Which BP is the right one?

[akroeze]

Hey folks,

If you have a dissecting anyeurism, which BP do you take as the "right" one for the purpose of treatment plans? The higher or the lower?

I'm thinking the higher but I'm not sure.

[Ecnalubma08]

I'd say higher too... :wink:

[sevenball842]

what's your treatment plan going to be?

[brock8024]

I think the treatment for this pt would be diesel and a surgeon. Well it might be some drugs and fluids when he decides to code on you.

[Ecnalubma08]

the treatment depends on the size of the aneurysm...i believe anything under 6.0 cm in size, they would not operate.

[captainstandup]

Both pressures are important as is mean arterial pressure since this is essentially the constant force applied to the vessel. Size doesn't necessarily decide whether they operate or not. Location and exact type of aneurysm are determining factors as are age, history and overall health status of the patient. Prehospital therapy, since an aneurysm in the field is a best a guess' will include high flow O2 two large bore trauma lines at very minimal KVO rates, gentle handling with no exertion. If it a known aneurysm such as an interfacility transfer Nipride may be utilized to keep the systolic BP @ or below 90mmhg. Clear communication to physician and the need for surgical intervention is a must.

[akroeze]

Both pressures are important as is mean arterial pressure since this is essentially the constant force applied to the vessel. Size doesn't necessarily decide whether they operate or not. Location and exact type of aneurysm are determining factors as are age, history and overall health status of the patient. Prehospital therapy, since an aneurysm in the field is a best a guess' will include high flow O2 two large bore trauma lines at very minimal KVO rates, gentle handling with no exertion. If it a known aneurysm such as an interfacility transfer Nipride may be utilized to keep the systolic BP @ or below 90mmhg. Clear communication to physician and the need for surgical intervention is a must.

Which brings me back to my question of WHICH of the two BPs do you keep @ or below 90.