NIBP

[mffrhorne]

I just have to ask now that Richard B has brought it up. Is there such a thing as a NIBP that does work in a moving unit?

--

Tom

[Arctickat]

My LP12s have been pretty reliable at speeds below 60kph and no sharp turns. If I'm lucky and have a smooth stretch of road It can be reliable when travelling at 120+ as well. I find that the most often cause of wacky readings is a poorly applied cuff or the wrong size.

[paramedicmike]

At the last ground job I had we were using the Zoll M series and then moved to the LP12s. Both worked fine for NIBP purposes while in motion.

At my flight job, well, there wasn't usually too much of an issue with bumps in the road.

[island emt]

Both the Zoll M series and Lifpack will get an accurate reading while moving if the tube is not flopping around.

The Hospital service just got a new LP15 with the coiled hose and it has has a hard time with accuracy while bouncing down our roads.

[Eydawn]

The NIBP can be a good time saver. However, if you don't verify significant changes manually, you are a fool... the machine is limited, so make sure you double check to see if your ears hear what the machine hears. Trust your own BP over the machine's. If you're not sure either, then have someone else check it.

If you're going to be basing interventions off of your pressures, you better be sure of those pressures! Heaven forbid you get a false high and give more narcs, or a false low and give pressors... @_@ that could really be bad!

Wendy

CO EMT-B

RN ADN Student

[Richard B the EMT]

When a CFR-D (Certified First Responder-Defibrillator) FDNY Engine Company crew-person takes a BP, I ask them for their reading, but explain I'll be taking my own, as will the Paramedics behind me, and the ER staff after them, and that's per policy. That way, I hope they don't think I don't trust them in getting a BP reading. (No jokes on the FFs please)

FYI, I don't think that the FDNY CFR-Ds, EMT-Bs or Paramedics are using automated BP units in the field, yet.

[island emt]

Always take a reading manually, then put the NIBP on for transport. It will take a reading Q-5 or whatever parameter you set.

Allows you to get your other assessments / treatments and skills done.

If you all of a sudden get an OFF reading then don't trust it without verifying manually.

[Medicman14]

Both the Zoll M series and Lifpack will get an accurate reading while moving if the tube is not flopping around.

The Hospital service just got a new LP15 with the coiled hose and it has has a hard time with accuracy while bouncing down our roads.

Interesting, we have LP15s as well and also have challenges with the coiled nibp hose.

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[fakingpatience]

My LP12s have been pretty reliable at speeds below 60kph and no sharp turns. If I'm lucky and have a smooth stretch of road It can be reliable when travelling at 120+ as well. I find that the most often cause of wacky readings is a poorly applied cuff or the wrong size.

Going off of this, which cuff does everyone find to be more accurate on our "large" patients? I alternate between using the maroon large adult cuff on the upper arm, or the regular blue one on the lower arm, but don't seem to get reliable results with either one. My problem with the larger cuff is I thought the blood pressure cuff is only supposed to take up a max of 2/3 of the length of the upper arm (don't quote me on the number, but I think it somewhere around there), but the larger cuff is not only longer, it is wider, so it ends up covering almost all of the upper arm. What these patients need is a cuff that is longer, not wider.

[Arctickat]

Hmm, all my cuff sizes are blue. The Large Adult one measures 1 inch wider and 2 longer than the Regular though. Ever tried the Thigh? In my mind, the most difficult are the morbidly obese people who have a huge circumference arm at the top of the cuff that narrows to mere inches at the elbow. Then gets larger on the lower arm again. Kinda like trying to get a BP on the top half of an hourglass.

Edited October 9, 2012 by Arctickat