Why do some nurses guess on BP?
- 1Jul 25, '12 by Dixon, future NPHello Everyone!
Why do some nurses guess when it comes to taking a blood pressure?
I am a patient, I am a CNA and CNA instructor. When I go to the doctor I do not share this information but it really bothers me when I see nurses make mistakes at the patients expense.
Yesterday I went to the doctor for a physical. I had my blood pressure checked by an LVN, a nurse, I was shocked that he guessed on my blood pressure. It took him about 30 seconds from placing the cuff to reading my BP. He didn't bother checking for brachial artery, stethoscope placement was wrong, blood pressure cuff placement was wrong and in my opinion BP was just a guess based on looking at sphygmomanometer. We all know that you cannot get an accurate blood pressure reading this way.
I tried to be very nice about it by saying my blood pressure is never that high, can you please re take it? He did but he did it the same way as the first time.
Please explain if you know, is reading a blood pressure that hard?
- 4Jul 26, '12 by AeternaTruthfully, once I realized that the brachial artery is pretty much in the same place in everyone, I've stopped checking for it (when I was in my first year of nursing school, an upper year nursing student taught me how to landmark for it and it works every single time). So, I put the diaphragm of my stethoscope in that spot. However, I was taught very specifically to listen for those key sounds (damn, I can't remember what they're called, lol) instead of eyeballing it.
I remember reading blood pressures was the most difficult part of learning vital signs as a student, but once we all had the steps and practice down, it became easy.
- 12Jul 30, '12 by Ashley, PICU RNI agree that it's not necessary to palpate the brachial artery. Placing the stethoscope in the center of the antecubital fossa is sufficient to hear Karotkoff sounds in almost all patients. It's also not necessary to decrease the pressure in the cuff by 2mm of Hg every second, as you're taught in school. I can easily take an accurate BP in less than 30 seconds.
- 3Jul 31, '12 by awalker1015I do manual BPs all day long at work and I can get an accurate BP in less than 30 seconds. If you know what you are doing it is possible. Every now and then I get a tough pt I have to palate the brachial, etc. But generally I can get a quick one and that doesn't mean it is inaccurate.
- 0Jul 31, '12 by Dixon, future NPAs the post stated, placement of key elements was wrong. The 30 seconds was a secondary factor in why I came to my conclusion.
My intent wasn't to find out which Nurse could do a BP in 30 seconds or less but thanks for the insight. One day I hope to be able to do the same and also do it correctly.
I have been doing manual BP's for only 10 years, I have a lot to learn, so I just don't cut corners like I felt this Nurse did. I had no confidence in any of his skills for many reasons this just being one.
- 1Jul 31, '12 by Meriwhen Senior ModeratorQuote from Ashley, PICU RNSo can I. Otherwise I'd be forever in triaging patients.I can easily take an accurate BP in less than 30 seconds.
Can't say anything about the cuff placement as I wasn't there.
Just because the LVN was looking at the sphygmomanometer doesn't mean he also wasn't listening for the Karotkoff sounds. I look while I'm listening so I know exactly what the BP reading is. Again, I wasn't there--nor am I him--so I can't say for certain whether he was listening. But looking at the sphyg alone does't automatically designate it a bad BP reading.
Ironically, I can't look at my watch while taking a pulse--I have to look at the wall and glance at the watch periodically.