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.
I had a comfort care patient who was breathing about 3 bpm. I told the family I felt certain he would die that night on my shift. He lived for nearly a week. Man did I feel like a jerk when they were standing vigil all that time. We were passing him off back and forth between shifts continually shocked when we came back and he was still there and continually thinking we'd be the one going downstairs.
These are not the same patient...but these are some of the lowest I've seen in people that continued to live. I have worked Oncology and it was pretty common to get some abnormal v/s and sometimes have to treat the situation or symptoms. For some people, abnormals are expected for a while.
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 always heard that about Iron Dextran...that it was one of those things people react to. But I never had anyone react, thankfully.
When I was in the hospital, the techs would freak out when they would take my blood pressure and see 70s/30s. Of course they would take it when I hadn't even gotten out of bed yet. Still alive!
My "working" BP is around 90-100/60, so there were a few cases I had it 50/30 when I had anaphylaxis and still was there and even talking some sense:yes:. I even had to put in my "allergy card" and medi-alert a plea not to push it above 120/80 because I feel like crap when it comes above 130 systolic.
Mine usually runs around the low 90s/60s. I freak the nurses out when I go to give blood because it usually drops a lot lower than that. Though last time, their machine wouldn't register my bp so they wouldn't let me donate at all. :/
I had a dying patient once whose BP was less than 60/40 for four hours before she died. I kept expecting her to just go ahead and die because most people I've seen drop that low don't stay there for long. I also had a patient recently who was perfectly A&O, just very nauseous, when a pressure cycled at 45/33. Most people aren't still awake for that.
I work on a dialysis unit. BP's can fluctuate pretty rapidly on my floor. I have a had a few 60's/30's. The lowest I have ever had was a completely asymptomatic pt who's systolic was 52. We used a Doppler to get the systolic, so no diastolic was known. As we rolled down to CCU, he was asking if he could have a sandwich once we got down stairs (frequent flyer). He lived for 4 more days on 3 pressers not going above 76/48. They all told me he was talking until he just wasn't anymore. I also had a pt who was 58 on systolic with a pulse of 48. The new tech we had come running out of the room and asked me to come recheck a manual. As I walk in to the room the pt was asking over and over, "Am I going to die?" My response was simply, "Not on my shift!" (It was 6:45 all I had to do was clock out at 7!)
Specializes in LTC, assisted living, med-surg, psych.
My husband was in the hospital and feeling a bit lightheaded when the nurse decided to check a blood glucose. It was 29! And he was alert, oriented and talkative. His average fasting BG is around 65. He is asymptomatic until he drops into the 40s. (Me, I'm on the floor at anything below 60.) Amazing, but also scary!
Oh, and here's a personal highest WITH interventions - had a patient last week who became NPO after coming off the vent because of problems with aspirating. She was A&O and refused a NG tube for a few days, so she started missing her PO blood pressure meds.
When I got on shift, she had a 220/110ish blood pressure while she was maxed out on a nitroglycerin drip and a cardene drip and the day shift nurse had just given 20mg of PRN hydralazine not 30 minutes before! Her maxes were 100mcgs/min of nitro and 20mg/hr of cardene. I had to call the physician to get new maxes for the drips and additional PRN IVP meds to get her pressure down.
Oh, and she was wearing a clonidine patch while all of this was happening.
It's just unbelievable how bad some people's hypertension really is. I wonder what I would have seen if the drips were off - 400s?
Mine usually runs around the low 90s/60s. I freak the nurses out when I go to give blood because it usually drops a lot lower than that. Though last time, their machine wouldn't register my bp so they wouldn't let me donate at all. :/
When I was in college I went to the Red Cross regularly to donate-- it was sort of a family tradition. Being a healthy young woman I usually ran a systolic in the 80s. After awhile they learned that it was normal for me, and I learned to jog the last few blocks to the center and Valsalva to push up the systolic pressure when the little needle hit about 114. Then I got extra pineapple juice and cookies afterwards. :)
I saw a person whose HR is 38, but he needed treatment. Once I saw a client, and his potassium was 1.1 mmol/L (The normal range is 3.5-5.5 mmol/L). Surprisingly, he did not have any symptom.
blondy2061h, MSN, RN
1 Article; 4,094 Posts
I had a comfort care patient who was breathing about 3 bpm. I told the family I felt certain he would die that night on my shift. He lived for nearly a week. Man did I feel like a jerk when they were standing vigil all that time. We were passing him off back and forth between shifts continually shocked when we came back and he was still there and continually thinking we'd be the one going downstairs.