Do you trust automatic "vitals" machines??

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At our hospital the CNA's use "robo nurses" to take vitals. It is relatively fast for them, taking BP and pulse and o2 sats at the same time. However the more I work, the less I trust them. It seems like one night the CNA reports all my pts. BP's are up, another night they are low. Or they can't get the machine to work. I take them manually to check. Sometimes I agree with the machine, sometimes not. Also the pulse ox seems weird. It will often show lower sats then the hand held machine.

When I was in RN school we were told to not use these machines, but the BP cuffs in the rooms are not always in good shape either. I do prefer to check my pts. pulses on both sides during an assessment if I can and at the same time I can accurately check respirations.

What do you all think about these machines? Does your facility use them???

Thanks for the machines, if you would have to do manual blood pressure in critical care unit, if will take up all your time, especially if somebody on pressors and you are checking vitals every 5-15 minutes.

We usually recheck BP manually if reading is abnormally high/low or inconsistent with the trend. I personally never caught the machine lying.

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Specializes in Rural Health.
Techs do blood draws, catheters, dressing changes, blood sugars . . ?!:confused:

I read this occasionally and it still makes me shake my head . . . . what do nurses do then?

Our CNA's do vital signs with a machine and baths and beds and ambulate patients but they do not do what I consider a nurse's job . . .

Amazing the differences in practice . . . .

oh, the op's question . . . . for the most part, yes I trust them if they are used correctly. I always recheck if it seems inaccurate . . . by looking at the patient and assessing the patient and not relying on a machine, as Tim said.

steph

As a tech - I did all the above as well with 12-18 patients. Great experience, hell work though - VERY tired after 12 hour shifts as a tech. Sure the RN's would pitch in, but they were busy with their 5-7 patients as well. And where I work we don't have LPN's anymore, so techs have had to learn to fill in the role of the LPN and techs have a very expanded role than they did say 5 years ago when they used LPN's. Great experience for a NS student though.......

To the OP, no I don't trust those machines - I didn't when I was a tech, still don't now as an RN. Sometimes it's operator error (you can only use a child size cuff on a child or a very small adult) but my patients are mainly in A-fib so the Dynamap is pointless.

And I've seen some crazy places that people put pulse ox's at to get a reading...what is scary though - a reading must take place on the area the probe is designed for. If you get a finger probe and place it on the forehead, that is not an accurate reading and a defense attorney will tear you to shreds if it ever came to that. We had some staff get fired when g-ma had sats in the 80's, was hypoxic and the RN and RT placed the probe on the forehead to get a sat in the 90's. Didn't call the doc, didn't get ABG's, just left it on the forehead and went about their day as normal because g-ma had sats in the 90's now. That's when we learned that was a big no-no. G-ma died, doctor was angry, it just got very ugly.

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Specializes in ICU, telemetry, LTAC.

Good gravy. Yah, if I have to put a probe on a forehead, that person's heading to ICU. I'm not interested in how well they perfuse their head, 'cause the body does that right up until the end.

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I'm not yet a nurse, but I know that for me at lest, the auto BP machine's ALWAYS up my bp. I've also had them mess up, and acutally bruise my arm, because it kept retaking it, and squeezing the crap out of me. I told the nurse that this was happening, and she said "Oh that's normal" I said, "I've had my bp taken MANY times, and never once has it felt like this" She said "It'll be over soon", it beeped, she took off the cuff, and well I hope next time she will listen when someone tells her something isn't right...

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Specializes in Physician office, Hosp, Nursing Home.

To me the most unaccurate device is the tympanic thermometer. Especially on children. I don't know how many hypothermic (according to the readings) i've had when in worked in a family practice clinic for over 10 years. Yes they're fast but very inaccurate... M aybe i'm old school but i like the old fashioned glass thermometers.

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When the machines are being difficult and taking forever, only to yield the dreaded (###), I could certainly do all of my vitals manually a lot quicker. But I've rechecked some manually that originally came up very high or low on the machine and it was pretty close, within 5-10.

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I worked at a University Hospital as a Senior Nursing Associate. When we were checked off in the lab (at school) and checked off 3 times with direct supervision by a nurse. We were allowed to be delegated blood draws, catheters, dressing changes, sugars, trach drsg changes... But remember it is up to the nurse to delegate these tasks and the should be sure of the competency of their aides. I loved the extra practice and it allowed me to keep my skills sharp. Its a great role transition for new nurses.

Nurses aides technically are not to be assessing pts. but any good nurse knows that you have to contantly assess, assess, and re-assess. So I can see you shock when techs do a drsg change ... "without assessing".

:roll

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Specializes in Hospice.

In regards to SpO2... so many things can affect the reading (nail polish, cold extremities due to environmental temperature, circulation etc...) and the respiratory effort of the patient is also very important. On the ambulance at least though, often it provides another "piece to the puzzle". We try to take a reading prior to O2 administration and then one after O2 has been administered a few minutes, so we have a point of reference.

I still hear my EMS instructor reminding us to "treat the patient, not the machine"!

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Specializes in Nursing assistant.

question: had my bp taken the other day manually by nurse in Doctor's office. The nurse commented "160/100...sounds like it is time for medicine...." the doctor came in and didnt even mention it. Does blood pressure just hop up like that from time to time, or does it need treatment?

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Specializes in ICU, telemetry, LTAC.

Chadash, my BP certainly does hop up there whenever people want to measure it. I had a 24 hour BP monitor a while back and it's wonderfully normal, but you get me in the doc's office and you'll see systolics up near 150's. Apparently I just get a wee bit too excited to have my BP taken.

However, your diastolic being around 100 isn't good. I'd start monitoring it more often and see if it tries to stay in that range. If so, see your doc again and cut down on the sodium in the meantime.

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Specializes in L&D, medsurg,hospice,sub-acute.

At a rehab---many of our older, most reliable nurses aides have difficulty hearing--new VS machines a Godsend!!! But with irreg. HR's, they don't really do well--so certain patients are noted to need manuals--and of course, re-check abnormals manually. And yes, the newer pulse ox's read much better than the older ones....

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Depends, I think sometimes they are accurate and obviously sometimes they aren't. In the ER, triage is supposed to always do manual--L&D--we have no CNA and most of the time, no time to recheck. Obviously if it is out of range, we recheck.

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