Ridryder 911 Posted April 4, 2006 Share Posted April 4, 2006 As long as it is not the evil voices.. Ace... R/R 911 Link to comment Share on other sites More sharing options...
medik8 Posted April 4, 2006 Share Posted April 4, 2006 Okay.. pass the Thiamine around.. oh, heck hang a "bannana pack" for me... :wink: R/R 911 LMFAO!!! =D> Definitely when you hear the beat...oh...and BTW new guys...if you DON'T hear a beat, and due to road noise, equipment, pt. condition, etc...it IS possible not to hear one or for it to be so faint that you don't hear it...try a re-take or let your medic listen. Even if you have to admit that you can't hear it or that you can't get a pressure...please don't make up a number....not good. Not good at all. :shock: xoxo 8 Link to comment Share on other sites More sharing options...
northwindmedic Posted May 24, 2006 Share Posted May 24, 2006 Poor kid, all the mean ol' medics picking on them! :twisted: yep i would too but ya'll said everything i would have i guess the Brady 5 series isn't doing the job anymore Link to comment Share on other sites More sharing options...
emt-b_wa Posted May 24, 2006 Share Posted May 24, 2006 On the topic of blood pressure. I had a pt. yesterday that we were called for a syncopel episode. The report was given that her BP was 210/112 HR 74 supine, 160/92 HR 72 sitting, and when stood up after approx. 15sec she experienced syncope. A BP was taken immediately and it was 60/p HR 74. Now I understand that Pt's. can be orthostatic and one of the biggest causes of that is dehydration but that typically presents with a change in heart rate. Right?? What else can cause this problem. She presented with no other complaints, Resp rations were 16 and she was a healthy looking 68 y/o female with no real medical hx.Any ideas? Link to comment Share on other sites More sharing options...
Ridryder 911 Posted May 25, 2006 Share Posted May 25, 2006 There are several factors that could cause such an event... 1) Inaccurate blood pressure findings (be sure to check both arms) 2) A period of sick sinus syndrome as well any arrythmia, that caused poor cardiac output and maybe has regained itself in pulse wise or I have seen patients in SVT with only a perfusion pulse of 60 and their ventricular rate was 180 and of course hypotension... 3) Poor or bad perfusion/ output.. R/r 911 Link to comment Share on other sites More sharing options...
emt-b_wa Posted May 25, 2006 Share Posted May 25, 2006 Int resting I did a BP on both arms and they were about 10 points difference. Also my medic didn't see anything unusual on the monitor however she did not do a 12 lead Link to comment Share on other sites More sharing options...
chbare Posted May 25, 2006 Share Posted May 25, 2006 Emt-B_wa, look at the third thing Ridryder911 mentioned. Remember that your heart does not instantly speed up on it's own in response to to dehydration, hypovolemia, etc. (does not usually) When you change positions or when your hemodynamic status changes suddenly, baroreceptors in your aortic arch and carotid sinuses detect these changes and alert the central nervous system to these changes, the central nervous system then sends a signal back, either sympathetic stimulation (faster heart rate and vessel constriction) or parasympathetic .(slower heart rate and vaso dilation) Chemoreceptors also play a role in this system, so if you have any pathology that prevents this system from working you may not see the usual signs. Some examples include, cardiovascular disease, diabetes, hypertension, heart transplant, and many other things. This may explain what you saw. Take care, chbare. Link to comment Share on other sites More sharing options...
emt-b_wa Posted May 25, 2006 Share Posted May 25, 2006 Thank you now that gives me a better idea on what could have een going on I will have to keep those ideas in mind. Link to comment Share on other sites More sharing options...
Arachne Posted May 26, 2006 Share Posted May 26, 2006 While this doesn't sound like it happened in this specific case, but if your blood pressures don't seem to make sense for what you see when you're looking at your patient, make sure you were using the correct size blood pressure cuff. If your patient is obese and you're using a normal cuff, your readings can be off. Link to comment Share on other sites More sharing options...
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