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how hard is it to take a BP????

Posted

So last night in the ED during a trauma alert with a pt who had gotten punched in the head and was post ictal I was trying to get a BP because the automatic was coming up 198/100.... well, I wasn't able to get it, after trying several times and getting more flustered because I could hear all the docs telling me to pump the cuff higher, did I get it yet, the trauma surgeon was like really?? and came over and took it himself... he got 140/70.. I completely cracked under the pressure, I might have broken a sweat. I got so flustered and I had told them when I was trying that it was around 140, and they were like no it's higher, why can't you get it?? I feel completely incompetent that I was unable to get it, in front of all these people. And all I can think is REALLY???? How hard is it to get a bp???? Every time I see this trauma surgeon, I know it's going to come down to the bp!!! Anyone have similar, embarrassing, make you feel really stupid stories???

brownbook

Has 36 years experience.

About once a week, ha ha......it just happens.

I find B/P's can be tricky in normal circumstances.

During an emergency...fergedaboudit. I can't hear a thing....or I hear the diastolic "thumps" all the way to zero....or think I hear one thump at 180 then hear nothing until 90.

Fortunately where I work there are no emergencies. (I don't allow them on my shift, ha ha). We use on automatic machines for B/P's.

I would love to give examples of when I felt like an idiot in front of a Dr.....but fortunately I am old so my memory stinks! (Yikes, you made me remember the last time.....I am trying to scrub the memory from my brain....no patients were harmed though!)

I have this great thing that I do...when I am alone with a patient I am an encyclopedia of nursing facts! A champion of education! When ANYONE of upper hierarchy is around, I am a total dumbass. Take it in stride. Surgeons aren't known for their bedside manner...don't take anything they say personal.

firstinfamily, RN

Has 33 years experience.

Truly, I doubt if the surgeon will remember the b/p incident. He has other things on his mind and should really not remember that!! Yes, embarassing things will usually happen with VIP's are present. Just maintain your cool, try to look professional and do your job. Hey, sometimes it is hard to get a B/P. I don't always rely on the automatic cuffs. I don't know if hospitals still carry the manual ones, but you might want to invest in one for yourself to use. If I cannot get a correlated B/P with a manual cuff I usually call in a co-worker and ask them, maybe my ears are off??? Don't fret, there are many more embarassing things that can happen. As long as there was no harm to the patient, you were fine. When you have an intense event happening and you are afraid you are going to lose your cool, take deep breathes, in and out, rhythmically. Learn how to continue to perform your duties even under stressful situations, using imagry may help. See yourself doing the task, picture it over and over and whala it will happen. Learn what to be looking for and anticipate what to get excited about and what treatment should occur. You will become an old pro before you know it!!!

Been there,done that, ASN, RN

Has 33 years experience.

There are MANY variables involved while obtaining a BP.

In this case .... the almighty trauma surgeon needed their BP to be taken.

Don't fold under the pressure... look them in the eye and tell them to give you a minute to auscultate the correct pressure.

I am not surprised that traumasurgeongod...got a 140/70.... whose to say his/her was accurate?

K+MgSO4, BSN

Specializes in Surgical, quality,management. Has 12 years experience.

Pfft...... the surgeon would of forgotten all about it.

Thank you all for responding!!! Just needed some reassurance, that it really is ok! I'm new at this job, and still meeting people, and just really hate to look incompetent.. I really want to be one of those nurses that make it look easy... how do they do that???

... how do they do that???

They do it after making tons of little mistakes just like this one. At least that's what I try to tell myself when I succeed in making goofy mistakes (which seems to be all the time.)

Sometimes it's just difficult with that patient too. Barring all noise, some patients are an anomaly. I had one guy who had very differentiated korotkoff sounds. His last sounds were so light and wooshy and I couldn't hear them from ~64mm HG to ~40mm Hg as my instructor reported (listening along).

akulahawkRN, ADN, RN, EMT-P

Specializes in Emergency Department. Has 6 years experience.

There really is an art to taking manual BPs. While the mechanics aren't all that difficult, you have to know the sounds and you have to know the anatomy. Then you must get experience doing it manually. Then to top it all off, you have to have confidence in yourself that you can get it even under stressful, noisy conditions. I'm a Paramedic. The vast majority of BPs I did were manual. Conservatively, I've done >20,000 over a period of a few years, and most of those were done in the back of an ambulance while it was moving.

You can imagine that I'm quite confident in my ability to get BPs at this point. Personally, I consider auto cuffs to be a luxury. Sure, it's nice to have, but know how to do the manual method just in case your machines give you an odd reading, become miscalibrated, break, or the battery dies.