Taking Blood Pressure

daughteroftheking

daughteroftheking

Forum Probie
Messages
13
Reaction score
0
Points
0
When taking blood pressure, my instructor said to listen for the first sound, but I see the needle fluttering before I hear the sound. I mentioned this to a medic at the station, and he said that if you go by the movement of the needle, you get a reading that is closest to the monitors at the hospital...What's the best and most accurate way to take the blood pressure? Should I listen for the sound, or look for the needle fluttering?
 
There's a reason we auscultate. Unless you have bad scope placement or crap ears going by the flutter will be inaccurate. If you can't hear or you want to double check wait a couple minutes and get a palpated pressure and you'll see.

Sent from my DROIDX using Tapatalk
 
If you want an accurate pressure, do it the proper way, auscultate it, don't rely on the "needle flutter".


Sent from my iPhone using Tapatalk
 
Last edited by a moderator:
That needle can flutter with simple muscle twitches, you base it off of when you first hear it.
 
View the cuff as a dam and the blood the water backing up behind it. You want to find out how much pressure is needed for the water to break through the dam. The water can leak through a small opening which can cause the twitches in the needle but we want to find out when it tears the dam down and all of the water flows through, which will be the first sound

Sent from my DROIDX using Tapatalk
 
adamjh3 said:
View the cuff as a dam and the blood the water backing up behind it. You want to find out how much pressure is needed for the water to break through the dam. The water can leak through a small opening which can cause the twitches in the needle but we want to find out when it tears the dam down and all of the water flows through, which will be the first sound

Sent from my DROIDX using Tapatalk
Click to expand...

This is an excellent explanation on why we auscultate and don't just read straight from gauge. When I was first starting I would use the needle flutter as the point where I listened extra hard as the sounds generally come soon after. Eventually though if you take enough of them those Korotkoff sounds will be so distinctive to your ears that they can be heard in most any environment.
 
Go with what you hear. That being said, you can use the needle bounce as a guide, but NOTHING MORE. For example, if you hear sounds but the needle isn't bouncing, reevaluate what's going on; it could be you're hearing something else as opposed to the Korotkoff sounds. On the other hand, if you see the needle start to bounce, start listening extra hard. Though this may not work perfectly every time, it usually gives you a good hint that the Phase I Korotkoff is coming!
 
Fish said:
That needle can flutter with simple muscle twitches, you base it off of when you first hear it.
Click to expand...
Last week I had a patient who was twitching a bit and it caused tremendous problems with the auto cuff used on the floor. In short, the machine never got a good BP. I had to take the reading manually... something not done very often there. That's a known limitation of auto units.
Tigger said:
This is an excellent explanation on why we auscultate and don't just read straight from gauge. When I was first starting I would use the needle flutter as the point where I listened extra hard as the sounds generally come soon after. Eventually though if you take enough of them those Korotkoff sounds will be so distinctive to your ears that they can be heard in most any environment.
Click to expand...
Very, very true. Those sounds are quite distinctive and once you know those sounds, they really do stand out from the background noise... unless they're so soft that any background noise obliterates it. I've rarely had that happen.
 
I can't add anything...

...Except that I don't like the phrase "Taking a Blood Pressure"

When I hear a medic tell a patient "I'm going to take your vitals." I cringe, because it sounds like the medic ia saying "I'm going to rip open your abdominal cavity and tear your liver out through the gaping wound." Or "I'm going to take your blood pressure."

When you tell someone you are going to "take" something, that means that they are no longer going to be in possession of that item. Therefore, it is not possible to "take a blood pressure".

My preference is to tell my client that "I am going to check your ...". IMHO it gives the client a more reassuring image of what I intend to do.
 
Last edited by a moderator:
Good replies. We often go back and forth from machine to manual readings based on where we pick up and drop off. The readings in the rig are all manual.

Didn't take me long to notice that my manual readings are almost always a bit lower than the machine readings. Happens pretty consistently.
 
ArcticKat said:
...Except that I don't like the phrase "Taking a Blood Pressure"

When I hear a medic tell a patient "I'm going to take your vitals." I cringe, because it sounds like the medic ia saying "I'm going to rip open your abdominal cavity and tear your liver out through the gaping wound." Or "I'm going to take your blood pressure."

When you tell someone you are going to "take" something, that means that they are no longer going to be in possession of that item. Therefore, it is not possible to "take a blood pressure".

My preference is to tell my client that "I am going to check your ...". IMHO it gives the client a more reassuring image of what I intend to do.
Click to expand...

A pet peeve of mine as well.
 
ArcticKat said:
...Except that I don't like the phrase "Taking a Blood Pressure"

When I hear a medic tell a patient "I'm going to take your vitals." I cringe, because it sounds like the medic ia saying "I'm going to rip open your abdominal cavity and tear your liver out through the gaping wound." Or "I'm going to take your blood pressure."

When you tell someone you are going to "take" something, that means that they are no longer going to be in possession of that item. Therefore, it is not possible to "take a blood pressure".

My preference is to tell my client that "I am going to check your ...". IMHO it gives the client a more reassuring image of what I intend to do.
Click to expand...

I say let me check, or I am going to get.......

But even if I said I am going to take, I would be fine with that to. Sounds a bit nit picky to be irritated over that.
 
Picking Nits is what I do best.

Professionalism comes in many guises. How we communicate with our patient is one of the most important.
 
ArcticKat said:
Professionalism comes in many guises. How we communicate with our patient is one of the most important.
Click to expand...

So when you go to the bathroom do you say I am gonna make a poop? No you say take a poop, therefore you must be taking something from the toilet right?

I think there is to much to have pet peeves over, with this being one of the lowest on the list. I don't feel it is unproffessional to say take a Blood Pressure, they know what your talking about. They in no way think your going to take something from them and not give it back, or maybe they view it as your "taking" a blood pressure reading, in which you would be taking something from them, the reading. If your gonna lead the charge against people using the wrong verbage do it on something like when people say o2 Stats instead of o2 Sat. :)
 
Psssh, so unprofessional. I say "I'm going to auscultate your Korotkoff sounds"
 
ArcticKat said:
...Except that I don't like the phrase "Taking a Blood Pressure"

When I hear a medic tell a patient "I'm going to take your vitals." I cringe, because it sounds like the medic ia saying "I'm going to rip open your abdominal cavity and tear your liver out through the gaping wound." Or "I'm going to take your blood pressure."

When you tell someone you are going to "take" something, that means that they are no longer going to be in possession of that item. Therefore, it is not possible to "take a blood pressure".

My preference is to tell my client that "I am going to check your ...". IMHO it gives the client a more reassuring image of what I intend to do.
Click to expand...

Except most of our patients have the mental capacity to know that it is not literally taking....

Sent from LuLu using Tapatalk
 
ArcticKat said:
When I hear a medic tell a patient "I'm going to take your vitals." I cringe, because it sounds like the medic ia saying "I'm going to rip open your abdominal cavity and tear your liver out through the gaping wound."
Click to expand...

This method of checking vitals was not covered in my course but it sounds way more fun (and interesting) than the way I do it now. I think I might try it on my next shift.

Will look a bit like this I imagine.

http://youtu.be/aclS1pGHp8o
 
Last edited by a moderator:
Sasha said:
Except most of our patients have the mental capacity to know that it is not literally taking....

Most, but not all.

Fish said:
So when you go to the bathroom do you say I am gonna make a poop? No you say take a poop, therefore you must be taking something from the toilet right?
Click to expand...

Actually, I don't say anything, I really don't think anyone cares to know if I need to move my bowels.
Click to expand...
 
You must log in or register to reply here.
Back
Top