserved.

 

[MSDeltaFlt]

The lessons learned from our mistakes. It only took me one time to forget to switch the nasal cannula from the ambulance tank to the portable when unloading a sweet 85 y/o grandmotherly patient. That was probably the worst cussin' out I have still to this day taken from a patient and it was well deserved.

I always forget to do that.

 

[Ridryder911]

What I have found when I seen people read numbers incorrectly is that they are reading the MEAN pressure as a systolic instead of the systolic number. Many do not see that it is a MEAN number, and as well do not understand what that means.

R/r 911

 

[Rattletrap]

I prefer manual vitals for the reason that Rid pointed out. There is information that can be gathered about the patient by looking and listening that a machine can't tell you. You hear the pulse with manual bp cuff and you feel the pulse with your fingers.

 

[Pittsburgh Proud]

I prefer manual vitals for the reason that Rid pointed out. There is information that can be gathered about the patient by looking and listening that a machine can't tell you. You hear the pulse with manual bp cuff and you feel the pulse with your fingers.

I felt the same way myself just watching some folks that in my opinion are just to lazy to do mauls checks. I'm sure in time they will learn as well.

 

[EMTIA2-7747]

I was about to chime in with my belief that taking a manual set of vital signs is a best-practice, when the thought occurred to me: "I can't back that belief with a factual argument." So if you don't mind too much, let me play a bit of devil's-advocate here:

1) My local hospital e/r always goes to the machines.

2) Ditto the trauma center in the next city over.

3) If the machines are good enough for the trauma center and the local e/r, who am I to go around believing that they aren't good enough for me?

All that said, my preference is to grab a manual set of vitals, if only to keep in good practice for when the machines aren't around, or for when the batteries die (like they did on me yesterday).

OK, so hospitals use them just about religiously....but they do so in a controlled environment, not in a moving vehicle. If the roads in your area are anything lile ours, you are lucky to have your electronic monitor work at all. many things affect the workings of an electronic BP monitor. bumps and vibrations can register as heartbeats. arm movement can change readings.
You should always begin with a manual set of vitals. then, if you opt to use the electronic monitor (it is handy), you have a fairly accurate baseline to compare to. if the numbers are way of, then you'll need to continue with manual BPs.

 

[firetender]

Since I couldn't figure out how to link to the post, here's my post regarding my first ambulance call. It set the scene for anything I did after that when I had to make a choice between using a machine or me.

New York. Flushing Community Volunteer Ambulance Corps. 1973. Converted hearses. Load and Go! EMT not required yet. Things were on the verge of humongous change!

Rookie as rookie could be. Just got through Basic First Aid. Showed up at quarters to hang out. One medic present. Emergency transfer call comes in. Hospital in Flushing to Columbia Pres, in Manhattan. The other guy scheduled didn’t show. Not yet trained in driving. Guess I was the patient guy!

Loaded an 80 y.o. man into the rig. Was told the transfer was to Intensive Care, Code Three. My seasoned partner helped me take BP and pulse, both WNL, though the man seemed barely conscious. Before he left, my partner took the man’s hand and clamped a clothes-pin-like device over his pointer finger. A green light on the end of it blinked on and off.

My partner, beaming with pride said, “We’re getting to test out these new devices. They’re pulse-monitors. It’s lots easier than feeling for it while we’re moving.”

Now this was rush hour. Bumper to bumper on the Long Island Expressway. New Yorkers, at that time, could give f***-all about an ambulance with lights and sirens blaring behind them. As my partner stopped and started, twisted and turned the ambulance wherever he could to make headway into the City, me and my patient were jostled around mightily. It was so bad that I had all I could do to watch the damn blinking green light!

We’re talking 68 minutes to go 15 miles. On a Highway! By the time we landed at the hospital, I had the feeling the patient wasn’t doing very well, but that light kept blinking. The Doctor was actually there to meet us. My partner opened the door and took one look at the patient and said, “Doc, you better take a look!”

The doctor got in and as he put his hand under the patient’s nose to check for breathing I noticed the patient was a lot grayer than before. Wasn't moving much, either. There was no breath. I missed something, I thought.

The Doctor paused a couple seconds and then muttered under his breath, “Expected. He’s done. It’s too bad we didn’t get him here in time to get the pacemaker electrode re-embedded properly!”

I looked at the blinking green light responding heartily to the electrical impulses that were not getting to the man’s tissue at about the same time as I noticed a squarish bulge close to the man's left armpit over his chest and under his skin. It was there I got my first critical lesson in the difference between man and machine.