- do you check the map every time you take bp? why (& what floor do you work in)?
our monitors display the map with every bp in our pacu.
2. do you report if map is below 60? how much below would warrant a call as opposed to further monitoring? how about if pt is asymptomatic?
the pacu is probably somewhat unique in that temporary changes in vs are expected. i will report considerable unexpected changes from the patient's pre-op, intra-op, and admission to pacu vitals. if the patient is asymptomatic i might give more fluids, provide stimulation, and recheck the bp. always consider the patient's baseline and report significant changes.
3. could a map be considered too high? at what point?
this would be patient specific. for example, if your patient just had a cardiac or vascular surgery you're going to want to keep the map in a somewhat narrow range.
4.what was the lowest/highest map you have seen? how was the pt and what did you do?
the lowest is 0. obviously resuscitation was attempted.
if it is low you will need to figure out why it's low (hypovolemia, sepsis, whatever) and treat approrpiately w/ fluids and/or pressors. if the patient is pulseless start cpr absent a dnr order.
i don't recall the highest map i've seen. i guess in the 150s. i medicated the patient for severe pain and also administered labetalol to bring him back down to his prescribed parameters. he did fine.
5. what else can you tell me about the map?
remember that it's a measure of blood pressure--you know what to do for low bp and high bp. some variation is to be expected. pay attention to baselines. "normal" values may be bad values for someone whose baseline is not normal and reflect a significant change in status.