Auscultated BPs

[Lithium]

Hello all,

Alright, it's been said many times that when you are auscultating a blood pressure, your reading should always be reported in whole round numbers. (Ie. 146/82, not 145/83). WHY?

I'll be honest in admitting I can't for the life of me figure it out. I may have been told once before, and if that's the case, I don't remember. But now, our student is asking us (my partner and I) after my partner told him that he should never report them like that.

To me, if the needle falls between 84 and 82 when I last hear the change ... then it's 83, but anyways.

I honestly told him I thought it was a whole big conspiracy theory invented by nurses to prove how dumb paramedics are ("haha .. we'll tellthem BPs can only be in whole numbers, that will show them!") and that seemed to amuse him and buy us some time to find the real answer.

So, what's the reason? And why are those NIBP cuffs allowed to use odd numbers? HMMM?

Jacob

[akroeze]

Speaking as a nurse, your conspiracy theory is correct.

I know I'm taking a huge risk by admitting this, and I already have a plane chartered to take me to my secret hiding place the moment I post it. Hopefully they can't find me there....

[Ridryder 911]

Show me an odd number not from a digital B/P and I will usually show you someone whom does not know how to do take a blood pressure. As well, most do not usually listen for the initial Korotkoff sounds, furthermore the numbers are only posted in even numbers, detecting a sound in-between numbers would be so minute, choose one or another. It has been a traditional charting and record method to always chart vital signs in even numbers, including pulses and respiratory rate.

It was only recently with the invention of digital read outs that even numbers have been accepted to chart as such, the theory was they were to be more accurate.

R/r 911

[MTNMANMEDIC]

With B/P's is one number gonna make a difference ?

What would be the difference in a BP of 154/60 as compared to 155/61 ?

I always take at least one manual BP before they go on the monitor and if it's a long trip down a bad road then all are manual.

The same being for all vitals.

Monitor being a lifepak 12.

[AZCEP]

The reason the B/P's are reported as even numbers stems from there not being odd numbers on a sphygmanometer's face.

If you report an odd numbered B/P, and you've used an instrument with no odd numbers, how did you come to this information?

One blood pressure, or pulse rate, or respiratory rate doesn't do anything for you anyway. Vital signs change on a moment to moment basis. Even in a cardiac arrest, the lack of a pulse initially may well be temporary. Ever have someone wake up while doing compressions with an indignant look?

NIBP's use a more accurate digital sending unit for the pressures they report, so they are able to deliver odd numbered B/P's.

[MTNMANMEDIC]

NIBP's use a more accurate digital sending unit for the pressures they report, so they are able to deliver odd numbered B/P's.

With that being said, should you record the BP from the NIBP as it is on the screen or round it up or down to an even number for charting purposes ?

[AZCEP]

NIBP's use a more accurate digital sending unit for the pressures they report, so they are able to deliver odd numbered B/P's.

With that being said, should you record the BP from the NIBP as it is on the screen or round it up or down to an even number for charting purposes ?

Document the numbers as the equipment presents them.

[tskstorm]

Document the numbers as the equipment presents them.

.

see here in NY even if we use the digital we have to record even numbers period the end (prehaps this is just the company i work for rule, but i dunno and dont really care i always round torwards a traditional vital sign, if the bp is 115/79 id round up to 116/80 if the bp was 123/81 would round to 122/80 and if the numbers are offset ie 129/77 id round to 128/78 or if it was 117/85 would go to 118/84)

as it's been said the 1mmgh up or down on the bp isnt a big deal no matter what you do. my philosophy is c.y.a and do w.e you need to to not get called into the office.

anyways best of luck in your decision

[AZCEP]

The plaintiff's attorney will LOVE the fact that you are documenting inconsistently with the results received from your equipment.

[tskstorm]

The plaintiff's attorney will LOVE the fact that you are documenting inconsistently with the results received from your equipment.

would love to know how hes going to see what the machine says.. and again its not my rule/protocol or w.e thats whats taught in class, thats whats taught when you first start working, thats whats taught to new trainee's, thats what is done on the st's here

p.s. the only time we have the ability to use digital b.p's is if we are picking up at a hospital for non-critical pt txp and we use the hospitals, rare i have to worry about the pt going sour. if im working 9-1-1 im using a good old fashioned bp cuff and my vitals are always even numbers at that point ... but if im txp a pt and if the vitals are not within the pt's norm i wouldnt be moving them therefore the "plantiff's attorney" can "F" himself cuz i aint got shit to do with the pt's health he can sue the hosp all damn day but he can leave me the "F" outta it

now we seem to be a bit off topic and im previously aggitated from seperate personal events which happend momentarily ago so this probably is going out really messed up and harsh etc.. but o well im an @$$ i never denied it