What's the craziest vitals you've seen on someone who lived?
I've not seen too many extreme situations, but the ones which stand out for me are:
BP - 60/35 - postpartum hemorrhage, recovered with blood transfusions
SPO2 - 40% - young MVA. Turned a really interesting shade of blue-purple. Patient stabilized and continued to live, comatose, but my shift ended then, so I'm not sure if he ever recovered.
HR - 38 - Michael Phelps at rest! But seriously, what's the lowest you've seen in a *normal* person?
RR - 40-60, continuous, despite numerous respiratory interventions. Patient unconscious and remained alive through my shift to the surprise of everyone.
When I was a critical care clin spec in the ICU we got a transfer from the med/surg/tele floor of a guy who kept dropping his heart rate to mid-20's whenever they moved him. When he rolled in and we were getting ready to slide him over to the ICU bed I reflexively said (hah!)(there's your hint!), "Don't hold your breath." He said, "Nobody ever told me that before." He didn't, and he did not drop his heart rate. BINGO. The power of the vagus nerve.
They did give him a backup pacer, but he never did it again so long as he remembered not to Valsalva. And nobody, including his docs, figured that out until I did. (Prolly cuz docs are rarely at the bedside when monitored patients are being moved, so they don't know to tell them not to Valsalva. Hah.)
BP of 56/38. Heard the nurse telling the paramedic who was transferring me from the outpatient infusion center to the hospital (ended up in ICU) after a severe anaphylactic reaction to an Iron Dextran infusion. Very scary as a RN to hear that about yourself. I remember in this light-headed, dizzy, about ready to pass out fog thinking, "Oh (blank)! That's not good."
I was hospitalized a few years ago for a TIA. I also have type 2 diabetes but at that time it was diet-controlled, no meds. One afternoon I told the CNA I was feeling a little light headed. She checked my blood sugar & it was 26! Still not sure how I was conscious at that point.
Hm, lady was in the 30s heart rate. Then we made her 160. Then she went into 90s with different rhythm changes. Then she was slowly going down but was at least sinus now with high ST elevation. She was in cath lab with 60s and ended up on the floor.
Pt. with a blood sugar of 29, totally awake & alert, asymptomatic. He said "I thought it might be a little low. I was going to ask to have it checked next time somebody came in."
My systolic BP hangs out in the low 90s. During nursing school I had a vasovagal syncope event (which causes both HR and BP to plummet), and my clinical instructor took me in a wheelchair to student health. Laying down my BP was 60/30 and my HR was about 55; I distinctly remember looking at the monitor and thinking, "Huh, why won't my heart rate go up to compensate?"
Then the student health nurse tried to sit me up for orthostatics: systolic BP went into the 45s-50s. I turned to her and said, "Nope," laid back down, and passed out.
Um, my own? We had baby #3 turned from breech position. After the turning, I was aware of lots of activity in my room. I remember looking up as anesthesiology was coming at my IV with a syringe. I asked what it was for and he just said "your blood pressure" I said "I think it's low". He said "understatement". My MD said it was 40/22. My DH was scared crapless (we were both EMT's at the time, we had a basic understanding of what a BP like that meant, LOL!
Momma1RN, MSN, RN, APRN
219 Posts
230/120. HR 32 in a woman who was paced. V lead wasn't capturing... her pressure was like 70/45 too.