Auscultated BPs

[Dustdevil]

The cuff is manufactured with the intended reading to be taken on or approximately on a black mark, not on a white space. If the sound stops on a white space then it stopped approximately on a black mark. If readings were ment to be taken on odd numbers, they would have a smaller black mark on them.

Listen up, young genius. If your watch has markings only on the hours, do the half hours not exist? Did Timex intend me to tell time only on the hour and not interpolate the remaining 59 minutes because there are no lines there?

Use your head for something more than a ballcap rack.

[tskstorm]

Oh?? since when?

for as long as i can remember ...

i personally think its ludacris a basic cant get a pulse ox, blood sugar etc... but thats how it is

[tskstorm]

Listen up, young genius. If your watch has markings only on the hours, do the half hours not exist? Did Timex intend me to tell time only on the hour and not interpolate the remaining 59 minutes because there are no lines there?

Use your head for something more than a ballcap rack.

lol ouch ..

[BEorP]

Well maybe I will get in on this... Remember first year chem and the importance of sig figs?

http://phoenix.phys.clemson.edu/tutorials/measure/index.html

"A measurement reading usually has one more significant figure than the least count reading of the scale. The least count of our laboratory meter sticks is 0.1cm and therefore a reading can be made to 0.01cm."

I know that our pressure gauges are only marked in 2 Torr intervals which is very different from a metre stick, but it still adds something to think about.

[Thunderchild145]

Listen up, young genius. If your watch has markings only on the hours, do the half hours not exist? Did Timex intend me to tell time only on the hour and not interpolate the remaining 59 minutes because there are no lines there?

Use your head for something more than a ballcap rack.

That's not a terribly good analogy, as most watches have marks for minutes as well. I'm sure in the booklet that comes with a watch, it would tell you that the minutes hand will take 60 minutes to go all the way around, and 5 minutes to move between the hour marks. We just dont have to read that because we know.

As a counter-analogy, taking an even blood pressure with a manual cuff is like saying it's 12:19 and 30 seconds because the minute hand is between the 19 and the 20. It's just not accurate.

[akroeze]

It's just not accurate.

And rounding up or down is?

[Thunderchild145]

And rounding up or down is?

Rounding an automatic? No. Automatics have the ability to decern that kind of detail though. Me? I'm only human and I can't really tell if it's on the line or the space anyway. For simplicity, it's on the line. But yea, I'd say rounding is not 100% accurate but if your patient dies because of a 1mmHg varience in blood pressure, I would be astonished.

[Dustdevil]

I'd say rounding is not 100% accurate but if your patient dies because of a 1mmHg varience in blood pressure, I would be astonished.

That's exactly my point! If it doesn't matter, why are you so firmly convinced that those who attempt to be more accurate than you are wrong?

I'll tell you what this is all about. Most every EMT-B class I have sat in on or precepted students from had some low-time, undereducated instructor who told them all the same worn out old line about how they would be "wrong" to give an uneven BP reading figure. Nobody ever questioned that instructor, just like he never questioned his instructor before him. And it's a good thing, because none of them had a clue why it was "always that way." The fact is, there is no reason. It's just another one of those stinky pieces of feces that has been passed through the generations without any evidenced based rationale.

It's time to stop the madness and worry about more germaine issues than people who want their numbers to be more exact than yours. If somebody wants to parse the numbers and split the difference, what business is it of yours? One point makes zero difference in my patient care plan. When it comes down to it, you're not telling people how to do it right. You're just telling them how to do it your way. Leave it be. Go spend some quality time with your new Galls catalogue instead.

NOTE: The terms "you" and "your" in the above rant are not meant to address any specific person, but to address all those who somehow think this issue is even worthy of discussion.

[akroeze]

I realise there are more issues than this but let's simplify this.

My protocol for nitro involves BP >100 systolic. If I am reading the white mark as a number then their BP is 99 and I can't give it. If I'm not, I round it to 100 and I give it.

I know that's overly simplified...

[JPINFV]

Of course this entire conversation is even more of a moot point when you stop and realize that must manual cuffs have a margin of error of +/- 3 mmHg anyways. This means that your blood pressure can be anywhere in a 7 mm range (3 in each direction plus the number you got). It gets even worse when looking at a change in BP because that change would have to change more than 6 mm in a single direction (example, starting with a BP of 100, a new BP at 106 is not significant because 103 is within both margins of error. This is an extreme example).