Lowest BP?

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Specializes in WOC, Hospice, Home Health.

So...

Patient today had a BP of 70/40 when therapist was in home around noon. Notifies PMD who says to call cardiologist. Notifies cardiologist who says to call PMD. Patient gives up and doesn't follow up...

Enter me around 4. BP low low low. I'm getting 66/36, 64/36... called and spoke to on call PMD who promptly tells me that he doesn't believe those bp readings, as she would not be "mentating" (exact words- I have never heard the word mentating before :confused:) at that BP, but to send her to the ER anyway.

Out of curiosity- what's the lowest BP you've ever seen on someone who was still conscious? I've had quite a few patients undergoing chemo, as well as octogenarians, who like to flirt with 70/40 to give us a scare.

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So...

Patient today had a BP of 70/40 when therapist was in home around noon. Notifies PMD who says to call cardiologist. Notifies cardiologist who says to call PMD. Patient gives up and doesn't follow up...

Enter me around 4. BP low low low. I'm getting 66/36, 64/36... called and spoke to on call PMD who promptly tells me that he doesn't believe those bp readings, as she would not be "mentating" (exact words- I have never heard the word mentating before :confused:) at that BP, but to send her to the ER anyway.

Out of curiosity- what's the lowest BP you've ever seen on someone who was still conscious? I've had quite a few patients undergoing chemo, as well as octogenarians, who like to flirt with 70/40 to give us a scare.

I've definitely seen 60s/30s in a pt who was still conscious, but symptomatic. The term "mentating" is used often where I work. It basically means no change in LOC.

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Specializes in WOC, Hospice, Home Health.
I've definitely seen 60s/30s in a pt who was still conscious, but symptomatic. The term "mentating" is used often where I work. It basically means no change in LOC.

She was symptomatic, very shakey, lightheaded. And now I have a new word to add to my medical vocabulary :)

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I wonder why the MD didn't believe the numbers? Did the patient go to the ER? Just wondering if they got similar BP readings there?

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Specializes in Oncology.

I've seen 40/20s and such on septic people. Not very conscious at that point. Pressors, here we come!

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Specializes in WOC, Hospice, Home Health.
I wonder why the MD didn't believe the numbers? Did the patient go to the ER? Just wondering if they got similar BP readings there?

She did go. I'll be checking later on!

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Just today I had a patient who was 70/50. Asymptomatic and up and walking around in the room (the tech walked with her in case.) They had increased her heart failure meds today and gave her some IV lasix. I find it somewhat surprising the PMD didn't believe you! Did this patient normally run high? Or did they tend to run in this range?

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Specializes in Emergency, Trauma, Critical Care.

I had an asymptomatic pt 40/15. Retook BP multiple times on both sides. Had to start her on some vasopressors.

People don't always fall into the categories of what we would expect.

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Specializes in WOC, Hospice, Home Health.
Just today I had a patient who was 70/50. Asymptomatic and up and walking around in the room (the tech walked with her in case.) They had increased her heart failure meds today and gave her some IV lasix. I find it somewhat surprising the PMD didn't believe you! Did this patient normally run high? Or did they tend to run in this range?

It was the first time I'd seen her, from her chart she usually ran much higher, 110s-130s systolic. Honestly, I just think the doc was a rude guy- interrupted me halfway through telling the situation and what not. My jaw was hanging open when he questioned my reading though.

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Specializes in Med/Surg.

30/16 on a patient in adrenal crisis. She was DNR and didn't want to be given high doses of steroids. I was really afraid I was going to lose her during my shift as this was her pressure at 1930 as soon as I got on but because of her code status they did not want to have her transferred to tele or ICU, so I had to try to manage her pressures while caring to 4 other patients, she was completely asymptomatic. Thankfully, by the time I left in the morning her pressure was back to 114/74 and as I understand it she went home a few days later (she had some other issues going on as well)

ETA I've seen a lot of post-dialysis patients 60/30s that are asymptomatic and don't understand why we are all fussing around as they think this is perfectly normal for them.

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seen those numbers many times on people up walking and talking. i work with an er doc who says that her bp normally is 70's/40's. what i always want to know is it they are symptomatic.

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Specializes in Home Health CM.
seen those numbers many times on people up walking and talking. i work with an er doc who says that her bp normally is 70's/40's. what i always want to know is it they are symptomatic.

That's a good question. Wow! With a BP like that, her MAP would be around 50 ~ just barely under what it takes to get adequate perfusion to the vital organs. I wonder how she can endure that long term. Seems like there would be some kind of organ damage or compromise.........of course my husband, who has a congenital heart defect has ABGs in the 80s and is walkie talkie. Amazing how the human body will try to adapt to maintain homeostasis........

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