Patient Assessment - VS - BP

Patient Assessment - VS - BP - EMS SKILL PATIENT ASSESSMENT...

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EMS SKILL PATIENT ASSESSMENT / VITAL SIGNS BLOOD PRESSURE PERFORMANCE OBJECTIVES The examinee will demonstrate proficiency in obtaining an accurate auscultated and palpated blood pressure reading. CONDITION The examinee will be requested to auscultate a systolic and diastolic blood pressure using a live model. The examinee will then be asked to palpate a systolic blood pressure on a live model. Necessary equipment will be adjacent to the patient. EQUIPMENT Live model, large/medium/pediatric sphygmomanometer, stethoscope/dual teaching stethoscope, goggles, mask, gown, gloves. PERFORMANCE CRITERIA y 100% accuracy required on all items designated by a diamond ( ± ) for skills testing and must manage successfully all items indicated by double asterisks (**). y Documentation, identified by the symbol (§), must be practiced, but is not a required test item. y Appropriate body substance isolation precautions must be instituted. y Reading must be within +/- 6 mmHg (systolic and diastolic) of examiner’s determination. PREPARATION Skill Component Key Concepts ± Take body substance isolation precautions y Mandatory personal protective equipment - gloves y Situational - goggles, mask, gown ± Select appropriate size blood pressure cuff y Each EMS unit should carry a large, adult, and pediatric cuff. y Appropriate cuff size must be selected or an inaccurate reading will be obtained. - Cuff width should cover 2/3 of the upper portion of the limb. - Cuff bladder should encircle 2/3 the circumference of the limb. ± Select an appropriate site: y Upper extremity y Lower extremity y Blood pressure measurements should not be taken on an extremity that is injured, paralyzed, edematous or has an IV, central catheter, arteriovenous fistula or shunt, or in an arm on the same side as a mastectomy. y Constriction of the arm or limb held in a tense position may result in inaccurate readings, discomfort, blood clots, injury to the vein or damage to the device. ± Position the extremity at appropriate level y The extremity should be at the level of the heart and in a relaxed position or readings will be inaccurate: - above heart level C - false low reading - below heart level C - false high reading UPPER EXTREMITY AUSCULTATED BLOOD PRESSURE PROCEDURE Skill Component Key Concepts ± Place cuff snugly around arm: y Approximately 1" above antecubital space y Center the bladder over the brachial artery y Ensure bulb and tubing are at bottom of cuff - if possible y Arm should be approximately at the level of the heart for the best sound to be heard. y Center of the bladder must be placed over brachial artery in order to register sounds clearly. y Bulb and tubing should be at the bottom of the cuff unless limb contractures or other positioning problems prevent this. ± Locate the brachial artery and palpate pulse
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Patient Assessment - VS - BP - EMS SKILL PATIENT ASSESSMENT...

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