using a level 1?

[whatnext]

I'm starting in SICU and have heard a couple people talking about using the "level 1". I haven't had the chance to ask what this is. Anyone know or use this?

Also, how do you obtain a BP by palpation?

[ready4crna?]

What-

A level 1 is a brand name for a type of rapid fluid infuser/warmer. (large amounts of fluid put into a patient under pressure)

B/P by palp. will give you an arterial occlusion pressure roughly equivalent to a sys.bp. Not very accurate, but will give you a ballpark. If you have the time to perform this in an ICU, go ahead and ascultate a real bp. Technique is typically this-

Inflate appropriate size cuff on the upper arm while palpating a radial pulse. When the radial pulse is obliterated, start to deflate cuff and note what pressure the radial pulse returns. Report/record this number as "whatever by palp" ex- b/p is 110 by palp.

Word of caution that bears repeating. If I was your preceptor in an ICU and you came back to me with a b/p by palp, there had better be some seriously extenuating circumstances that required you to obtain the b/p this way.

[whatnext]

Thanks for the info. I thought that was what the level 1 was.

The only reason I wanted to know palpable BP is just for info purposes. I have heard people talk about them. For instance, I had to take a trauma core class (our SICU and TICU are merging in Oct) and there was a case scenario with a BP of 60/palp. Also, my friend use work on a volunteer rescue squad and she would do them that way--I guess in certain situations it might be hard to hear. She never told me how to do them, though ("I'll show you later" she'd say, and we'd forget) and I just thought about it when posting. I figure I probably won't ever do this (have been an RN for over a year now and never had a reason to do this) but wanted to know. Some people that I asked didn't know.

[Larry77, RN]

Info on the Level 1...all the tubing has been recalled and we don't even have a date when they will make more. We had to switch to another brand.

Latest update from the company is we can use the old tubing but we just have to test it before we hook it up to a patient---um no thanks we will switch the brand. If you are using the Level 1, time is of the utmost importance and you certainly don't want to have to "test" the machine.

[K98]

Info on the Level 1...all the tubing has been recalled and we don't even have a date when they will make more. We had to switch to another brand.

Latest update from the company is we can use the old tubing but we just have to test it before we hook it up to a patient---um no thanks we will switch the brand. If you are using the Level 1, time is of the utmost importance and you certainly don't want to have to "test" the machine.

We now have to test our level one tubing prior to use. This means that we must be able to accurately predict emergency use of our rapid infusers. Heh. We will not switch brands until current stock is depleted. If the level one rep shows up with a bigger sandwich ring than the competitor, we will continue guessing (er... I mean "leak testing").