Auscultated BPs

[AnthonyM83]

You document even numbers, because that is what is on the face of the manual cuffs.

To document in-between would be a guess, and a falsification, that would lead to bigger issues.

I don't have a cuff in front of me right now, but aren't the black lines and the white spaces about the same width? HOW THEN WOULD AN ODD NUMBER BE A GUESS?

MOST OF THE BLACK MARKS/LINES DON'T HAVE NUMBERS EITHER, but you logically deduce that if the line before said 90 and the 5th line after it said 100, then the line you're at has a value of 92 (EVEN THOUGH there's no 92 written on the face).

In the same manner, you logically deduce that if needle lands on a white space and line after it says 92 and line before says 90, then your true measurement is 91. It would be falsification (where it not for the fact we were trained to read only evens) to say either 90 or 92.

Someone reread my previous post and reply to it, please.

(Once again, I wouldn't teach anyone to record odd numbers..I'm just debating the way we teach things.)

[AnthonyM83]

but now i must question are nibp's in protocol or in your scope of practice ?

I don't think they're mentioned...A lot of things just say "splint extremity" or "record _____" but don't say how to do each thing or what material to use.

We weren't taught the NIBPs, but when we get to the hospital we're expected to get a fresh set of vitals using their (hospital's) equipment...

You do have a logical point, though

[tskstorm]

I don't think they're mentioned...A lot of things just say "splint extremity" or "record _____" but don't say how to do each thing or what material to use.

We weren't taught the NIBPs, but when we get to the hospital we're expected to get a fresh set of vitals using their (hospital's) equipment...

You do have a logical point, though

yea I know, I use the NIBP's 2 when I'm at the hospital... I'm not claiming to not be at fault for using them, I'm trying to show why we give even numbers.

my logic...

assuming we all agree we can only get an even reading on a manual bp cuff.

we use the NIBP but because we can only get even numbers on the manual we round off so as to deceive and show we used a manual cuff . therefore there is no right or wrong as to how you round, as it shouldnt be done.

of course this isnt realistic, we use whats convenient. which is the nurses/hospitals NIBP

just my 2 cents and yes i do use the NIBP's im not innocent just offering opinions

[AnthonyM83]

Well, I'm not agreeing we can only get even numbers....but do agree you brought up a valid point about using equipment we haven't received training on (though that's actually common...the company might use a different type of c-collar than what you trained with...I was just agreeing as in technically you've got a point).

I think it's ridiculous to round an odd numbered NIBP reading to an even number to make it seem like you used a manual cuff, though. I would view that even more wrong than using an NIBP (which I don't see as wrong actually, unless specifically against protocols). Using the NIBP isn't something to be guilty off...changing the reading, though IS.

[PRPGfirerescuetech]

I don't have a cuff in front of me right now, but aren't the black lines and the white spaces about the same width? HOW THEN WOULD AN ODD NUMBER BE A GUESS?

MOST OF THE BLACK MARKS/LINES DON'T HAVE NUMBERS EITHER, but you logically deduce that if the line before said 90 and the 5th line after it said 100, then the line you're at has a value of 92 (EVEN THOUGH there's no 92 written on the face).

In the same manner, you logically deduce that if needle lands on a white space and line after it says 92 and line before says 90, then your true measurement is 91. It would be falsification (where it not for the fact we were trained to read only evens) to say either 90 or 92.

Someone reread my previous post and reply to it, please.

(Once again, I wouldn't teach anyone to record odd numbers..I'm just debating the way we teach things.)

Each line has a number.

Thus, we can only conclude a pressure at the lined marks.

Lined marks are only marked with even numbers. If your cuff is different, throw it out, the manufacturing standard has even numbers at the black marks.

Documenting a BP in between the even numbers would require you to "logically" put a number there.

Since theres no standard to your logic, that means your making up an odd number. Because odd numbers dont appear on your BP cuff.

Not that any of this truely makes a darn bit of difference in your treatment.

120/80 documented versus 122/80 documented isnt going to make anyone blink an eye.

However, if your patient crashed and the sue happy family finds just the right slickhaired lawyer, the first thing he's going to pick you apart on is the little inconsistencies. Like at BP of 121/85 and no NIBP.

[PRPGfirerescuetech]

(Once again, I wouldn't teach anyone to record odd numbers..I'm just debating the way we teach things.)

I figured, and I do this too. Nice move telling us first to lessen the initial agitation of someone challenging this EMS gospel...

[AnthonyM83]

If this is getting too annoying, let me know. It's just for the sake of debate.

BUT

The line marks on the faces we use don't actually have even numbers on them. They only have 20, 40, 60, 80, 100, 120, etc....You DEDUCE that that the first black line after 100 is 102. Using the same logic, you must then assume that the white mark after 100 is 101. BPs don't just cease to exist b/c there's a white mark there. If that's where the cuff reads it at, then that's where the BP (theoretically) is and then be reported as that.

[emtd29]

ny emt-b's lose there cert if they use and/or document a pulse ox

ty for prooving my point, its not rocket science but thats how it is here

Oh?? since when?

[Thunderchild145]

The cuff is manufactured with the intended reading to be taken on or approximately on a black mark, not on a white space. If the sound stops on a white space then it stopped approximately on a black mark. If readings were ment to be taken on odd numbers, they would have a smaller black mark on them. Since the standard is to record manual blood pressures in even numbers only (and I personally think that this is mainly for making easy work of calculations related to blood pressure, like when calculating mean arterial pressure or intracranial pressure, that sort) then you are only allowed to record a reading on or near a black mark, not on a space. Personally I don't really care whether it stops on the mark or the space anyway, cause I'm going to write down the number by the mark. :wink:

[BushyFromOz]

I cant believe you guys are actually arguing about this.............. :roll: :roll: :roll: :roll: :roll: