Pulse Oximeters and BP

[firedoc5]

Palpating a BP is just a preliminary reading. But you do need to auscultate one at first chance and go from there. Maybe I'm just too old school but I just couldn't get use to the idea of trusting machines to do things that can be done manually. For monitoring purposes it's fine, but if for your base-line readings it's best to do it yourself. IMHO

It does take a bit of practice to hear a BP in a setting where you are bouncing around, kind of like getting your sea legs. I can't remember exactly who it was, I think it was an MICN on one of my very first transfers that gave me the advice of having a shorter stethoscope to hear better. So that's what I did. I just had a Sprague-Rappaport and I shortened it and by golly it worked.

[AnthonyM83]

If you can check a pulse, one should be able to obtain a BP by palpation. I'm confuzzled.

Not always. On constantly bumpy roads, you might be able to make out a radial pulse, but not track it constantly, thus not knowing where exactly the systolic is with a pretty wide margin of error (depending on road, patient cooperation, etc). Also, sometimes you can get a carotid pulse...but you can't really palp that...

[VentMedic]

I would prefer Masimo and Nellcor gain approval from the FDA for BPs and start to market their pulse oximeters for this use in taking BPs. These two companies have spent millions on reseach, all of which can be found on their websites.

Equipment reps are also very careful not to make any claims about use that is not approved.

The one article from 1998 Air Med sited by someone earlier in this thread did not list the exclusionary factors for their study. They may only have used patient with a very good pleth and strong BP while discarding the rest. That is a researchers perrogative if it is only being written for Air Med or JEMS and not NEJM or JAMA where the audience might be more critical.

http://www.nellcor.com/clin/index.aspx#clinical

http://www.masimo.com/cpub/ClinicalStudies_SET.htm

[AZReam]

Mindray have Vital Signs Machines (the VS-800) featuring both Masimo or Nellcor as alternatives to their own SpO2, and these are available in the U.S.

They also have economically priced handheld units (PM-50 and PM-60) with a full range of accessories.

AZReam, as a distributor, offers these, together with alternative blood pressure cuffs - both single-patient use / disposable and reusable.

Would this solve the problem?