Blood Pressure Monitoring help please

RE: Blood Pressure Monitoring help please

Kayy26 — Tue, 18 Sep 2018 10:53:15 GMT

Hi there, Is there any chance I could have a copy of this laminate too please my email is kay.adamsvets@gmail.com thanks in advance xx

RE: Blood Pressure Monitoring help please

James Colver Cert. Ed, RVN — Sat, 24 Mar 2018 23:26:45 GMT

Given that almost all of the drugs used to perform GA cause hypotension to some degree, I would regard BP monitoring intra-op as almost essential. If I could choose only one piece of equipment to assist in the monitoring of a GA, BP monitor would come second only to capnograph.

There are two types of non-invasive blood pressure monitors, oscillometric (usually as part of a multi-parameter monitor) and the doppler. The oscillometric machines detect pressure changes in the cuff - it's very straightforward as the only thing to do is place the cuff and set the machine to measure. It is less reliable than the doppler, particularly in small patients (<5kg). Appropriate cuff size should be used and ideally machine placed level with the patient.

The doppler method involves placing the cuff, and then placing a probe over an artery distal to where the cuff was placed. When the probe is correctly placed, the pulse is heard through the speaker / headphones. The cuff is inflated until the pulse cannot be heard, and slowly deflated until it becomes audible again. This reading is taken as the systolic pressure.

Again, many patients will become hypotensive under GA so it's important to know about it, and act. Normal MAP range is considered to be ~60 to ~120mmHg and if it falls below this then the person monitoring the GA needs to speak to the surgeon about what to do about it - usually looking at ways to turn the iso down (perhaps considering local blocks / other analgesia) and if this doesn't improve the BP then IVFT boluses are often considered (to help boost the circulating volume and raise the BP) - usually up to 10ml/kg over 15 minutes, repeating if necessary.

https://www.aaha.org/public_documents/professional/guidelines/fluid_therapy_guidelines.pdf

RE: Blood Pressure Monitoring help please

Sierra Bravo — Sat, 24 Mar 2018 19:07:06 GMT

Hi! is there any chance i could get a copy of this if you still have it?

S.J.B2@hotmail.co.uk

Thanks x

RE: Blood Pressure Monitoring help please

Sarah Southworth RVN CertVNECC — Sat, 25 Jul 2015 21:10:50 GMT

Hi could you please email me the sheet ? sarahsms@hotmail.co.uk

many thanks

Sarah

RE: Blood Pressure Monitoring help please

lisa 1998 — Sat, 25 Jul 2015 14:18:21 GMT

Hi could you please email me this sheet i would find it very useful. My email address is lisa_mustchin@yahoo.co.uk

thank you

RE: Blood Pressure Monitoring help please

Jade.Simmons — Sat, 25 Jul 2015 09:09:45 GMT

Ah ok, yes ours we use in theatre have found it pretty reliable x

RE: Blood Pressure Monitoring help please

gemima — Sat, 25 Jul 2015 09:08:43 GMT

Hi,

No probs will do it for you next week as its on work comp xx

RE: Blood Pressure Monitoring help please

Steph Worsley — Fri, 24 Jul 2015 20:48:56 GMT

[quote user="Jade.Simmons"]

do you use the cardell touch steph? We've just got one it seems fine every time I've used it and seems reliable - how do you find it?

[/quote]

Hey Jade, no we just have the normal cardell (we have other multiparameter machines in theatre which I don't touch) It is reliable, BUT we always check that the HR matches that on the machine as have found them to be WAY out at times (usually when the HR is either really high or low, better with anaesthetised patients though,

RE: Blood Pressure Monitoring help please

Jade.Simmons — Fri, 24 Jul 2015 09:33:02 GMT

do you use the cardell touch steph? We've just got one it seems fine every time I've used it and seems reliable - how do you find it?

RE: Blood Pressure Monitoring help please

Steph Worsley — Thu, 23 Jul 2015 18:26:50 GMT

we have both doppler (parks) and oscillometric (cardell) machines, personally I prefer the doppler machine as it is my hearing, there can be issues with the cardell not obtaining correct heart rate and therefore the BP can be wrong.

With the doppler I would recommend investing in headphones to use with it.....2 reasons: 1 it helps focus you on just the pulse and 2 the loud noise of contact/pulse can freak the animals out so gives a false high BP.

Metaccarpal pulse is a really good pulse to use, I can do the majority of cats on my own with them sat either in the kennel or in their basket if they are outpatients

Always do the BP prior to ANYTHING else that might stress the animal out (bloods etc) to gain accurate results, make sure you have a good range of cuffs (width of cuff should be approx 40-60% circumference of leg), loads of gel (can use KY if desperate but ultrasound gel best), and take min of 3 readings preferably 5.

Personally the hardest thing is locating the pulse, but once you have that then you can do a BP in 5-10 mins (have been known to do 5 readings in about 2 mins before now) As with everything, the more you do the easier it will be.

I think as long as you know normal ranges (doppler you will only get the systolic anyway) you can understand what is high and what is low, it's just putting that into context with everything else with the patient....we have 1 dog in particular who when his BP is taken with the owners present it is perfectly normal. but when he's out back it goes up quite a bit and he doesn't even appear overtly stressed

If you are looking to use it for senior pets in particular it is fantastic as these patients can often have undiagnosed hypertension, either idiopathic or as a result of an underlying disease: hyperthyroid or kidney disease as 2 big examples. and of course the heart patients

We have a lot of animals coming back to us for routine BP monitoring for all these reasons, also cushings patients need regular BP checks.

Errrrm think thats about all.....any other questions I'll try and answer when I can

RE: Blood Pressure Monitoring help please

Sarah Bolton — Thu, 23 Jul 2015 17:17:03 GMT

Hi Gemima

Would you be able to email it to me as well. It sounds great. My email is sarahboltonuk@btinternet.com

Thanks

Sarah

RE: Blood Pressure Monitoring help please

Holly anon — Thu, 23 Jul 2015 15:50:08 GMT

Its all easy when you know how isn't it. I need to get up to speed with interpreting Capnographs and ECGs. Straight forward setup and measurements, non-invasive, quick reading. The only tricky part may be setting a protocol within the practice of when to intervene and how.

RE: Blood Pressure Monitoring help please

gemima — Thu, 23 Jul 2015 14:58:01 GMT

Hi,

We routinely use Doppler blood pressure for ga's etc, I have a sheet that I did for the students that I keep laminated in theatre im more than happy to email to you. If using during aneasthesia depending on the surgery etc I normally take a reading every 10-15 mins, it is easy once the Metacarpal artery is located and I always tape the probe to the animal to keep it secure. Any other queries will help if I can! xxxx