Auscultated BPs

[MTNMANMEDIC]

Document the numbers as the equipment presents them.

and specify NIBP, so the nurses don't get a case.

[AnthonyM83]

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.

I disagree with this. The white spaces are about as wide as the black marks, right? Your ability to read the needle over the white area should not be harder than your ability to read over the black mark.

If it the needle lands in between 96 and 98, it would be inaccurate to say either 96 or 98, because you KNOW it's in between those. The closest number to "in between those" is 97.

ADDITIONALLY, just because white spaces don't have a number, doesn't mean they're not meant to be read. A lot of the black lines don't have numbers, unless they're 10, 20, 30, etc. Would that mean you don't count all the numbers in between, because a number's not written in?

The ONLY good argument I've heard is that the instrument was constructed for people to read at the line marks only, because only the lines count as readings. But this only works if that's actually true...I believe the in-between count as readings, too, though.

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?

If you use a face that only has numbers in increments of 10, and you come up with a BP of 96, how did you come up with that information? You had to logically assume that the black numberless lines in between counted as even numbers. You can likewise assume that the white spaces count as odd numbers. The needle lands wherever the true BP is (as accurately as possible), not where the lines are or aren't.

Now, I'd never tell a trainee or ride-along to start giving odd readings and I'd never give one myself, BUT what I'm saying makes sense doesn't it?

[ERDoc]

Personally, it doesn't matter how you report them, as long as they are accurate. Most docs and nurses I know don't hear or care about the last number. We hear 210 or 120 or 70 and that's about it. You get the point.

[tskstorm]

Document the numbers as the equipment presents them.

and specify NIBP, so the nurses don't get a case.

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

i mean a monkey can use them but are you trained in them ? if not we probably shouldnt use them therefore documenting as such indicates you as operating out of your s-o-p and screws u more then helps you

i dunno just saying ...

[Ridryder 911]

I can't believe this is even debatable! One should had been taught back in basic EMT that manual b/p's are given in even numbers, even nurses aides know this much! This is due to the dial is only in even numbers, and I do really doubt that one could really hear and correlate the difference. Refer to manufacture and even the teaching of how to document and auscultate blood pressures.

Whenever someone reports an odd number, one would assume it would be electronic, otherwise all credibility would be questioned that one could not read the dial increments.

R/r 911

[bassnmedic]

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

i mean a monkey can use them but are you trained in them ? if not we probably shouldnt use them therefore documenting as such indicates you as operating out of your s-o-p and screws u more then helps you

i dunno just saying ...

Wow, NIBPs have a scope of practice? Maybe you could enlighten me as to how a basic or Intermediate shouldn't use one..........you put a cuff on, push a button and document the readings.......it's not rocket science. Or maybe we shouldn't use pulse oximetry unless trained on them either.

[tskstorm]

Wow, NIBPs have a scope of practice? Maybe you could enlighten me as to how a basic or Intermediate shouldn't use one..........you put a cuff on, push a button and document the readings.......it's not rocket science. Or maybe we shouldn't use pulse oximetry unless trained on them either.

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

[PRPGfirerescuetech]

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.

[PRPGfirerescuetech]

Wow, NIBPs have a scope of practice? Maybe you could enlighten me as to how a basic or Intermediate shouldn't use one..........you put a cuff on, push a button and document the readings.......it's not rocket science. Or maybe we shouldn't use pulse oximetry unless trained on them either.

Actually, pulse oximetry isnt in the education and "scope" for a number of states. Tsk used in-correct terminology.

Regardless of the simplicity, NO ONE should be using any piece of equipment they are not trained on, and trained on with documented education.

Why?

Because the first time you use it inappropriately or misinterpret the information, YOU ARE LIABLE FOR USING EQUIPMENT YOUR NOT TRAINED ON.

Think they cant get you on it? Work a hospital based EMS system. They do established competencies every year on even the simplest equiptment. No, its not because they think your stupid either.

[tskstorm]

Actually, pulse oximetry isnt in the education and "scope" for a number of states. Tsk used in-correct terminology.

Regardless of the simplicity, NO ONE should be using any piece of equipment they are not trained on, and trained on with documented education.

Why?

Because the first time you use it inappropriately or misinterpret the information, YOU ARE LIABLE FOR USING EQUIPMENT YOUR NOT TRAINED ON.

Think they cant get you on it? Work a hospital based EMS system. They do established competencies every year on even the simplest equiptment. No, its not because they think your stupid either.

yea i probably used incorrect terminology but i think it got the point accross, however the definition of Scope of practice is as follows ..

Scope of Practice is a terminology used by licensing boards for various medically-related fields that defines the procedures, actions, and processes that are permitted for the licensed individual. The scope of practice is limited to that which the individual has received education and clinical experience, and in which he/she has demonstrated competency. Each state has specific regulation based on entry education and additional training and practice.

Professions with defined scope of practice regulations include nursing, emergency medical services(EMT), social workers.

Copied and pasted from wikipedia.

Noting the italic font my interpretation is the same as PRPGfirerescuetech, and as the scope is defined above, that you need to receive education and training, and furthermore proove proficiency on any equipment you use. This is what I meant by operating out of your scope.

... Regardless of the simplicity, NO ONE should be using any piece of equipment they are not trained on, and trained on with documented education. ...

This is what I meant, If you say you are using an NIBP and document as suck, as the platiff's attorney I would ask if you were trained to use it.

The rest of my points were covered by PRPGfirerescuetech