90/64, when you hear the first sound around 130 and disappear then repick up at 90 it's called an auscultatory gap. Meaning it's diminished sounds when taking a systolic pressure. When taking a BP you want consistent flow of sounds at it's peak and end. Not a sound then it disappears = the auscultatory gap. This gap can give you false systolic readings.
Hmm... I was taught to still use the first sound for systolic, even if the gap is present, and then note the duration of the gap in the documentation. đ€
step 1: pump until you don't hear any beating, keep your attention at the meter. step 2: deflate tha cuff slowly until you hear the first beat, this number is your systolic step 3: continue to deflate cuff until the last beat when the beating goes silent, this is your diastolic
@@debbiefriesen3413 or a minimum of 3.5 minutes. Equally important is 3.5 to 5 minutes of patient/person sitting still, no talking or chewing gum, and with feet flat on the floor immediately prior to taking BP. If you decide on a second reading, using these same parameters is what can reduce the 5 minutes to a 3.5 before restarting.
I heard the first beat at around 130 but then it disappeared. It reappeared around 92 and continued until about 60. However, because of that first beat at 130, I would have retaken it just to be sure.
I was taught the same. Pt's emts treat typically won't know their BP. Nurses depending on where they work are more likely to have pt's with whom they'd regularly see and they be able to track it.
Yes always. U pump until you stop hearing beats. Then u know u have surpassed the systolic. But donât go too high bc this could effect reading. Also make sure patient is sitting with feet touching ground. No limbs crossed and palm up for arm you are taking reading from.
92/62, someone needs some fluids lol. Paramedic here: for EMS weâre taught to just send it to 200 because the pt may not know whether or not they have hypertension plus any ride in the boo boo bus will usually raise your BP lol
You should teach the obliterate method before taking a BP so people know where to pump up to. It helps a lot to make sure the reading is more accurate đ
@MizzBee13 where you hold the stethoscope on the artery, and pump until you don't hear a heart beat anymore through it. Take note of that number and pump up 20 past that when taking BP. It's different for each person so you know what number to pump to without hurting them too bad or not pumping up enough
Check for radial pulse while you're pumping up the cuff, when you no longer feel the pulse, add another 20mmhg of pressure, deflate cuff and reinflate cuff 20 mmhg over what was left felt
I also got 90/60. I've always wanted to be a nurse as well and I'm actually working on being a nurse right now. We practice vitals basically everyday. We practice on people in our class. I hope you achieve your dream of being a nurse! It's so worth it!
@@that_girl2005 Thank you so much! I hope you achieve yours as well! I hope you enjoy as much I think you're going to! Im wishing you all the blessings you can you handle!
I never heard of an ausculatory gap until this video and it looks like people have learned different things on whether to record the first sound, or to record the sound once it is consistent, so I googled it. It looks like you record the first sound for systolic and last sound for diastolic and record if the gap was present. There are studies that show people with an ausculatory gap have false low systolic readings, so you need to record the first sound. If you aren't sure if it is an ausculatory gap or artifact, you recheck it.
That is exactly what I struggle with! My main struggle with taking BP manually literally is just placement of the bell/diaphragm and keeping still, thatâs all. I always nudge something and think thatâs the korotkoff, or I place the bell/diaphragm wrong and donât hear anything.
I would also put a finger on the pulse, the beat would also be significantly stronger during and consistent throughout the range, which can help eliminate wild bump at 130
Actually for me as a Nursing Student, we always use manual Bp or manual taking of the VS of patients. First beat is systolic and from what Iâve heard the systolic is 130 and the diastolic which is the last beat is 60. So for me itâs 130/60mmHg
but everyone else said it was a random (?) beat at 130 because it hasn't started beating normally at that point so the actual systolic is at 90? I'm confused
Our nursing school taught us about the auscultatory gap. It gives you a false systolic reading. You first heard it at 130 and it disappears then repicks up at 90 consistent and strong ending around 60 something. You want consistent sounds in a BP. I got 90/64.
You donât usually see a BP with such a high systolic with such a low diastolic. In this case, you would use your judgment and retake in the other arm if there was confusion on the first beat of 130. Also, there wasnât a a consistent beat after the 130. I got 92/62
I use to take my dads manually as the automatic ones varied widely. He would then try himself and hear nothing and say well I must be dead. He was hard of hearing.
As a regular patient I really do not like the new machine blood pressure. Sometimes it feels like its going to cut my arm off. It is painful. I hate to think what it does to old people
Seriously. After I had my son, I had some complications and they had me hooked up to the automatic blood pressure reader thing for like 3 days straight, night and day. And every time it would take my BP, it was so painful.
In Nursing school you are taught some people have an ascultory gap. That first beat is where you start counting. If you want to be precise perform the occlusion test. Palpate the radial artery while inflating the BP cuff. When you no longer feel a pulse dedlate the cuff. Wait 2 minutes and take the Bp going 20mmhg over that last number. The reason you inflate 20 more is to catch an ascultory gap. 130/60 is normal for any healthy adult. A BP of 90/60 would have me more concerned unless the patient had known heart or kidney problems. Any lower than 90 and im going to start a bolus or call a rapid. Some hospitals will start interventions if systolic falls below 100. Depending on the patient's baseline. Charting a 90/60 will scare the care team. Especially if the nurse before correctly charted 130/60. That's a 40 point difference and i would personally call a rapid.
130/60 is not normal for any healthy adult. 120/80 is ânormalâ and a wide pulse pressure of 130/60 would likely have me questioning if this patient has a cardiac condition or is heading toward sepsis. Iâd be watching them. Closely. Pulse pressure gap normally should be 40-60. Any more than that and you should be asking more questions and alerting someone.
@katies3201 you clearly don't work in Healthcare. No one would be concerned for 130/60 bp. 120/80 is ideal, but no one has that bp. One end of the spectrum, you have athletes or people who used to be with really healthy hearts, and they typically run bp's on the lower side. I'm talking 100/60 with HR in the 40s! Then you have unhealthy, sedentary, or just plain sick people with bps like 200/110. But no doctors or nurse will bat an eye for 130/60. Unless systolic goes above 180 or drops below 90, most doctors will say continue to monitor. Same with diastolic, if it drops below 60 or goes above 100, most will not be concerned. You always look at a patient's baseline and judge based on that. I know text books tout the 120/80, but that's very rare, bp. If you continually run a bp 140/90, that's considered your baseline, and no intervention would be required. Also, that's not in the least bit alarming. You have to discard book knowledge once you're in healthcare and use clinical judgment in every situation. Book knowledge guides us as the golden standard. But each individual has their own standard, which we call their baseline. Our goal is to return patient's to their baseline, not get them to the golden standards. This is across all healthcare professions and lab results. If a patient uses an assistive device and break their leg. Our goal is to get them ambulating using that device again. Our goal isn't to get the patient walking like a normal person. This is true for all vital signs and labs. COPD patients may have an O2 sat of 91% and respiration rate of 25. Both outside the normal value, BUT it's normal for that patient(baseline), and no Healthcare professional would be concerned. MAP is a better indicator than systolic/diastolic for bp. 130/60 is a MAP of 83, which is completely normal(70-100 is normal). You'll understand cardiac conditions more once you actually work in the field and not read it from a book. I had to toss a lot of things I learned in Nursing school myself. Real world vs ideal world.
@@ashleyblackmon3917 to calculate what a pedi systolic BP should be you use 70 + AgeĂ2 = minimum systolic bp so and 11 year old shouldn't have a systolic lower than 92
@@jazmineokoro001 it will always land on an even number whenever youâre using a manual BP cuff. The lines in between the numbers are 2, 4, 6 and 8⊠It was 130/62. Hope this helps âșïž
90/62 is what I heard, sounds like a good case of hypotension, they need a iv bolus, or midodrine, or what ever the doctor orders depending on age history and symptoms đ
I HATE those blood pressure machines! They always hurt my arm and most times have to reinflate several times to get a bp reading. I have been in tears before with the pain from them. It has gotten to where I am having an anxiety attack by the time the machine is finished, which shows an elevated bp anyway. I recently had an outpatient procedure at a hospital and told this to the pre-op nurse. She was so kind and took time to check it the manual way. When I went into the OR they strapped that machine on me and started squeezing my arm on the machine again. It hurt so bad. I started panicking so the nurse anesthesist just put me under with no warning. I had bruises and blood blisters on my skin from the bp cuff afterward.
138 was what I thought I heard initially. however, this is a near impossible mission! Considering we cannot visualize your movement and realize that is the reason for the possible phantom beat. More importantly, if 138 was in fact, their systolic, the absence of a consistent heartbeat between 138, and around 90ish would lead me to believe that we have bigger problems then figuring out a manual BP! iâve noticed comments were people say that the silence is normal!? I donât think so?!? that would mean that you have the cuff so tight that youâre restricting blood flow to the brachial artery. I say, Silence of ANY kind is never good when it comes to the heart, or children playing alone! đ
Youâre actually partly correct. The cuff is provide just enough pressure on the arterial walls to restrict blood flow to the areas below the cuff. Blood pressure measures the work of your heart. So essentially we restrict the artery to see at what pressure can your heart forcefully get blood to your arm. And the second number is when the pressure is reduced enough so that the heart doesnât have to force the blood anymore. And sometimes our heart can get out more force but needs more time before the next âbeatâ to get through to the arm
90/60? See this is why I hate this đ all the different answers and everyone swears theyâre right. So I know for a fact some of these patients blood pressures are wrong
So now I understand the procedure, but I've always wondered: how does this work? I know it involves cutting off circulation and then releasing, but why does high bp make the pulse resume earlier? Why does the pulse stop after a few seconds of coming back as the cuff pressure decreases? And, correct me if I'm wrong, but from what I understand, systolic is the pressure experienced during a beat; dysystolic is the pressure between beats. How does the resumption and cessation of the pulse, which spans over several beats, correspond to numbers relating to separate points of a beat?
Haha. I learned but Iâve always been bad. So far I know you pump it as much as you can. Once you hear the start of the beat thatâs the sbp and where it goes silent is the dbp. Then again I always got my numbers wrong with comping to the professer
Another video I saw said feel the after and pump up until you can feel any pulse anymore. Then youâll pump 30 past that number because it will get rid of that gap thatâs common in hypertension patients.
Itâs 92/60, first single at 132 wasnât it, it has to be continuous âbump.bump.bumpâ after systolic, there was no continuous pumping after 132, it tripped me up too
Omg. Thank you so much for this. I have a toddler who needs his blood pressure taken and sometimes we can only get an accurate reading on a manual machine. And his peds office can't do it. And I can't take him to the children's hospital every time he has a couple high seeming readings.
In MA they taught us the book way. But from their experience they say just pump until 180 and go from there since most people donât know what their bp is normally
If you go by Korotkoff sounds, it would be clear that the random beats arenât the beginning of the systolic reading. You need to first listen to two consecutive heartbeats, etc,.
I wish my blood pressure was this low. Geez. I'm dealing with hypertension now. 160/90 my nurse freaked out. I'm on amlodipine 10mg, 5'8, 260lbs, 40bmi. I'm damn near a vegetarian, drinking 64oz water daily, very low sodium diet, low fat, rainbow veggies, hibiscus tea, beet juice, taking magnesium supplement, eating walnuts, pistachios, spinach, Swiss chard and do Box breathing technique. I have a sleep apnea test in a couple of weeks. Let's see what that brings. But I'm thinking if getting the endoscopic balloon or the stomach Suture to assist in weight loss.
As an EMT student, you donât necessarily have to pump it to 150 my instructors have told me you can go to 180 people are not really gonna know the difference because they know that the cuff is going to be tight 180 is the max but 160 is the standard across the board also, at times you are going to have to pump it farther than 160 due to people who have smaller arms or the geriatric patients hard to get blood pressure on patients like that most of the time. An important thing to note too, is that each of the mini dial or lines are always going to be an increments of 2 so if you get an odd number on a manual blood pressure itâs considered as a made up blood pressure and this is how most people can tell that you are shit at blood pressure. Automatic blood pressure you are going to get odd numbers but never on a manual. Another Iâve learned to is that never go by the needle always go by the sound . As for me I alway go by the sound. How to place or start a manual blood pressure you are going to take the cuff wrap it around the bicep/tricep and the stethoscope go on the arm where flexion occurs except that itâs going to be place on the inner side of it why because thatâs where your brachial artery is located and yes you can feel a pulse there. Forgot to mention on blood pressure cuffs thereâs a mark at the bottom of the cuff that marks or gives you a guide where the artery is located. If you donât know where the brachial artery is located take two fingers place it on the side of your elbow thatâs closest to you or inner side of your arm and you are going to have to move some things around to feel it. Canât find it follow your pinky start from the pinky and work your way up to your elbow and move the muscles out of the way and apply a little bit of pressure you should find or feel a pulse. You can also find a pulse on your thumb too itâs really hard to find it lol but itâs there
Pump while palpitating wrist till pulse stops note pressure. Re-pump to 30mm/Hg above the noted pressure, identify when sounds stop and start while releasing valve.
Why I can't be a nurse I'm a care aide and would love nursing but I literally can't do the math, people tell me "don't worry machines do it for you" but you need to have those fundamental skills that incude math. Same with dosing medication if there's no machines My respect to all you nurses :)
I was a nurses aide before certification was mandatory (OJT). I believed for many years that âI couldnât be a nurse because of the math.â Guess what - I did it & then some - so can you!! NA, CNA, LPN, RN, BSN & Masters bound⊠if I can do it, anyone who wants to can. You can do it. Donât let ANYONE (even yourself) keep you from your goals & dreams! Best wishes!
@@jennakhivkapratt8751 there is but it's not "hard " math for most people, but since I have dyscalcula it's hard for me, like with vitals you have to count and rememeber numbers while you are counting, so hard đ When I took first aide I couldn't do it and almost failed because of that đ maybe my other skills can make for up for this serious lack of one
I say 90/60 but would retake it, the sound at 130 threw me of. Also I wouldn't bump to an expected RR . I learnd to feel the puls from the radialis, when you can't feel it anymore go 20mmhg higher and start hearing and deflating the cuff. But there are different methods around , do what you are comfortable with
You can go by sound and watch the pointer, it will jump when it picks up your systolic and stops when you reach your diastolic. Not really visible in this animation. Just in case you have to do this in a loud environment. But maybe i'm talking out of my ass because the last time i had to do a manual was aprox 10 years ago and the devices have changed. Maybe someone can confirm ?
There's actually a way to check as to how much you should pump the cuff, especially if you don't know their average reading. It's too much to write. So just research it. I learned it in nursing school.
92/58! Iâd be a bit concerned if the vital machines are down especially the one in the video because itâs not just BP that is monitored! (Well in the UK that is the case anyway)
90/64, when you hear the first sound around 130 and disappear then repick up at 90 it's called an auscultatory gap. Meaning it's diminished sounds when taking a systolic pressure. When taking a BP you want consistent flow of sounds at it's peak and end. Not a sound then it disappears = the auscultatory gap. This gap can give you false systolic readings.
Thanks for the info
Huh I didn't know that, thank you! Now I'm wondering how many false BPs I've read
125/70 is what I got from my bad hearing
Isn't that dangerous?
Hmm... I was taught to still use the first sound for systolic, even if the gap is present, and then note the duration of the gap in the documentation. đ€
This is when I would just go ahead and retake it- cuz that random sbp beat at 130 has me messed up lol
Love this exercise!!
I'm so glad you said that because I noticed the same thing!
I thought it was just me.
I want you as my nurse!
Redoing a bp check is easy and quick but the result is critical.
Same lol
It could represent an ascultatroy pause or gap and the higher number is correct
step 1: pump until you don't hear any beating, keep your attention at the meter.
step 2: deflate tha cuff slowly until you hear the first beat, this number is your systolic
step 3: continue to deflate cuff until the last beat when the beating goes silent, this is your diastolic
Do it twice, the second measuring is the more accurate.
Thank you
When I first did this, i didnât know what sound I was looking for. My teacher never explained it right, now I understand
@@kathidori8504donât do it right away. You need to wait at least 5 minutes after and between pressures otherwise the numbers are skewed.
@@debbiefriesen3413 or a minimum of 3.5 minutes. Equally important is 3.5 to 5 minutes of patient/person sitting still, no talking or chewing gum, and with feet flat on the floor immediately prior to taking BP. If you decide on a second reading, using these same parameters is what can reduce the 5 minutes to a 3.5 before restarting.
92/62 is what I would've documented.
Same!
You can be in the range of between 4, I got 90/62
Me too
Same lol yay ! When I first watched this video I had no clue Iâm so glad I do now lol
96/66 been a nurse for over 20 years and have never stopped doing vitals manually
Totally agree!
@@Lyonesss101omg i would hate to do them manually!
Your answer is the closest to mine. I got 98/66. I heard the first beat at the first mark after 100. I'm just learning how to do it manually
I heard the first beat at around 130 but then it disappeared. It reappeared around 92 and continued until about 60. However, because of that first beat at 130, I would have retaken it just to be sure.
I needed this right now. I'm taking my CNA skills exam in 24 hours and this is exactly the kind of exercise I need to be doing.
How'd it go?
You passed the exam! congratulations
sphygmomanometer
â@@BridgetMcdaidhow do u know they passed? Her watching utube instead of studying worried me. Lol
đ,,, nothing wrong in relaxing abit to ease tensionâ@@JessDougie-ro2hl
In emt school we were told to pump it until you stop hearing the beat, since you or the pt won't always know their normal BP lol
Iâm in an emt class rn and weâre told to go 30 after, so itâs p consistent on my end. Might just be CA vs. national too though
@@anthonytran8670 that is what NREMT says but I know every instructor has their own professional opinion on what works best
I was taught the same. Pt's emts treat typically won't know their BP. Nurses depending on where they work are more likely to have pt's with whom they'd regularly see and they be able to track it.
Yes always. U pump until you stop hearing beats. Then u know u have surpassed the systolic. But donât go too high bc this could effect reading. Also make sure patient is sitting with feet touching ground. No limbs crossed and palm up for arm you are taking reading from.
Also watch cuff size. This can affect bp reading as well. Always use the proper size cuff for your patients
88/66. But I agree that random one at 130 threw me at first.
So why doesn't that random one count?
I miss ICU bedside nursing, Im terminally now in my 30's. Watching and making videos like this is keeping me alive (no pun intended lol)
92/62, someone needs some fluids lol. Paramedic here: for EMS weâre taught to just send it to 200 because the pt may not know whether or not they have hypertension plus any ride in the boo boo bus will usually raise your BP lol
The patient is alive
đđđđ
That's what I got, too!
LOL
First beat is systolic 130/60
Thatâs what I got
I got the same,⊠but idk if itâs right
Agree
The sound at 130 was artifact not a beat
That was just artifact at 130
You should teach the obliterate method before taking a BP so people know where to pump up to. It helps a lot to make sure the reading is more accurate đ
Please tell me it's not as scary as it sounds đ I don't wanna be obliterated
What is the obliterate method?
@MizzBee13 where you hold the stethoscope on the artery, and pump until you don't hear a heart beat anymore through it. Take note of that number and pump up 20 past that when taking BP. It's different for each person so you know what number to pump to without hurting them too bad or not pumping up enough
â@@hobbythat5285đ
â@@hobbythat5285no mam
Check for radial pulse while you're pumping up the cuff, when you no longer feel the pulse, add another 20mmhg of pressure, deflate cuff and reinflate cuff 20 mmhg over what was left felt
*30mmhg
I've done several over palpate
90/65 was my listen. I was only a phlebotomist but had to learn this 20 years ago. Still a great accurate reading.
Iâm just so proud of all of you for working so hard to take care of us people itâs absolutely incredible and grateful for you all đđđđ
I got 90/60. I didn't start hearing a consistent beat until 90. Am I correct? I wanna be a nurse so bad. This was a great practice đ€âșïž
Go for it mamas . Youâll be glad you did .
I also got 90/60. I've always wanted to be a nurse as well and I'm actually working on being a nurse right now. We practice vitals basically everyday. We practice on people in our class. I hope you achieve your dream of being a nurse! It's so worth it!
@@that_girl2005 Thank you so much! I hope you achieve yours as well! I hope you enjoy as much I think you're going to! Im wishing you all the blessings you can you handle!
130/60 .. first beat is what you go with
I got the same
I never heard of an ausculatory gap until this video and it looks like people have learned different things on whether to record the first sound, or to record the sound once it is consistent, so I googled it. It looks like you record the first sound for systolic and last sound for diastolic and record if the gap was present. There are studies that show people with an ausculatory gap have false low systolic readings, so you need to record the first sound. If you aren't sure if it is an ausculatory gap or artifact, you recheck it.
92/62 but girl you were making too much noise đđđ I heard the first sound on 130 but I think that was just a bump
The first beat you hear is your number systolic number and the last beat you hear is your diastolic number.
That is exactly what I struggle with! My main struggle with taking BP manually literally is just placement of the bell/diaphragm and keeping still, thatâs all. I always nudge something and think thatâs the korotkoff, or I place the bell/diaphragm wrong and donât hear anything.
I would also put a finger on the pulse, the beat would also be significantly stronger during and consistent throughout the range, which can help eliminate wild bump at 130
That's what I was thinking. I take manual BP so all these 90/60 results were throwing me off
90/60 but I did hear the first sound at 130 but I didnât continue so maybe I would do it again just to double check but I think 90 /60
Actually for me as a Nursing Student, we always use manual Bp or manual taking of the VS of patients. First beat is systolic and from what Iâve heard the systolic is 130 and the diastolic which is the last beat is 60. So for me itâs 130/60mmHg
Same I graduated December 2021 and I would have said 130/62
but everyone else said it was a random (?) beat at 130 because it hasn't started beating normally at that point so the actual systolic is at 90? I'm confused
â@@sherine9033 it's at 90 because it was only 1 beat and not consistent, wich. is what you are looking for.
Our nursing school taught us about the auscultatory gap. It gives you a false systolic reading. You first heard it at 130 and it disappears then repicks up at 90 consistent and strong ending around 60 something. You want consistent sounds in a BP. I got 90/64.
You donât usually see a BP with such a high systolic with such a low diastolic. In this case, you would use your judgment and retake in the other arm if there was confusion on the first beat of 130. Also, there wasnât a a consistent beat after the 130. I got 92/62
Yea that first one around 130-140 threw me off but it doesn't stay consistent until 90ish
I use to take my dads manually as the automatic ones varied widely. He would then try himself and hear nothing and say well I must be dead. He was hard of hearing.
As a regular patient I really do not like the new machine blood pressure. Sometimes it feels like its going to cut my arm off. It is painful. I hate to think what it does to old people
Seriously. After I had my son, I had some complications and they had me hooked up to the automatic blood pressure reader thing for like 3 days straight, night and day. And every time it would take my BP, it was so painful.
@@shannonrickard8605 I hope you and your son are doing great now.
Systolic around 130ish plus u should be pumping tbat thing between 160 and 180 closer to 180 on adult
In Nursing school you are taught some people have an ascultory gap. That first beat is where you start counting. If you want to be precise perform the occlusion test. Palpate the radial artery while inflating the BP cuff. When you no longer feel a pulse dedlate the cuff. Wait 2 minutes and take the Bp going 20mmhg over that last number. The reason you inflate 20 more is to catch an ascultory gap. 130/60 is normal for any healthy adult. A BP of 90/60 would have me more concerned unless the patient had known heart or kidney problems. Any lower than 90 and im going to start a bolus or call a rapid. Some hospitals will start interventions if systolic falls below 100. Depending on the patient's baseline. Charting a 90/60 will scare the care team. Especially if the nurse before correctly charted 130/60. That's a 40 point difference and i would personally call a rapid.
130/60 is not normal for any healthy adult. 120/80 is ânormalâ and a wide pulse pressure of 130/60 would likely have me questioning if this patient has a cardiac condition or is heading toward sepsis. Iâd be watching them. Closely. Pulse pressure gap normally should be 40-60. Any more than that and you should be asking more questions and alerting someone.
@katies3201 you clearly don't work in Healthcare. No one would be concerned for 130/60 bp. 120/80 is ideal, but no one has that bp. One end of the spectrum, you have athletes or people who used to be with really healthy hearts, and they typically run bp's on the lower side. I'm talking 100/60 with HR in the 40s! Then you have unhealthy, sedentary, or just plain sick people with bps like 200/110. But no doctors or nurse will bat an eye for 130/60. Unless systolic goes above 180 or drops below 90, most doctors will say continue to monitor. Same with diastolic, if it drops below 60 or goes above 100, most will not be concerned. You always look at a patient's baseline and judge based on that. I know text books tout the 120/80, but that's very rare, bp. If you continually run a bp 140/90, that's considered your baseline, and no intervention would be required. Also, that's not in the least bit alarming. You have to discard book knowledge once you're in healthcare and use clinical judgment in every situation. Book knowledge guides us as the golden standard. But each individual has their own standard, which we call their baseline. Our goal is to return patient's to their baseline, not get them to the golden standards. This is across all healthcare professions and lab results. If a patient uses an assistive device and break their leg. Our goal is to get them ambulating using that device again. Our goal isn't to get the patient walking like a normal person. This is true for all vital signs and labs. COPD patients may have an O2 sat of 91% and respiration rate of 25. Both outside the normal value, BUT it's normal for that patient(baseline), and no Healthcare professional would be concerned. MAP is a better indicator than systolic/diastolic for bp. 130/60 is a MAP of 83, which is completely normal(70-100 is normal). You'll understand cardiac conditions more once you actually work in the field and not read it from a book. I had to toss a lot of things I learned in Nursing school myself. Real world vs ideal world.
Bp is 90/60
I got the same thing but for some reason ppl are leaving mean comments under mine. Lol I'm glad I wasn't the only one that got this answer
I got 92/60. đ
92/64 đ«ą
So, does the single beat at ~130 count or not?
No it doesnât. You need continuous beat.
What if theyâre a fib?
You do not need continuous beat according to many official medical sources. None of the publications, resources, or books state continuous beat.
More stuff like this please! This was great thank you
We had to learn that as a student-nurse...always needed it
BP 92/62 ??
I got 92/60
That's normal if you're 11 years old lol
How?
@@ashleyblackmon3917 to calculate what a pedi systolic BP should be you use 70 + AgeĂ2 = minimum systolic bp so and 11 year old shouldn't have a systolic lower than 92
@@jakesilliman5906 Not necessarily, I had a BP of systolic around 90-100 up until I got a job as a nurse. Now it is 20-50 points above that đ„ž
Systolic is 130, then silent gap, wich is quite common. Diastolic 62.
62???? are you some machine lmao
@@Lurkzor oops, ment 60, see it now
I got 130/65 the first time I watched it and 125/65 and then I saw comments saying 90/60 now Iâm thinking I did something wrong đ
No, you were correct lol it was 130/62
@@jazmineokoro001 it will always land on an even number whenever youâre using a manual BP cuff. The lines in between the numbers are 2, 4, 6 and 8⊠It was 130/62. Hope this helps âșïž
90/62 is what I heard, sounds like a good case of hypotension, they need a iv bolus, or midodrine, or what ever the doctor orders depending on age history and symptoms đ
I heard this too. Good catch!
Not necessarily, my BP is 9/6 on a daily basis
@@thesalazar7328 This is true if this is a part of your normal history.
I HATE those blood pressure machines! They always hurt my arm and most times have to reinflate several times to get a bp reading. I have been in tears before with the pain from them. It has gotten to where I am having an anxiety attack by the time the machine is finished, which shows an elevated bp anyway. I recently had an outpatient procedure at a hospital and told this to the pre-op nurse. She was so kind and took time to check it the manual way. When I went into the OR they strapped that machine on me and started squeezing my arm on the machine again. It hurt so bad. I started panicking so the nurse anesthesist just put me under with no warning. I had bruises and blood blisters on my skin from the bp cuff afterward.
I'm a nurse student. And the problem is not having a quiet place to listening carefully. There's always people talking load in the backgrounds
Old school-
Pump to 200, release, listen for first and last beats.
138 was what I thought I heard initially. however, this is a near impossible mission! Considering we cannot visualize your movement and realize that is the reason for the possible phantom beat. More importantly, if 138 was in fact, their systolic, the absence of a consistent heartbeat between 138, and around 90ish would lead me to believe that we have bigger problems then figuring out a manual BP! iâve noticed comments were people say that the silence is normal!? I donât think so?!? that would mean that you have the cuff so tight that youâre restricting blood flow to the brachial artery. I say, Silence of ANY kind is never good when it comes to the heart, or children playing alone! đ
Youâre actually partly correct. The cuff is provide just enough pressure on the arterial walls to restrict blood flow to the areas below the cuff. Blood pressure measures the work of your heart. So essentially we restrict the artery to see at what pressure can your heart forcefully get blood to your arm. And the second number is when the pressure is reduced enough so that the heart doesnât have to force the blood anymore. And sometimes our heart can get out more force but needs more time before the next âbeatâ to get through to the arm
Could be a-fib. Pause like that would be totally normal in that case.
Love this I was very good at it and could hear better than many, you would be surprised how many have problems with out the machines
WOW! I was today's years old (I'm 40!) when i understood how the cuf blood pressure thing works!! Pretty NEAT!! Thanks for explainning!
I got 135/70. Let me say that I love love love that you did this! It's awesome.
You canât get an odd number on this kind of cuff.
Please let me know the correct answer. Thanks
130/70mmHg
I agree with this but I am not sure
Finally right answer
Yes, thatâs what I think too.
I did this and my evaluator failed me 3 times. I also took a refresher class.
I take my cna final exam in a couple weeks, and I cannot do this to save my life. I always feel like I canât hear anything
Interesting. I never knew how they figured out your BP from that. I just cry internally until I can feel my hand again
đ€Łđ€Łđ€Łđ đ
90/60? See this is why I hate this đ all the different answers and everyone swears theyâre right. So I know for a fact some of these patients blood pressures are wrong
This is so hard even when i was in nursing school 10 years ago i could never master this. Now they have the digital one.
9/6 I always loved this when I was on the nursing school
130/60-70mmhg
You should try taking BPâs in a moving ambulance! đ
So now I understand the procedure, but I've always wondered: how does this work? I know it involves cutting off circulation and then releasing, but why does high bp make the pulse resume earlier? Why does the pulse stop after a few seconds of coming back as the cuff pressure decreases? And, correct me if I'm wrong, but from what I understand, systolic is the pressure experienced during a beat; dysystolic is the pressure between beats. How does the resumption and cessation of the pulse, which spans over several beats, correspond to numbers relating to separate points of a beat?
This is neat. Kind of calming and nice to listen to as well. Work asmr.
92/60
Haha. I learned but Iâve always been bad. So far I know you pump it as much as you can. Once you hear the start of the beat thatâs the sbp and where it goes silent is the dbp. Then again I always got my numbers wrong with comping to the professer
128/98
Another video I saw said feel the after and pump up until you can feel any pulse anymore. Then youâll pump 30 past that number because it will get rid of that gap thatâs common in hypertension patients.
This is so hard for me im taking some emt classes atm
132/60!
Itâs 92/60, first single at 132 wasnât it, it has to be continuous âbump.bump.bumpâ after systolic, there was no continuous pumping after 132, it tripped me up too
93/62
I think it's 130/60, I actually learned to read BP manually when I was 15 on our Science class.
Omg no way at 15? thatâs so young. You must be a doctor by now, great job!
@@elijahsmith5683 nooo I'm not suitable for medical courses due to my hemaphobia, I am still on college student as an accounting student đđ
@@YoonAReMYlight either way, you got this!
Yes, this is exactly what I got
Itâs 130/62
My blood pressure was so low when I was younger they always had to do it manually. The machines wouldn't read it.
Omg. Thank you so much for this. I have a toddler who needs his blood pressure taken and sometimes we can only get an accurate reading on a manual machine. And his peds office can't do it. And I can't take him to the children's hospital every time he has a couple high seeming readings.
92/62
Wow I've always wondered what it's like taking a BP. Thanks for sharing!
In MA they taught us the book way. But from their experience they say just pump until 180 and go from there since most people donât know what their bp is normally
If you go by Korotkoff sounds, it would be clear that the random beats arenât the beginning of the systolic reading. You need to first listen to two consecutive heartbeats, etc,.
My nursing professor says that with manual BP it cannot be an odd number
Thank you so much for sharing your knowledge with us! Blessings!
I wish my blood pressure was this low. Geez. I'm dealing with hypertension now. 160/90 my nurse freaked out. I'm on amlodipine 10mg, 5'8, 260lbs, 40bmi. I'm damn near a vegetarian, drinking 64oz water daily, very low sodium diet, low fat, rainbow veggies, hibiscus tea, beet juice, taking magnesium supplement, eating walnuts, pistachios, spinach, Swiss chard and do Box breathing technique. I have a sleep apnea test in a couple of weeks. Let's see what that brings. But I'm thinking if getting the endoscopic balloon or the stomach Suture to assist in weight loss.
Faintly the diastolic is still heard at 64 I was always told to stick to the sound clearly heard -which would be 60bp
What's the answer op?
I know we have a window for error so 132/60
As an EMT student, you donât necessarily have to pump it to 150 my instructors have told me you can go to 180 people are not really gonna know the difference because they know that the cuff is going to be tight 180 is the max but 160 is the standard across the board also, at times you are going to have to pump it farther than 160 due to people who have smaller arms or the geriatric patients hard to get blood pressure on patients like that most of the time.
An important thing to note too, is that each of the mini dial or lines are always going to be an increments of 2 so if you get an odd number on a manual blood pressure itâs considered as a made up blood pressure and this is how most people can tell that you are shit at blood pressure. Automatic blood pressure you are going to get odd numbers but never on a manual.
Another Iâve learned to is that never go by the needle always go by the sound . As for me I alway go by the sound.
How to place or start a manual blood pressure you are going to take the cuff wrap it around the bicep/tricep and the stethoscope go on the arm where flexion occurs except that itâs going to be place on the inner side of it why because thatâs where your brachial artery is located and yes you can feel a pulse there. Forgot to mention on blood pressure cuffs thereâs a mark at the bottom of the cuff that marks or gives you a guide where the artery is located. If you donât know where the brachial artery is located take two fingers place it on the side of your elbow thatâs closest to you or inner side of your arm and you are going to have to move some things around to feel it. Canât find it follow your pinky start from the pinky and work your way up to your elbow and move the muscles out of the way and apply a little bit of pressure you should find or feel a pulse.
You can also find a pulse on your thumb too itâs really hard to find it lol but itâs there
Pump while palpitating wrist till pulse stops note pressure.
Re-pump to 30mm/Hg above the noted pressure, identify when sounds stop and start while releasing valve.
130/62
Got the same BP.
130/60.
As a CNA who worked in SNFs and only took manual BPs, I wouldn't accept this. I would take it again.
Thank you so much this really helped cause I never knew how to manually do BPs.
98/62 Please confirm Thank you! đ
exactly what i got
Me too
Same
Yup i heard same. 98/62.
I got 96/66
90/60
Hold the damn stethoscope still đ
Thatâs around what I normally run at for blood pressure đ mine is normally around 90/60 đ
đđy'all I legit was like 100/60 damn I need to work on my vitals ig
Same here actually
Why I can't be a nurse
I'm a care aide and would love nursing but I literally can't do the math, people tell me "don't worry machines do it for you" but you need to have those fundamental skills that incude math.
Same with dosing medication if there's no machines
My respect to all you nurses :)
I was a nurses aide before certification was mandatory (OJT).
I believed for many years that âI couldnât be a nurse because of the math.â
Guess what - I did it & then some - so can you!!
NA, CNA, LPN, RN, BSN & Masters bound⊠if I can do it, anyone who wants to can.
You can do it. Donât let ANYONE (even yourself) keep you from your goals & dreams!
Best wishes!
I can't even add double digits together and I'm a nurse đ€Ł that's why you have calculators girl
@@nutella4220 but what about vitals? I can't read vitals yo đ đ love it though you guys are awesome thanks for the support:)
There's no math in recording a BP though.
@@jennakhivkapratt8751 there is but it's not "hard " math for most people, but since I have dyscalcula it's hard for me, like with vitals you have to count and rememeber numbers while you are counting, so hard đ
When I took first aide I couldn't do it and almost failed because of that đ maybe my other skills can make for up for this serious lack of one
I say 90/60 but would retake it, the sound at 130 threw me of. Also I wouldn't bump to an expected RR . I learnd to feel the puls from the radialis, when you can't feel it anymore go 20mmhg higher and start hearing and deflating the cuff. But there are different methods around , do what you are comfortable with
You can go by sound and watch the pointer, it will jump when it picks up your systolic and stops when you reach your diastolic. Not really visible in this animation. Just in case you have to do this in a loud environment. But maybe i'm talking out of my ass because the last time i had to do a manual was aprox 10 years ago and the devices have changed. Maybe someone can confirm ?
I heard 90/62 but I'd probably recheck that one
That's what we got:)
92/58
In India docs believe on readings from manual clinical mercury manometers, some have Aneroid ones too.
96/66?
..can anyone recommend a video or book to deeply learn about the details and auscultatory gap
90/60 đđđ
There's actually a way to check as to how much you should pump the cuff, especially if you don't know their average reading. It's too much to write. So just research it. I learned it in nursing school.
If you dont have a steth you can warch the gauge closely it starts bouncimg at systolic and stops at diastolic
I use to do manual BPs all the time,I trust them more.
I trust automatic more
130/70 I'm not a doctor or a nurse. But I was in a past life . Knowledge passed over I just know weird things .
What do I do if I cant hear the brachial pulse aoth my stethoscope?
96/62 is what I would've documented
Oh god donât trust anyone to take a accurate bp according to these comments đ
130/70
90/60 -is a good record because they can go 2 up a number -92/62
92/58! Iâd be a bit concerned if the vital machines are down especially the one in the video because itâs not just BP that is monitored! (Well in the UK that is the case anyway)
90/50?đ i am soooo bad at Manual bp