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Blood pressure without equiptment

Discussion in 'Survival Medicine' started by MO titmouse, May 14, 2007.

  1. MO titmouse

    MO titmouse Mrs monkeyman

    I had read a post a while back on useing the cuff to take BPs in survival situations and it seemed strange to me to rely on the equiptment in a survival situation where it may not be available. I work in the medical field and had learned several years ago how to take BPs without a cuff and realized most people may not know about it so thought it would be good to share.

    You take the pulse in the right curotic arterey and the rate per minute is the sistolic then take the pulse on the left side and the rate there is the distolic. It should always be within about 2 points on each of what you would get with the cuff.

    This can come in very handy if the arms are to messed up to be able to do anything there or if you dont have a cuff.
  2. ghrit

    ghrit Ambulatory anachronism Administrator Founding Member

    This tribe will have a cuff, I promise.
  3. phishi

    phishi Psy-Ops Moderator Emeritus Founding Member

    MO Titmouse: I have never heard of this method and am having some trouble understanding how or why it would work. Could you post how you came across this info please? Link to an article or journal would be great.

    My opinion: While I believe that a stethoscope and BP cuff are easily obtainable and easily learned, I can understand MO titmouse's point concerning what one would do when they are not present.

    My response is two fold: First, while BP is part of the vital signs and important to know and track, it is less important than pulse and respiration rate. It can help identify a high blood pressure (hypertension) or low blood pressure (hypotension, possibly shock from blood loss), but each of these could be identified by other symptoms which do not rely on a BP cuff. The real question IMO is what you would do to treat what you have discovered. If the answer is "not much I could do", well maybe you were better off not knowing....
    Second, the vascular system (heart, arteries, veins, and capillaries) is a closed loop system. As the heart pumps, pressure is generated throughout the system, which is what we read with a BP cuff. This pressure allows blood to reach the capillaries in your fingers and toes. As a result, if you can feel a pulse at the wrist or at the ankle, you have at least the minimum blood pressure needed for your body to function. (I can not seem to find my copy of what the numbers work out too. If someone can come up with this info it would be a great help to this discussion. Thanks ahead of time.) If you where to add this information to the rest of your patient assessment, one could have a pretty good idea of how well the patient is doing without needing a BP cuff.

    Ghrit: I would get two, they are realitively inexpensive and I can think of a few situations (pregnancy for example) where I would not want to be without one. They also make a great tourniquet for something like a lower arm amputation. Make sure you have the right sizes if you are expecting infants or very large individuals.

    Just my .02,
  4. ghrit

    ghrit Ambulatory anachronism Administrator Founding Member

    The one I already have is mercury and sized for adults. The point is, it's a place to start. We'll have to organize the dispensary at some time --
  5. melbo

    melbo Hunter Gatherer Administrator Founding Member

    Yes. Loads of stuff here.
    Staplers, BP cuffs and OB kits- oh my.

    On the Blood pressure method... I think you are supposed to pinch off both carotids and count the seconds until you hit the floor? [troll]

    I'd be interested in how this works as well.
  6. phishi

    phishi Psy-Ops Moderator Emeritus Founding Member

    It is a good place to start. I'm impressed that its mercury.....might be a collectors item. They don't make them like that any more, EPA won't allow it [booze] .

  7. Pru

    Pru Monkey+++

    I'm an RN and I don't think the method MO titmouse describes is accurate. The pulse is the pulse, the number of pulse beats per minute reflects the number of heartbeats per minute - actual surges of blood through a closed system.

    A rough method of assessing BP would be to evaluate the strength of peripheral (wrist, groin) pulses. A non-palpable pulse (unable to feel) could indicate low BP. Bounding strong pulses can indicate high BP. But both can also indicate other things, some of them concerning, some of them not.

    If your patient's BP is dangerously low, you'll know it cuz they'll pass out. Their heart rate (pulse) will typically be rapid as they attempt to compensate for low system pressure. Your interventions will be focused on correcting whatever is causing the low BP - such as heavy bleeding - and maintaining circulation to the vitals (brain and heart) by positioning the person lying flat with the legs elevated.

    If your patient's BP is high... well, that's why hypertension is called the silent killer. There are no symptoms until it's bad. Unless you have antihypertensive drugs and the knowledge to use them, there's not much you can do. High BP is better when it's prevented by healthy lifestyle choices.

    A manual cuff costs about $20, and it doesn't take long to learn how to use it. It's a safe, non-invasive test that you can practice as often as you like. The cuff I bought (at Wallyworld) has an attached stethescope, so you can take your own without fumbling about.

    And regarding sizes. Adult arm size fits the calf of most children (ages 5 - 10 or so, depending on the individual). To take BP on the calf (which is SOP in the NICU), spin it around so that the stethescope & tubing are at the back of the knee - that's where you'll find the artery that you're using.
  8. phishi

    phishi Psy-Ops Moderator Emeritus Founding Member

    Good info, especially on the location for a calf BP, Pru. Thanks for posting. [winkthumb]

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