Automated BP cuffs

[PRPGfirerescuetech]

Did I say it was difficult??? I don't remember ever saying that. What I recall saying is that I do not use automatic anything. I get at least 4 manual BP's on a pt before arriving at the ER. The only thing I use as far a machines is the pulse OX along with taking a manual pulse. And no matter what your skill level is...it all comes down to the basics. Listen ...touch and feel.

When I run my shifts...which is 96 hours a week straight through....It's just me and a driver...I'm the only Tech in the back of the ambulance and I'm not one of the lucky ones who gets a driver with medical training. My driver's only medical training is CPR. But he's great....he's got the muscles that I lack as far as lifting etc...It does get busy in the back for me especially when I have more then one pt back there.....would an automatic machine make things easier for me? Sure it would....but I've never used one and don't feel I need to.

I was just curious as to what "andrean678" said about agreeing that it would not be good for a BLS provider to use one.......I personally think that the issues of what BLS can and cannot use is bogus....not that it would change how I do my pt care if I had automatic equipment to help me out. It will still come back to using the basics. Listen...touch.....feel.

Interesting dichotomy in this thread. amazing how people can say that it's poor for a BLS provider to utilize one, but acceptable for a ALS provider to use one. y? Because your busier? Ok, ill accept that. Makes me wonder, if thats the case...why isnt it acceptable for BLS usage? Because we arent as busy?

Seems to me these are responses from medic who are ok with cutting corners on necessary skills. If you feel EMT's should go manual pressures on every call, so should you. Unless you have a clinical reason for not using manual pressures.

Which their isn't one.

If the tool is unacceptable for one type of provider, it has to be unacceptable for all.

Now that is out of the way, I will say this. Technology is a wonderful thing in this business, but I have to wonder, have we gotten too reliant on technology? When will we realize that we are losing the basic skills of assessments, that sixth sense.

At least, till they design a machine for that...

*Steps off soapbox*

PRPG

[Dustdevil]

amazing how people can say that it's poor for a BLS provider to utilize one, but acceptable for a ALS provider to use one. y? Because your busier? Ok, ill accept that. Makes me wonder, if thats the case...why isnt it acceptable for BLS usage? Because we arent as busy?

Exactly.

Seems to me these are responses from medic who are ok with cutting corners on necessary skills. If you feel EMT's should go manual pressures on every call, so should you. Unless you have a clinical reason for not using manual pressures.

Which their isn't one.

Ah, but there is. ALS is busy treating the patient all the way to the hospital, trying to do half a dozen more things at once than a basic would be doing. ALS also has a need for serial BPs to track the efficacy of therapy. BLS does not have that same need. And it has already been established that we are talking about serial BPs, not routine starting baselines.

If the tool is unacceptable for one type of provider, it has to be unacceptable for all.

What is unacceptable is to utilize it for no other reason than you're too lazy or too mesmerized by technology to do it manually. What is acceptable is to use it to maintain a constant eye on the patient's condition after baselines have been obtained and therapy has been instituted. Has nothing to do with levels of provider, except that basics are not nearly as likely to be engaging in therapy to change blood pressure.

Technology is a wonderful thing in this business, but I have to wonder, have we gotten too reliant on technology? When will we realize that we are losing the basic skills of assessments, that sixth sense.

Some have. Others have not. But that is certainly something you risk when you put dubious technology in the hands of people who have no need for it.

[temsp40]

I work BLS/ALS calls....It doesn't matter if you are ALS it all comes down to the basics first. When taking a BP ALS shouldn't rely on machines to calculate an accurate BP anyway. As secondary...sure. BTW why don't you agree with it for a BLS provider? I'am on all my calls by myself and there is ton's for one BLS provider to have to do. Not that I would solely rely on it. Just like the pulse ox.....I use it....but I don't rely on it. Mainly just to check the stats I'm getting with what the machine is saying.

Ok -- perhaps I misunderstood you with this. I still do not like to rely on a machine to get important information such as a BP.

Auto-BP's are great if you are in a "stable" environment I am sure, coupled with a whole lot of maintanance and support options and backups when it goes down. How many of us have run into the BLS provider who relies solely on a machine to take their vitals and doesn't know what to do when the machine breaks? Probably to many to mention. I have met another service in my area that does rely on one of those machines and takes great offense when someone asks them to take a "real" BP.

[Nate]

What happens when the BP machine goes dead or hay-wire? Hope they remember how to take one by hand.

[Guest]

What happens when the BP machine goes dead or hay-wire? Hope they remember how to take one by hand.

Me too.

I'm all for new technology, but don't forget the basics.

[emt-b_wa]

I like to use them on transfers but i get a manual bp first and then i switch to automic. If things change a go back to manual

[Jeep_911]

Do I use automatic BP cuffs?.......well yes and no. We do carry the Zoll cardiac monitors who give the option of using automatic BP cuffs but I dont normally use it. The first base blood pressure that I take I always take manually that way I know its right. For long transfers I will sometimes use the automatic BP cuff because its easier but will not rely on it. If the numbers look like they are right and my patient is happily sleeping and the rest of my vitals look great then I will use those numbers otherwise no.

I have used those monitors hundreds of times and about a quarter of the BP's I received from my monitor were completely off. You take your initial BP which looks great then 5 mins later you take another one and still looks great yet your pt looks like crap and is obviously not doing so good. I would have double check my BP manually and BINGO my BP is going down the drain. The monitor was wrong..yet again. I rather rely on my numbers than those of a machine if I can help it.

Even I have it available in the trucks I dont usually use it.

[Ridryder 911]

Me too.

I'm all for new technology, but don't forget the basics.

geez.. folks.. how hard is to remember how to take a blood prssure... this is not rocket science here...automated blood pressure cuffs have been out for over 30 years.. they have proven their point, better than judging someones hearing sometimes.

Be safe,

R/R 911

[UMSTUDENT]

Do any of you have any idea how inaccurate the human ear can be? Put 10 people together and they'll almost all tell you a different BP within a few torrs. My point is simply that if human beings can be slightly inaccurate, then why not use a machine that is sometimes slightly inaccurate. What is to say that you're more right than the machine? It's not about laziness, it's about efficiency.

This is especially true in a profession that is exposed to a lifetime of high pitched sirens, road noise and screaming loved ones. After 20 years the machine is probably more accurate. I'm young and I can barely hear a BP on a rough road let alone some of you who've been doing it for the better part of two decades. Some of you were teenagers in the 80's and don't tell me you didn't have Walkmans either...

After all, tell me the difference between a systolic of 176 and 180. Better yet, tell me the difference between 150 and 180. They're both hypertensive. What are you, as a medic, going to do for them? No matter how you look at blood pressures they are based on set standards. The difference between 82 and 80 is a radial pulse (and in my state, the ability to give vasodilators is 90), but how significant that is in terms of treatment given is based entirely on a set standard a group of people have decided upon. When a machine becomes highly inaccurate is when you have a significant problem. Of the machines I've had experience with most have been fairly accurate.

[Ridryder 911]

That was my main point as well. My boss still refuses to allow machine B/P... the old I want to be sure it is accurate. I will tell you after 38 years of siren... 6 years of helicopter I can assure you my hearing is off..

The other point is how many times I see repeat blood pressure actually taken in the rig... every 15 minutes. At least after the first initial auscultated BP, you have a base line. If they use a machine, at least you know it will be done by the print out.

Be safe,

R/R 911