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 ) 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 often have very low bp... and even during routine checkups, nurses and other medical folk get a little freaked out. I've thought about getting one of those medical ID bracelets and having it etched: "Normal systolic is around 80-90."
When I was in highschool, I was extremely athletic and my normal BP ran about 80/40. I had no problems or symptoms with that. I was diagnosed with Grave's Disease at age 19 and at that time my blood pressure ran about 124/80 and it felt like my heart was pounding out of my ears!
Specializes in Med-Surg; Telemetry; School Nurse pk-8.
Was it a manual BP or a reading taken by a Dynamap/portable vital sign machine? I've found more than once technology lies! Throws you into a panic for nuthin'
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.
Doc sounds like a jerk..we've got heart failure pt's with low bp's like that who mentate just fine! I hate when docs act like that. There is a lot of assessing that goes into trying to figure out why the pt may have had a drop like that.
Was it a manual BP or a reading taken by a Dynamap/portable vital sign machine? I've found more than once technology lies! Throws you into a panic for nuthin'
Yeah I've found that too, first thing I do if anything's out of whack is take a manual on the opposite arm or legt if opposite arm is unavailable.
Was it a manual BP or a reading taken by a Dynamap/portable vital sign machine? I've found more than once technology lies! Throws you into a panic for nuthin'
nah, all manuals. She had a wrist cuff in the home but we couldn't get a read with it.
She ended up going by ambulance, getting 750cc fluid en route and arriving at hospital with bp 100/50. Admitted, Dx acute renal failure and dehydration.
) at that BP, but to send her to the ER anyway.
phoenixrn
72 Posts
I often have very low bp... and even during routine checkups, nurses and other medical folk get a little freaked out. I've thought about getting one of those medical ID bracelets and having it etched: "Normal systolic is around 80-90."