Background - Non-invasive blood pressure measurement is the standard technique of measuring blood pressure and it is routinely used in the perioperative period. However, invasive blood pressure measurement using a cannula in artery is considered a more accurate standard of monitoring in patients requiring tight blood pressure regulation. Both these techniques are widely employed during many surgeries and they yield different numbers as a function of their differing measurement techniques. The relationship between these numbers is still poorly characterized and differences in readings may influence clinical interventions such as vasopressor use, fluid management and blood transfusion. There has been number of studies looking into the correlation …show more content…
Insertion of arterial catheter is not without its own complications which may be either technique related, infectious or thrombotic. Continuous NIBP recording may fill the gap in certain cases here, but due to non availability of continuous NIBP measurement devices, IBP monitoring is either over utilized or underutilized. Most often, also observed is a combination of IBP and NIBP monitoring being used in the perioperative setting. There have been cases of gross discrepancy between the invasive and non invasive blood pressure readings during the perioperative period 2. All the currently available blood pressure monitoring devices like oscillometric blood pressure (OBP), IBP and aneroid manometers (ABP) are all based on different mechanism of recording blood pressure and hence it becomes very difficult to say that which actual blood pressure is. Often a combination of IBP and NIBP is employed, and often times a discrepancy is observed between the readings. There had been few studies in the recent past where a comparison of IBP and NIBP was done in different settings with variable results3–7. Most of these studies were either on critically ill pediatric patients, cardiac patients or patients with renal failure, and hence its bit difficult to extrapolate these results in normal healthy population who might be coming for surgery requiring IBP monitoring but has none of the other risk
According to an article by Timsit, J., et al. an estimated 5 million central venous catheters are inserted in patients each year. CBIs, most of which are associated with central venous catheters, account for more than 11% of all health-care associated infections. Additionally, more than 250,000 central-line associated blood stream infections also occur annually, with an estimated mortality rate of 12-25%. For patients within the intensive care unit, the numbers were even higher. Each episode significantly increases the patient’s hospital stay, as well as increasing costs from $4,000 to $56,000 per episode.
How does this history of high blood pressure demonstrate the problem description and etiology components of the P.E.R.I.E. process? What different types of studies were used to establish etiology or contributory cause?
A total of 22 patients were admitted for the study, with 11 on the BiPAP side and the other half on the BiPAP using the AVAPS. Every patient had to be in a select range of APACHE II score within 4, age within 10, pH within.04, Glasgow Coma Scale within 2, and BMI within 2 points; also referred by a doctor who did not know about the study. Both of the groups received the same parameters for their BiPAP machines, including an IPAP of 12 cmH2O, EPAP as 6 cmH2O, a tidal volume 8-12 ml/kg of ideal body weight, respiratory rate of 15 bpm, rise time 300-400 ms, and finally Helsinki-based inspiration time at a minimum of.6 seconds. Arterial blood gases, maximum tidal volumes and IPAP, EVT, leaks, respiratory and heart rates, and blood pressure were all assessed every 1, 3, 12, and then every 24 hours.... ... middle of paper ... ...
There was a series of people used in this experiment to look at blood pressure. The first step was to take the subjects normal blood pressure, then after showing them a scary clip retakes the blood pressure. While taking blood pressure consider age, weight, family history, commitment and gender to see if the subject has low or high blood pressure normally. After receiving all the data the charts that were made were based on age and gender.
High blood pressure is called the “silent killer” because it often has no warning signs or symptoms, and many people don’t know they have it. For most patients, high blood pressure is found when they visit their health care provider or have it checked elsewhere. Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure. Some people may experience: bad headache, mild dizziness, and blurry vision. Traditionally, diagnosis of high blood pressure (BP) has relied on consecutive checks of clinic BP over a 2 to 3 month period, with hypertension confirmed if BP remains persistently raised over 140/90 mmHg. This method of diagnosis has significant limitations because the BP measured for an individual patient in a clinic setting may not reflect their BP in day-to-day life. The main concern is that as a result of the “white coat syndrome”, hypertension may be over-diagnosed when checked in the clinic setting; resulting ...
The purpose of this clinical journal entry is to elaborate on the details of lab day three. On lab day three, we had check-off for blood pressure and apical pulse. In addition, we took a safety test, and learned about mobility, immobility, how to use ambulatory devices, and reposition (C#4, C#6).
Essential IV information management and application of patient care technology is an essential that I consider most important to my practice. My nursing skill and technology is challenged every day while working. The new technology, change in procedures, and new equipment are essential to working in the Cardiac Catheterization Lab. One must adapt and change daily in order to keep up and stay educated. New physicians join and we must learn their technique styles and equipment needs while still maintaining exceptional patient care.
The research problem is clearly stated in the introduction and various times during the literature review. While it is known that automatic sphygmomanometers are not as accurate when compared to the gold standard of manual sphygmomanometer during single blood pressure readings they are still being used a triage instruments in emergency departments (Dind, Short, Ekholm, & Holdgate, 2011, p. 526). Triage is an essential step in the emergency department and instruments used in triage need to be accurate. Little is known about the accuracy of automatic devices when assessing postural blood pressures. It is shown in this study that orthostatic hypotension is a direct link to what triage category the patient is assigned, which can affect variables such as wait time and care received, so accurate measurement of this is an important factor in the emergency setting (Dind et al., 2011, p. 531).
Sayar S.,Turgut, S., Dogan, H., Ekici, A., Yurtsever, S., Dermirkan, F., Doruk, N., Tsdelen, B. (2009) Incidence of pressure ulcers in intensive care unit patients at risk according to the Waterlow scale and factors influencing the development of pressure ulcers. Journal of Clinical Nursing 18, 765-774.
Blood pressure is measured by two pressures; the systolic and diastolic. The systolic pressure, the top number, is the pressure in the arteries when the heart contracts. The diastolic pressure, the bottom number, measures the pressure between heartbeats. A normal blood pressure is when the systolic pressure is less than 120mmHg and Diastolic pressure is less than 80mmHg. Hypertension is diagnosed when the systolic pressure is greater than 140mmHg and the diastolic pressure is greater than 90mmHg. The physician may also ask about medical history, family history, life style habits, and medication use that could also contribute to hypertension
Dentist and dental hygiene providers are an integral part of the whole healthcare system. They provide oral health services that help patients' maintain their dental health, as well as provide a standard of care that incorporates a level of quality patients' will experience, together with quality treatment patients' expect and deserve. Although the vast majority of dental patients' that who are able to go the dentist are generally well, it’s essential to be able to assess their overall well-being. Therefore prior to comprehensive dental work, it is our dental office policy to implement a patient assessment in order to evaluate for possible risk of complications that could develop due to a high blood pressure diagnosis. In this paper, information about the importance of monitoring dental patients’ blood pressure prior to dental treatment, what blood pressure means, as well as a scenario of an issue where more training is needed on how to use a manual blood pressure monitor as opposed to operating an automatic digital blood pressure monitor.
D. standing near her room, breathing sharply. While asked what has just happened, she answered, ‘I feel dizzy and can faint!’ Mrs. D. then explained that she rose up from her chair in the television room and felt lightheaded. I decided to bring her to the room hoping she would feel less dizziness if she could sit. After consultation with my mentor and third year unit nursing student, I decided to perform measurement of her vital signs. Since only electronic sphygmomanometer was available for me that time, I had to use it for my procedure. Gladly, I discovered that I have already used such equipment in my previous nursing practice. Using the standard sized calf, I found that her blood pressure was 135/85, respirations were 16, and her pulse was 96 beats per minute (bpm). However, I decided to recheck the pulse manually, founding that it was irregular (78 bpm). The patient stated that she felt better after rest. Immediately after the incident I made a decision to explore carefully the medical chart of Mrs. D., along with her nursing care plan. That helped me to discover multiple medical diagnoses influencing her
Monitoring a patient’s vitals during anesthesia is extremely vital and cannot be stressed enough. Using the massive amount of technology and electrical instruments available within a surgical suite, machines can lie and should never be trusted. Your eyes and ears are you most valuable tools you have. Of course, there are the simple things of observing your patient’s heart rate and breathing rate with a stethoscope but there are many other things you can observation skills can tell you that machines can’t. For example, it is very important to open your patient’s eyes during surgery to investigate the position of the pupils. If the pupils cannot be seen, this can indicate a too deep and inappropriate level of anesthesia. Another example is checking
Discussing potential risk issues associated with using automated blood pressure/pulse machine in relation to contemporary practice.
Schnall, P., Landsbergis, P., Belkic, K., Warren, K., Schwartz, J., & Pickering, T. (1998). Findings In The Cornell University Ambulatory Blood Pressure Worksite Study: A Review. Psychosomatic Medicine, 60, 697.