Before posting this I tried searching google and allnurses forums but I wasn't able to find answers to my questions so I hope you guys can help! (What happened to the search function anyway, or did I go blind?)
2 questions:
1) I recently had a pt with BP of 124/48. She was fine, no concerns. However, I haven't seen a dbp that low and asked a fellow nurse when dpb would be considered too low and something to contact the doc about and she said she didn't know and to judge it by how the pt was doing.
I didn't pursue the question because we were pretty busy, the pt was fine, and I wanted to do some research later on.
I know that we should be considered if the sbp is below 80 or sometimes 90 depending on the pt - is there some kind of parameter for the dbp?
2) What was the lowest dpb you have seen and how was the pt doing?
I have seen very athletic people w/ bp 90's/40's, and heart rate 46-56 at rest. No problems.
For many years, I ran 100-110/50's without problems unless I jumped up from a lying position, and then my head would swoon momentarily. Also, I could not be the catcher on a softball team that I was on because I could not squat then jump up without getting dizzy.
Just yesterday, was 108/48 about 4 hours after my BP meds! I felt just fine.
As it has been said, it is all dependant on the entire picture.
Specializes in Trauma Surgery, Nursing Management.
Mine! I was exhausted for about a week, had orthostatic hypotension and felt like I was going to faint all the time. Finally dragged my sorry butt to the doc and my bp was 50/30, HR 43. Turns out I had adrenal insufficiency.
I've had a BP of 135/35, once in my late teens; I wasn't feeling too good, but I was coming down with a viral infection at the time.
I routinely see post-anaesthesia patients with low BPs, and kiddies can show 70/30, but it shoots up when the patients wake up fully. I usually check the MAP, if it's stable over 60, I'm happy.
Specializes in Emergency, Critical Care (CEN, CCRN).
...Yes, I've seen zeroes over zeroes before, and I recall one or two of them that we actually got back. The 62/32 lady was the lowest that was still awake and oriented. She made it too, by the by.
emtb2rn: I've heard horror stories about variceal bleeds, and other contemporaries of mine have had those patients; I just haven't had the luck (?) to be on caring for one. The worst hemorrhagic low I've seen was an 82/48, in a guy who'd been run over by a truck and had his leg basically pulped from mid-thigh to mid-calf. He got four liters of .9, eight units of PRBCs, four units of FFP, and one very fast chopper ride to the local Level I. Lost the leg, but lived.
I was 61/23 one time... Saw that just before I passed out. I had told my coworker in triage I am hot, I need to lie down and I think I'm going to puke as the BP monitor went off. Next thing I knew I was laying on a stretcher in the ER hallway...
My XYL regularly posts a 60-70 over 30-35 after dialysis. She'll be sitting up talking, smiling, and completely asymptomatic. It drives the nurses and techs at the clinic absolutely crazy.
Mandychelle79, ASN, RN
771 Posts
my BP has been 60/40 before, felt like crap, ended up in the ICU for the night. I was in anaphlyatic shock from a bee sting.