heart rate 40 ,SBP 60, for over an hour

Specialties Cardiac

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JettRNurse

25 Posts

Specializes in Telemetry, Psych.

Sounds like you did the right thing. IVF's are a solid choice, and continuously monitoring, which it sounded like you did. The only thing that comes to mind is the documentation. "Physician notified re: bradycardia and hypotension. MD aware, no new orders given. Continuing to monitor the patient." Also as was mentioned, asking the MD if they have considered an EP consultation is a great idea.

BuckRN

55 Posts

Did your BP monitor tell you the MAP? The patient could have been fairly asymptomatic if his MAP was still 60 or above. MAP is generally an important reading in ICU, but is often forgotten about on other units. I've gotten several patient on pressure supporting meds due to telling the MD that I calculated the MAP and it was less than 60 and I was concerned that even if the patient was asymptomatic at the time, a prolonged time of a MAP less than 60 means vital organs are not getting perfused.

As someone with vasovagal syncope, this is an interesting thread to read! My first episode happened at home. I thought I was having a heart attack. Thank goodness my husband was home and called 911. Paramedics came and never could get my pulse or BP since both were extremely low. It wasn't until the ambulance got me to the ER that they were able to get my VS. I was completely out of it, lost bladder control, and remember feeling like I was floating outside my body watching what was going on. After 2 days in the hospital and all sorts of tests, I was cleared by my cardiologist and neurologist. I periodically have "episodes" but I've learned to recognize the signs and do what my neurologist told me to do: lay down and put my feet up no matter where I am. I've done that in Target a few times (their lights will sometime trigger an episode) as well as the mall and the grocery store.

Little_Mouse

146 Posts

Did your BP monitor tell you the MAP? The patient could have been fairly asymptomatic if his MAP was still 60 or above. MAP is generally an important reading in ICU but is often forgotten about on other units. I've gotten several patient on pressure supporting meds due to telling the MD that I calculated the MAP and it was less than 60 and I was concerned that even if the patient was asymptomatic at the time, a prolonged time of a MAP less than 60 means vital organs are not getting perfused.[/quote']

Good point. Honestly, MAP isn't really emphasized working on my unit (med/surg)..good to know though... thanks for bringing it up. I usually just ignore that number!

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