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 don't remember the circumstances clearly, other than he/she was admitted for 3rd degree AVB and bradyed down to 23 at one point, only feeling a "little woozy." The strip we printed out was crazy. I spent a good part of that night watching the monitor to see if there was going to be another QRS on the monitor. Needless to say, he/she went down for a permanent pacer in the morning. MD said they were OK to wait for a reason I don't quite remember...
HR of 33- not feeling great, but walking and talking. Young thing too. She was originally placed into the urgent care section of the ER and then was immediately transferred to another room after initial assessment. Never did get to find out what happened to her.
During my home health preceptorship, we had a patient who's standing BP was 32/22. Sitting, it was 50/32. He said he felt a little "dizzy." Apparently his BP was chronically hypotensive, but never that low. He agreed to go to the ER, but was sent back home a day later. Don't know what happened to him, however I believe he was put on hospice care not long after.
Um myself...on my first day of clinical I felt a little lightheaded so my clinical instructor made one of the other students take my blood sugar and it was 45.
Needless to say, she watched me like a hawk all day and continued to monitor until I was up to normal.
I have had my BGL drop into the mid 30's when I take my Metformin and then don't eat. I get really, really cranky...well, mean, actually.
My mom had a GI bleed with a INR of 7. She was dizzy, but had a good BP with the Fire Department. They rolled her into a regular room, she had a large melena stool, and they transferred her directly to the STAR room. Her BP by the time they were able to get the ART line in was 40 SBP. Needless to say, they initiated their Trauma Blood protocol on her, receiving around 7 units, and a month in the hospital.
Had a pt for the last 2 days in a complete HB - sustained HR in the 40's with several 8 second pauses....kept 1 mg atropine taped to her bed rail and the code cart in front of the door!
Had a pt for the last 2 days in a complete HB - sustained HR in the 40's with several 8 second pauses....kept 1 mg atropine taped to her bed rail and the code cart in front of the door!
Atropine isn't indicated for complete heart blocks! Perhaps this was before that was known?
Not a vital but my mom had been calling her gyn to get an appointnent because of excessive menstrual bleeding. They put her off and off and she finally convinced them she needed to be seen. Hematocrit of 6. Her md was furious at his staff that they hadn't worked her in sooner. He told her if she ever wanted to get in like that again, she was to speak to an rn, not reception, and tell them that lab value.
My mother called me, and said her automatic B/P cuff was recording my stepdad's HR as 35.
I told her to count his carotid pulse, she said she got 35. I told her take him to the ER. He refused, but drove himself to his PCP's office. The doc also got an AP in the 30s. He called an ambulance, and had my step dad direct- admitted. He got a pacemaker that night. His only sx had been feeling tired.
Not a vital but my mom had been calling her gyn to get an appointnent because of excessive menstrual bleeding. They put her off and off and she finally convinced them she needed to be seen. Hematocrit of 6. Her md was furious at his staff that they hadn't worked her in sooner. He told her if she ever wanted to get in like that again, she was to speak to an rn, not reception, and tell them that lab value.
RN_jess
20 Posts
I don't remember the circumstances clearly, other than he/she was admitted for 3rd degree AVB and bradyed down to 23 at one point, only feeling a "little woozy." The strip we printed out was crazy. I spent a good part of that night watching the monitor to see if there was going to be another QRS on the monitor. Needless to say, he/she went down for a permanent pacer in the morning. MD said they were OK to wait for a reason I don't quite remember...