Question about Blood Pressure

[Frozin]

Hello all, I'm new and currently loooking for a job in the field anyways.

My father has a heart issue. The doctor has diagnosed it and asked that he have his blood pressure taken twice a day.

I was taking it and got 130/110 then silence until the needle it 80 and it gave me one last beat. I'm a bit confused as to which diastolic to use.

 

[LucidResq]

Are you sure that you didn't accidentally strike the bell of the stethoscope with something? It's easy to accidentally let your hand with the bulb hit it or hit the tubing and you might hear a little tap.

 

[medichopeful]

Hello all, I'm new and currently loooking for a job in the field anyways.

My father has a heart issue. The doctor has diagnosed it and asked that he have his blood pressure taken twice a day.

I was taking it and got 130/110 then silence until the needle it 80 and it gave me one last beat. I'm a bit confused as to which diastolic to use.

Go with the second one you got (80). Occasionally, it will fade out and then re-appear.

I would also suggest you take it again. You could have accidentally moved the bell or the cuff, which could have caused the sound.

 

[Frozin]

Thanks for the quick responses!!!

I took it 3 times and all were the same and I was making sure I didn't hit the stethoscope.

I"ll go with the last beat then. Thanks again all, any other info on this subject would be great as well

My father was diagnosed with premature ventricular contractions. While taking his pulse it beats (at worst times) two beats then skips, within a minute at its worst it skips 27 times.

 

[mgr22]

Thanks for the quick responses!!!

I took it 3 times and all were the same and I was making sure I didn't hit the stethoscope.

I"ll go with the last beat then. Thanks again all, any other info on this subject would be great as well

My father was diagnosed with premature ventricular contractions. While taking his pulse it beats (at worst times) two beats then skips, within a minute at its worst it skips 27 times.

Try letting the air out of the cuff more slowly so you don't miss that last, irregular beat.

 

[medicdan]

It's also possible your father has an irregular heart beat, perhaps from atrial fibrillation, letting the air out of the cuff slower may help you hear more...

 

[wolfwyndd]

MGR and EMTDan both said it. It's quite likely that an irregular heartbeat will cause the same thing. I'd go with 80 also.

 

[irish_handgrenade]

sometimes when you take a blood pressure it will fade in and out. always go with the first and last sounds you hear.

 

[Whittier]

sometimes when you take a blood pressure it will fade in and out. always go with the first and last sounds you hear.

That's good to know... if it was ever explained in my class I must have missed it.

 

[Frozin]

Thanks again everyone.

I dont know if I should make a new thread but I'll ask this anyways.

I did a ride along and the emt told me about Taking the blood pressure and while listening to the beats you can also get the pulse rate. Unfortunately for me this was 3 months ago and I was a super greenhorn with barely any experience taking BP, so I never practiced or tried the way he was talking about, I now am confident (excluding the incident above ) enough in BP taking that I'd like to incorporate this technique. If it is useful of course.

Do any of you use this technique? If so, can you explain to me how it is done. I'd like to practice this, unless of course it is not as accurate as actually doing the pulse rate the way it is taught.

The ride along was Transport only, so I don't know if this technique is viable for use in emergency settings.

Thanks

Greenhorn EMT-I

 

[irish_handgrenade]

it takes 15 to 30 seconds at the most to get a decent HR don't sacrifice quality, to save a few seconds. Once you get on the truck and get comfy there you will start to learn the little tricks that make things easier, but for now just work on taking quality vitals when you get the chance.

 

[Frozin]

Cool, thanks for the response. Just out of curiosity how is the technique done?

 

[irish_handgrenade]

I dont use the technique mentioned before I use the monitor while I palpate the pulse and make sure it matches. I also make note if it is regular or irregular.

 

[mycrofft]

You will learn to do lots of things at once.

BEyond that, even before you have a concrete answer to record, you will know that the pulse (it has other characteristics than just rate), respirations, skin color/temp etc, are wrong, right, or "??".
First, learn the science. The art will follow.

 

[irish_handgrenade]

^^ agreed, couldn't have said it better my self.

 

[Frozin]

I'm only recording what the doctor instructed to be recorded. Skin color and temp, and the strength of the pulse doesn't matter in this particular case. The doctor only needs the BP, Rate of pulse, and the amount of skips.

While I appreciate your response, the complete assessment is not needed.

 

[mycrofft]

Then, Frozin, you will remain a mere technician.

Naw, not really.

"Meet the standard then exceed it" and "Keep it simple". Experience will tell you what else the doc will want to know about. Protocols will keep you and the pt safe until the art begins to seep in. Done good now and as you grow, you will get the "big picture" ("gestalt", "holistic whole" or something like that).

NOT a criticism. Yet.


PS: look up "dicrotic pulse" and ask one of our ACLS gurus about it.

 

[irish_handgrenade]

you want to check other characteristics of the pulse because PVCs come in all shapes and sizes. Just because it feels like it "skips a beat" or what ever doesn't tell you much. If you decide to go further in your education you will understand this more.