Paramedics should stop doing these 3 things if they want to deliver better care to their patients. Check out the podcast to hear all about it!
#1- Stop Using Orthostatic Vital Signs as a Diagnostic Tool
Orthostatic Vital Signs
- Typically obtained by measuring BP with the patient lying, then sitting, and finally standing.
- An increase in heart rate of 30 bpm or decrease in SBP of 20mmHg = Orthostatic positive
- Results of orthostatic testing are not likely to help gain a better clinical picture
- Not useful in the prehospital or emergency medicine setting
Orthostatic Hypotension Debunked – Anand Swaminathan from Statenislandem on Vimeo.
Instead of relying on a highly inaccurate test, use what you SEE and what the patient TELLS YOU to guide your treatment plan, as you would with any other patient.
#2- Don’t Rely on the Presence or Absence of a Palpable Pulse as an Indication of Blood Pressure
- It is a common misconception that a patient’s SBP can be estimated by palpating a pulse at different locations.
- Example: If the patient has a palpable radial pulse, then their SBP must be at least 80 mmHg
- This is NOT TRUE
- If you want to know what a patient’s BP is, use a BP cuff to assess the patient’s BP.
- Article Here
#3- Stop Using the “EC” Method When Obtaining a BVM Seal
- The “EC” technique of maintaining a BVM seal is simply not effective.
- Even experienced providers can find it difficult to gain and maintain a good seal using this technique.
- Either of the two-handed techniques shown below can increase the effectiveness of your seal.
- Article Here
- Another Article Here
Thanks for listening/reading! I hope you enjoyed this weeks episode! Please take a moment to leave a rating in iTunes, and be sure to subscribe to the site so you don’t miss any future episodes! You can also connect with me on Twitter, Facebook, and Instagram. Until next time, stay safe and treat aggressively!
Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ : British Medical Journal. 2000 Sep 16 [accessed 2017 May 27]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27481/
Joffe AM, Hetzel S, Liew EC. A Two-handed Jaw-thrust Technique Is Superior to the One-handed. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2010 Oct 1 [accessed 2017 May 27]. http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1933275
Otten D, Liao MM, Wolken R, Douglas IS, Mishra R, Kao A, Barrett W, Drasler E, Byyny RL, Haukoos JS. Comparison of Bag-Valve-Mask Hand-Sealing Techniques in a Simulated Model. Annals of emergency medicine. 2014 Jan [accessed 2017 May 27]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866830/