Replies to This Discussion

Permalink Reply by Jason Brooks on December 31, 2008 at 2:16pm

Just be aware that you can actually get bad readings based on how you apply the cuff from the machine. Make sure that the arrow pointing to the vein is where is it supposed to be. If you move it to either side of that, you can drastically change the reading. I have seen guys put it on up side down as well. Unless your protocol is drastically different from ours, a basic can apply EKG electrodes if he feels that the patient should have a monitor. He is unable to interpret or treat the rhythm. The EMT would then just present the strip to the doc. This is not operating outside of your scope at all.

Permalink Reply by FETC on December 31, 2008 at 2:29pm

Was it with the same arm? or an Orthostat?

Permalink Reply by Joe Stoltz on December 31, 2008 at 2:47pm

My bad.

The original manual readings were on the LEFT arm, while the automated cuff was on the RIGHT arm. And prior to disembarking we checked the RIGHT arm manually with the same cuff as was used on the left. And found agreement with the left arm readings. All with a supine patient.

There is always the possibility for dissimilar readings right to left, but these were way different.

Sorry for not making it clear up front.

Permalink Reply by Mike Schlags (Captain Busy) Retd on December 31, 2008 at 4:34pm

You need to confirm baseline vitals. Cardiac symptoms for example may not manifest right away, there are different symptoms. It is considered good medicine to maintain and secure vital signs. I would not want to look like an idiot, dropping someone off on a transfer that was having a major MI enroute to the hospital, right under my nose when I could have done these basics.

Permalink Reply by Paul Montpetit on December 31, 2008 at 4:39pm

I have about 30 years in ICU and ER Nursing....I will tell you from experience even inideal settings...a quiet, clean and dry room the electronic monitors are NOT always accurate.....We normally use arterial readings from the Art-line and CVP readings from the central line....So, I prefer to do my readings manually.....Stay safe.....Paul

Permalink Reply by Beverly on December 31, 2008 at 5:03pm

If we could always rely on the electronic equipment than pts. would be treated by robots not humans. Anything that we as humans can get as information than we should use our own abilities and save the equipment for what we cannot, i.e. O2 sats. Spending too much time watching the monitor doesn't allow for objective assesment, if you are taking a pulse or BP manually then you can be observing the pts resps, quality, quantity, efficacy, checking skin color, temp, auscultating breath sounds and heartrate allow you to check the quality of the "numbers" that you would be relying on if you only used a machine. Also, keep in mind that the pt is HUMAN and that for the most part a human in distress is calmed by anothers persons touch, even something as simple as taking a pulse allows for personal contact. If you are too busy treating the machine you are not treating your pt. More good can be done in many situations by interacting with your pt., talking them through breathing techniques, using distraction, using calming behavior techniques rather than slapping a LP on the pt. and staring at the monitor all the way to the hospital. That said there is a time and place for everything and if the manual vitals you get are unreliable i.e. too much loud noise or you are unable to obtain them than electronic information is better than none at all.

Permalink Reply by danny on January 3, 2009 at 8:09pm

You know if ya have and ya trust it use it but it never hurts to do it manually and nothing replaces good knowledge of signs and symptoms for general things have a good one

Permalink Reply by Chris on January 5, 2009 at 11:46am

What is wrong with basics using the lifepack? I am assuming you mean like the physio-control lifepack. But I mean I wouldn't use the lifepack to monitor BP anyway those things are highly inaccurate. I mean people put too much emphasis on monitoring blood pressure as well. But they should be trained on the lifepack anyway if they are going to use it in AED mode.

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