Do you trust automatic "vitals" machines?? - page 6
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
Feb 18, '07Occupation: Clinical Nurse Manager Specialty: 18 year(s) of experience in TCU,ICU,OHRR,PACU,5Solid Organ Transplan ; Joined: Feb '07; Posts: 57; Likes: 29Unfortunately health care is becoming automated. We use dinamaps, hand held sats, electronic thermometers, etc. My first assessment of the night, I checked all machine readings manually. That way I knew the difference in numbers. I did this every 4 hours. That way, I felt comfortable relying on the quick method. However, I have worked with nurses that were slaves to these machines. If the monitor alarmed VF, it was VFDon't pay attention to the patient sitting up and telling you they are ok. Ok, Ok. That is an extreme example but you catch my drift.
Feb 18, '07Occupation: RN & CRN Tele/PCU Specialty: 5+ year(s) of experience in Cardiac Telemetry/PCU, SNF ; From: US ; Joined: Jun '05; Posts: 306; Likes: 195We use dynamaps and tele-mons on our unit. For the most I do trust, but like have been put out there, if the reading is odd, I'll check it by hand. One thing I did find is that the automated cuffs can have a difficult time getting accurate readings on my afib/flutter patient, especially those with faster ventricular rates.
Machines are great, but nothing like getting eyes on your patient. And when the monitor shows something untoward like VT, we'll be in there in a heart beat. It's bad though, I hear the alarms in my sleep now...
Feb 19, '07Joined: Nov '06; Posts: 3I use the automatic machines, but I also take the intiative to visually check my patients health status. If the vital signs are too high, I do the vitals manually.
Feb 24, '07Joined: Jan '07; Posts: 3The PCT's use "datascopes" but I (I'm an LPN who works in a small hospital)don't always trust them. If someone reports an "out of whack" reading, I ask them to recheck, especially the blood pressures, manually. Sometimes the machines are accurate, and sometimes they're not. I only trust what I hear or see.
Feb 24, '07Joined: Oct '06; Posts: 1,306; Likes: 243Auto BP cuffs will not get an accurate reading for hypotension!
Mar 22, '07Joined: Sep '05; Posts: 937; Likes: 136Quote from FairlythereAt 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 seems like one night the CNA reports all my pts. BP's are up, another night they are low. Or they can't get the machine to work. I take them manually to check. Sometimes I agree with the machine, sometimes not. Also the pulse ox seems weird. It will often show lower sats then the hand held machine.
When I was in RN school we were told to not use these machines, but the BP cuffs in the rooms are not always in good shape either. I do prefer to check my pts. pulses on both sides during an assessment if I can and at the same time I can accurately check respirations.
What do you all think about these machines? Does your facility use them???
i use a wrist one- wasnt so sure of em at first- always checked- one time got a very weird reading like 190 something over 40 something or some such reading - had 4 people including me and the administrator recheck it and it was accurate - so i totally trust them-
i do agree- if the resident is moving around it shoud b rechecked ( even with regular ones i would cause even our hearing can miss it with movement or noise) - i do a monthly chek on the system to be sure it hasnt been dropped or broken somehow cause i let others use it - and i make sure to show my aides HOW to use them as if they dont use em right they get bad readings also.
Mar 23, '07Joined: Sep '05; Posts: 937; Likes: 136Quote from dali92when i see the tympanic ones not reading what seems accurate i have noticed ( even my own doctors nurse i had to "educate" on how to use it) - one can not just tuck it in the ear and expect an accurate reading - one needs to tug gently ( lol tug may be wrong word lol) to open the canal so the heat sensor can read where it is suppsed to be reading ) at leas that is what i was taught - up and back for adults down and back for kidsAutomatic machines are used in the OR- & where I work, these are the same machines we use in PACU & in ICU. When we have a patient w/an A-line- and this depends on positoning too-- it is very close to what we get on the automatic machines, so yes, I trust them!!! I asked one of the CRNAs once what they did years ago-- he said they used to have to take every BP manually in the OR- AND w/no Sa02 monitors they were watching their patients VERY closely-- this was also in the days of ether! I would say if you're getting all high one shift and all low another then you need to look at the technique of the people taking them, and whether or not your machines are regularly maintained to function optimally. What I DON'T trust are the tympanic thermometers!!! I have heard the temporal ones are more accurate, but that's what they used to say about the tympanic ones. (the mercury ones were alot more accurate but not as quick)
Mar 23, '07Joined: Sep '05; Posts: 937; Likes: 136Quote from Fairlytherewhen my grandfather was passing on i was in hospital with him- the RT came in for a sat and he couldnt get a reading - i said here use this hand ( the one i had been hoolding that i had been wiping periodically along with his brow ) cause his other hand was on the other side of bed and under the covers yet cool and clamy and i said that may be interfering as the reading relies on circualtion so i thouht - he said that isnt the problem it just isnt working - he never did come back to get one with a "working" unit - the nurse said he wined about my voicing up to him and the nurse let him know that i was a nurse and just might have a clue to what was wrong - the nurse came in washed his hands - dried them - warmed em ( whilke washing them up ) and did get a sadly low sat -Oh I wasnt talking about the OR and PACU vitals which are hooked up to monitors and I am sure are VERY accurate! I was indicating the rolling "robo nurse" that the CNAs wheel from pt. to pt on the floors.
Thanks everyone, I will definately bring up the contamination factor and the idea of indiviual cuffs per pt. that could be cleaned by CS in between.
I cant count the number of times an aid has come to me with a low pulse ox reading and they didnt realize the machine needs certain perameters to read correctly, like a good pulse.
Mar 23, '07Joined: Sep '05; Posts: 937; Likes: 136Quote from chadashcan - called white coat syndrome- some folks get really high when going to docs ( me im opposite - i get lower at doc- we laugh cause its the only place i go without kids and or stress LOL)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?
at the very least the doc shoudl have redone it an of still high recommend you come in for 2 or 3 sepearate VS visits - as high b/p is actually diagnosed on continuos high b/p not just one incident here and there.
Mar 23, '07Joined: Sep '05; Posts: 937; Likes: 136Quote from FutureNurse35proper education on how to use them is a must and yes- they do need to be double checked for accuracy in my opinion at least monthly in case of droppage or anything that coud cause it to go awry - ( i had one cna who told me days later she dropeed my cuff - told her i wasnt mad - accidents happen especialy on our wing where we have combative people but necxt time to please tell me right away so that we can double check to be sure it wasnt broken or whatever.)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.
Mar 23, '07Joined: Sep '05; Posts: 937; Likes: 136Quote from climberrnthis happens way to often - in geriatrics its never having a big or small cuff ( which need both, rarely is the "regular" one the right size lol) though expensive- i invested in all my own equipment - have electronic and manual - and i also feel better cause i KNOW they are correct ( i check them often) and they are clean ( i make sure they are on my own time)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.
i even carry my own thermometer ( use thier covers - lol i dont feel i need to supply those also lol) cause the last job i jhad had 2 thermometers that worked for 4 wings- umm yeah - that was a joke.
i even get laughed at cause i crry my own handheld pedal doppler - lol - love ebay hahaha. dont have oone in the nursing home - but they were gla i wsa working one day - they ctually had to use it.
Mar 3, '08Joined: Mar '08; Posts: 2Quote from berryI never liked the auto vitals machine. I have seen way too many errors,In controlled trials automatic NIBPMs perform constantly more accurate then manual auscultation. I will add this involves proper size and placement of cuff. If you have frequent errors (everybody's pressure is up or down) it is far more likely operator error than machine
Remember the trials are controlled. What unit these days can duplicate a controlled trial's methods?
Mar 3, '08Joined: Feb '06; Posts: 33; Likes: 6Hello, Although the machines are quick, I do not think they are reliable. This is a good question to ask us.