Matthew99 Posted July 31, 2011 Posted July 31, 2011 (edited) So I was allowed to go help on an ambulance today and there was this old lady with really high blood pressure (sys 230!) having difficulty breathing. A person on the scene said she has rapid pulse rate and high-blood pressure. I asked him how did he know she had a high-blood pressure before we came and he said "well she had rapid pulse rate so that comes together with high BP". I thought for a moment and nodded, but later I thought of it more and while it does make sense, I don't think it's NECESSARILY the case all the time. I mean, what if a person has diluted blood? In this case tachycardia doesn't necessarily mean high-BP. Is that right? Edited July 31, 2011 by Matthew99
medicgirl05 Posted July 31, 2011 Posted July 31, 2011 The example that comes to mind is dehydration. Symptoms of dehydration are tachycardia and hypotension. I'm sure there are more examples but this is all that pops into my mind.
BushyFromOz Posted July 31, 2011 Posted July 31, 2011 (edited) So I was allowed to go help on an ambulance today and there was this old lady with really high blood pressure (sys 230!) having difficulty breathing. A person on the scene said she has rapid pulse rate and high-blood pressure. I asked him how did he know she had a high-blood pressure before we came and he said "well she had rapid pulse rate so that comes together with high BP". I thought for a moment and nodded, but later I thought of it more and while it does make sense, I don't think it's NECESSARILY the case all the time. I mean, what if a person has diluted blood? In this case tachycardia doesn't necessarily mean high-BP. Is that right? To answer your question, yes, tachycardia does not necessarily mean high B/P I dont know where this guy got the tachycardia = hypertension from. There's a myriad of reasons why a person will be tachycardic, and theres a myriad that will have no effect on, or caused by blood pressure amd they are too numerous to list. Relationship between poorly perfused patients and their vital signs are dynamic, complex and different for each individual and cant be placed into canned responses like this fellow on scene has done. Edited July 31, 2011 by BushyFromOz 1
MedicAsh Posted July 31, 2011 Posted July 31, 2011 As the others have said, do NOT assume that if someone is tachycardic that they are hypertensive. Patients going into shock may be tachycardic but be hypotensive. That is why they teach you to assess your patient. This way you can find out what is going on and so you can put all the signs and symptoms together to create a working and differential diagnosis.
tcripp Posted July 31, 2011 Posted July 31, 2011 I wonder if he was really feeling how strong/bounding the pulse was and when it came out of his mouth, he said rate? Did you happen to ask him to clarify for you his statement? Or, did you just accept what he said for gospel? (Yes, I know it's the latter based on your statement, "I just nodded.") You should get in to the habit of asking someone to clarify if something has been said or done that you don't understand. You will be a better student in the long run. (And this includes if you are a student/partner/commander/subordinate.) You can do it with tact so that it doesn't make you sound like you are challenging them. As a matter of fact, I would respect my student more if he/she did ask questions because, you see, we all are occasionally wrong and it keeps us all honest. Then, if it still doesn't make sense, do as you are doing now and do further research. Toni
Matthew99 Posted August 1, 2011 Author Posted August 1, 2011 I wonder if he was really feeling how strong/bounding the pulse was and when it came out of his mouth, he said rate? Did you happen to ask him to clarify for you his statement? Or, did you just accept what he said for gospel? (Yes, I know it's the latter based on your statement, "I just nodded.") You should get in to the habit of asking someone to clarify if something has been said or done that you don't understand. You will be a better student in the long run. (And this includes if you are a student/partner/commander/subordinate.) You can do it with tact so that it doesn't make you sound like you are challenging them. As a matter of fact, I would respect my student more if he/she did ask questions because, you see, we all are occasionally wrong and it keeps us all honest. Then, if it still doesn't make sense, do as you are doing now and do further research. Toni You're absolutely right. I just needed to help with the transport of the lady to the ambulance so I didn't have time to talk it out. I told myself to ask my partner later (though my partner wasn't the one who told me that), but I forgot so I thought to ask you But I definitely never accept what people say for gospel unless A) It makes sense and More than one source confirms it This is a great quote Relationship between poorly perfused patients and their vital signs are dynamic, complex and different for each individual and cant be placed into canned responses like this fellow on scene has done. Also ashley-- thanks for your input. One thing the ambulance driver did that I forgot to ask him about is lower the patient legs from the stool. So in high-blood pressure you lower the legs of the sitting patient because that way the blood fights more against gravity and therefor there is less circulation in the blood and lower BP. That made a whole lot of sense. If anything is wrong with this statement I'd like clarification. Thanks regardless.
DFIB Posted August 1, 2011 Posted August 1, 2011 So ,,, What was her actual pulse rate? Good job tcripp!
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