Do any experienced EMTs or Paramedics have advice for hearing blood pressures in an ambulance?

Question

I am a new EMT and have been having trouble hearing blood pressures when I take them in the rig. Looking for advice anybody may have to make it easier.

Answer 1

Palp a pressure first. Use your Systolic Estimate...If you don't know what that means and you are in a ALS system, consult with your medic partner, if not seek direction in palpating bp's from your education dept.

Answer 2

just watch the instrument and you can tell when it pulses

Answer 3

the best type of stethoscope for in the ambulance is one with single tubing. This prevents noise associated with friction. Also if you can control the AC in the box turning it down or off may reduce noise.

Answer 4

Get a good quality stethoscope...not those cheap $20 double tubing stethoscopes, but something along the lines of a Littman.

Practice makes perfect! You can always practice checking your partner's BP while the ambulance engine is running. Until you get the hang of it, you could always check vital signs while on scene, before you load the patient into the ambulance.

If you can't hear a BP, you also can check by palpation instead. It only gives you the systolic, but at least it's something.

Another thing...make sure you've got the correct placement of your stethoscope on the patient's arm. Should be just over the brachial artery. The brachial artery usually runs on the inside of the patient's elbow...towards the medial side (the side closest to the patient).

Hope this helps!

Answer 5

You can feel for the pulse first as suggested but the truth is that practice makes perfect. It does take time to really feel comfortable. Staying calm and not worrying about it is a step too. Take Blood pressures constantly in and out of the rig and that comfort zone will get better. The other thing is that if it is just a hearing problem all the way around then purchase yourself a better stethascope to carry with you. Just make sure that you tell your medic that you are still working with it and they will help you...don't be shy and keep the honesty.

Answer 6

Feel the pulse first at the brachial artery.  Then put the stethoscope on the spot where you felt the pulse.  Make sure your stethescope is of good quality and that you have it turned the correct way.  I have seen lots of new EMT's with the stethoscope backwards.