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BASIC VITALS
O.K., I was just wondering how everyone else does this, or if you have any good tips to pass along....say, you are at the scene of a motor Vechicle accident and have a entrapment, you need to get basic vitals but all you can see or reach is a forearm, elbow to hand, how would you take blood pressure, pulse and everything else you need.?
Replies to This Discussion
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Permalink Reply by Joe Stoltz on
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If you can get a radial pulse, at least that tells you the person has a BP of what, 90? And that the ABCs are working, at least for that moment. You can obviously check pulse rate and quality at the same time.
I think I've heard someone say that you can put a BP cuff on the forearm and get it that way, though I've never seen it done. I'm certain that someone will chime in here.
I confess that I have gotten lax about getting a quick set of vitals on a trapped person. It's important to get a baseline established with the patient still entrapped just to see if there is any degradation after extrication.
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Permalink Reply by Oldman on
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While a baseline is important, a radial pulse tell you a systolic BP of at least 90mm hg which will sustain life. The immediate priority however are the basic ABCs. Do they have an airway? Are they breathing? Are they bleeding? Then to extricate and immobilize the victim to ensure they will keep all of the above. Once they are extricated, then a more thorough exam can be done including a good set if vitals.
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Permalink Reply by Pablo J. de la Torre on
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Ah, but there's the rub.....you can't get tell if or where they are bleeding and you are looking to a long extrication and without a pulse ox how can you tell how they are breathing?
I'm not trying to bust chops ! just trying to get as much info as I can.
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Permalink Reply by Brian Dumser on
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Can the victim speak? If you can't tell if they're bleeding or not, they might be able to tell you.
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Try this experiment. Take a glass test tube and put a teaspoon of black coffee in it. Put the probe on the end of the tube and rock the tube back and forth. The point of this experiment is; a pulse oximiter only sees the color red. The more red it detects, the higher the reading. The light diffusing through the coffee shows red and gives a reading. Machines are just an assessment tool to assist you. The same as mechanism of injury. You don't treat the vehicle, heart monitor or the pulse ox. There may be times you cannot tell what is going on unless and until you get the victim out.
But I'll play along. You can only "see or reach a forearm, elbow to hand". You cannot feel a pulse, or you pulse ox doesn't read, and you cannot auscultate a blood pressure. Based on your scenario, you might assume a fatality until the vehicle is opened up to find that the limb you were seeing had been severed by the impact. The victim was unconscious but breathing, with a pulse, and very little bleeding due to the retraction of the axillary artery. My point is, you will come upon a situation where nothing you've ever been taught, read or heard applies. Again, if you can't get to them, you can't treat them.
But it's fun to play what if.
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Permalink Reply by Beth on
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They do sell forearm BP cuffs at medical supply stores. You may have to buy one your self or you could try to get your dept. to buy one. But try to get the pt. talking or at least moaning. But with just the forearm and hand you can get a pulse pulse rate, quality of rate, and cap refill. As long as the arm is not amputated.
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Permalink Reply by Marie on
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well if you get a radial pulse you have a bp of at least 80 (70 at brachial and carotid but not radial, and 60 at only carotid not brachial or radial) which is the base BP for central organ perfusion.... i've seen bp's taken on the actual forearm before too, you just have to REALLY have a good ear and it wont necessarily be 100% accurate it'll get you an idea and if you use the same site multiple times you can get trending. You cant really get respers unless you can see the chest rise or hear them breathing......... you can also get a dexi from a forearm prick..... and the skin CTC on the forearm can give you a bit of an idea of whats going on.
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Permalink Reply by mike angle on
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if they have a good radial pulse they also have a bp of at least 80 thats all i need
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Permalink Reply by Levi on
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I WOULD SAY ABC'S AND DONT WORRY THAT MUCH ABOUT THE BP BECAUSE YOU CANT TREAT IT JUST YET ANYWAY. DONT GET ME WRONG IF YOU CAN GET IT GREAT, BUT THERE ARE OTHER, MORE IMPORTANT THINGS TO DO OTHER THEN THE BASELINE BP. BUT THEN AGAIN THATS JUST ME.
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if you already know theres a low bp you can at least get ALS to step it up and start a line though.... plenty of veins on the forearm :)
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