Back to basics

[marjoriemac]

Just wondering, if you checked a BP with an electrical device and it appeared very low but the patient was looking fine and talking etc, would you then check again with electric sphyg or a manual one. A nurse I know checked again with an electric device and proceeded to call an ambulance.... I think I would have double checked with a manual device as electric devices are prone to faults, especially since the man looked fine, was talking and laughing etc. Incidentally BP recorded on elctric as 80/40

[MNmom3boys]

You could even start w/ rechecking cuff placement and tightness and then rechecking w/ the machine. Just last week, in each set of vitals taken by the CNA on a particular pt. the BP was consistently low, but when I took it again with good cuff placement it was WNL.

(BTW - I did also check manually. Pt. had "floppy" arms - my guess is CNA was being too nice and not getting the cuff tight enough, which would have also impacted any manual numbers.)

[Chaya, ASN, RN]

I would definately recheck manually plus on the other arm if OK to do so, and help pt back into bed. Also if pt asymptomatic would encourage PO fluid intake and retake pressure again in 15-20 minutes.

[Dolce, RN]

If the patient is moving while the BP cuff is deflating the numbers can get really thrown off. I was chatting with a patient whose BP measured 40/27. I don't think so! Always recheck a BP manually on abnormal numbers. BTW, that's pretty weird to call an ambulance for ONE BP of 80/40 without even rechecking it.

[BlueRidgeHomeRN]

. another thing, you treat the patient, not the number. you're right.

i still trust my ears, eyes, and hands over most machines!

[lovingtheunloved, ASN, RN]

I hate electric cuffs. I don't allow my CNAs to use them. For instance, I had a little old man who had diarrhea and vomiting all morning, refused to drink anything, and the electric cuff said his BP was 206/140. Right. My CNA came running to tell me, I went and checked it, and lo and behold, his BP was actually 90/46. I've had several very high or low results, only to check them manually and find out they were normal.