Do you trust automatic "vitals" machines?? - page 5

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... Read More

  1. by   Polly Dipcya
    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.
  2. by   NoMoreStudying
    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.
  3. by   jmeador
    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".
  4. by   vampiregirl
    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"!
  5. by   chadash
    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?
  6. by   Indy
    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.
  7. by   Patti 2nd gen RN
    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....
  8. by   cajunnga
    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.
  9. by   Franksters
    I encourage my nurses, especially new nurses, to manually check any VS that is high or low. When I worked in ICU I checked all my readings manually. Machines are good but nothing can replace good ole nursing judgement.
  10. by   NaomieRN
    If the automatic vital machines are so inaccurate, why do hospitals still use them?
    According to most of you, these machines are not reliable. Maybe the hospitals should be made aware for the safety of the clients, to go back to the manual way to take vitals. I personally think if these machines are use probably they will do the job right. I use them at the hospital where I am working as a nursing student tech. So far, they are accurate. I always make sure to use the right size cuff and put it the right way. The nurses usually get similar readings when recheck manually. If you having out of wack readings, maybe it it time to alert the supervisor of the problem.
  11. by   Sheri257
    Do I trust the machines? No. But when I was an aide with 10-13 patients ... I had to use them because the RN's would get really PO'd if I didn't get the vitals in on time.

    Besides, the manual BP cuffs at the hospital didn't always work either. So ... if the vitals seemed really off I'd do it manually as much as I could with my own cuff.

    Last edit by Sheri257 on Feb 18, '07
  12. by   climberrn
    Totally didn't read all 7 pages of this but in my old hospital you COULDN'T check a BP manually. The hospital didn't have manual cuffs. One time I couldn't get our monitor to get a reading on a kiddo, did everything trouble shooting I could do, looked for a manual cuff and there wasn't one in the entire floor. Couldn't believe it.
  13. by   pcicurn7
    I trust the dynamaps, they are usually pretty accurate. However, the machines are most definitely not a substitute for assessment. If you get a set of abnormal (or even just "funny" vitals), you should not think twice to repeat them manually. However, in my experience, the machine is usually not that far off.

    We used to have tympanic thermometers...yeah, that didnt last long. They are garbage. I'd sooner do an axillary temp.

    As far as sats go...I learned the hard way (i wasnt even in nursing school then)...i had an 18 month old patient who typically gave me sats in the 80s, and one day he came in and i could not for the life of me get a sat or BP (he was most 18 months old do when they come to the office). So, i hooked him up to the ecg machine, and lo and behold...he was in full SVT, tachying away at 300+. Lesson learned. Now i do a quick little look over before i take vitals...then i continue assessing based on what the vitals say (to make sure it all makes sense...)

    Like i said...dynamaps are great, but not a replacement for assessment.