taking BP

[Tincanfireman]

Good points, Goddess; not to mention the reduced circulation, peripheral neuropathy, and (oftentimes) cardiac issues (CHF) that these patients can present with, not to mention improper bandaging of the shunt site with the associated heavy bleeding, fluid overload in the lungs, and hypoxia if their O2 isn't maintained for the several hours of treatment. Kind of turns the "Renal Roundup" into somewhat of a wild rodeo when you have a patient like that!

 

[RedZone]

Inflate the cuff to at least 200...let the air out about 2 mm a second...the first thump you hear is the systolic. and the last thump you hear is the diastolic

200 might be a little on the painful side for some patients.

The PROPER way is to palp first and then inflate 20-40 mmHG over ther palped systolic to auscultate.

In practice, I generally listen while I inflate to a range of about 100-120 where I would expect to hear thuds on a good majority of patients... then I inflate more until I don't here them anymore... deflate slowly until the thuds return (systolic) and continue deflating until thuds go away (diastolic).

 

[eggshen]

5 pages of posts on B/P taking. Is it that hard?

Egg

 

[Airwaygoddess]

5 pages of posts on B/P taking. Is it that hard?

Egg

No just learning good technique and skill.

 

[Thanach]

Airway, methinks we are on the same page, I absolutely agree with you, but not only dialysis patients, any patient with a chronic, severe medical problem should be monitored, no matter how minor or simple the call. you never know what could go wrong.

 

[eggshen]

If someone would like to burn loads of pages on "technique and skill" let's talk about "history taking" for a spell shall we? How about giving our line of work some respect and not cutting loose for days on end regarding something that is really one of the most simple things we do(next to showing up for work). Please, keep in mind that I take no issue with very newly trained people trying to sort this out. However, when there are people with so called "experience" going on about "this way and that way" I hope that I never land up in some other town finding myself with the need to call 911. "Oh good golly!!!!! What should the top number be and what is the best way to recite it!?!?!?" I know full well that this a "BLS" post but please...do not insult those of us that are able to grasp the most humble of tasks. If you need to go back and forth about something that even the most simple of fools can explain I suggest football.

Egg

 

[BossyCow]

Egg, a discussion like this happens because as new members hit the site, comments are made on old posts and a thread is revived. If you don't like a particular thread, perhaps you could start one on the topic you would like to see.

We all have our ways of doing different tasks, even the easy or basic ones. Hearing a different technique can be educational. I do a lot of teaching. Often one technique doesn't work for every student. It's nice to hear a different approach that might work for a student who is having a difficulty with a particular task.

You will find in EMS that there are a billion ways to 'skin a cat' and everyone has their firmly held opinion on why someone else's method is anything from inefficient to downright dangerous.

 

[MICU]

Make sure you have good contact with the scope on the artery.

Also, make sure your knee isn't resting on the railing on the gurney... lol the road vibration can drown out the pulse.

I recommend for all my students to just practice on everyone they know. Not just over and over on the same person but fat arms, skinny arms, old arms, muscular arms, kids arms.

A lot of the problems that new EMT's have are based on them expecting everyone to be the way they are in the book. People's anatomy is very different and getting used to finding pulses in odd little nooks and crannies is part of learning the craft.

It is prertty easy to take BP on a healty guys, the real practice is on hard pts. Also try to take the systolic without scope, but with your fingures on the Radial A. you will fill only the systolic, we usally use this method in Trauma when the systolic is more vatial.

Good luck

 

[Arkymedic]

I really don't care what level you are, and work with all levels. As long as you perform good patient care and are proficient. Being friendly to patient, families, and other members of the patient care party. I believe anyone can learn at all times, so being stagnant is one of the most hidden dangers is in this profession.


R/r911

complacency kills