Parameduck

What setting do you work in? If you need a BP in a pinch and it's noisy, consider palpating one. It doesn't give you a diastolic pressure (or even the exact same systolic BP as auscultation), so it's probably not good for obtaining routine BP's.

Interesting discussion so far. I'm interested in a different aspect of the issue: Why is your DON insisting that you deal with the issue? You may or may not have run into this issue yourself as a paramedic, but I know I'd be setting myself up for disciplinary action if I called up a nurse in order to settle an incident. Normal procedure in all of my past agencies (volunteer or paid) would be to notify a supervisor of the incident and let it go from there. I can't imagine a scenario where I would be told to just handle it myself. That doesn't seem very supportive. Even an EMS supervisor would have a chain of command to utilize when on-scene attempts fail to work out a disagreement. It must work a lot differently as a nurse.

Sounds like fun! Good luck on your big exam.

OR2CA, This is good information that you've posted, but how does this knowledge translate to what you would see on a rhythm strip for a patient with an AV block?

I love my Littmann Cardiology III, but I would sell it if I thought I couldn't bring it to work and use it. No sense in spending all the money and leaving it at home.