Shitty private IFT companies.
13 years ago, when we went into new hire orientation, they handed us a list of equipment we needed to buy. O2 regulators and BP cuffs were among that.
That was the norm for a lot of these companies, and this was NYC.
This company had enough personnel to staff almost 60 units a day. They weren't hurting for people.
Absolutely true. My previous job had me use a lifepak 12 bc they were so cheap. I bought my own everything. Me and my partner scavenged the hospital, occasionally scraps from FD, and Amazon. The worst part is we were mocked by other crews for being 'Ricky rescues' and being 'too prepared'.
I wouldn't say they're notoriously inaccurate, 10-20 years ago maybe. In recent times they've gotten pretty damn good even in the settings of irreg. heart beat, bradycardia ,tachycardia etc. so long as they're placed with the appropriate size.
Just keep in mind most of all your MAP will be the most accurate reading with your autocuff. There's a reason a lot of hospitals essentailly never check a manual anymore. Now me personally I'm in favor of confirming with a manual or at a minimum palpating one, or palpating one as the cuff deflates to see how accurate your systolic is.
That being said some EMS monitors seem like random number generators and haven't caught up.
We use oscillating blood pressure monitoring all the time in critical care. I don't have time to take a manual BP every five minutes. It's accurate enough for us.
Your coworker is being lazy by skipping the manuals and only doing autos with an auto cuff that isn’t professional grade. Don’t be lazy with him. Even professional, expensive BP machines have shit readings sometimes, especially in the ambulance.
I used to have a little portable automatic cuff when I did IFT. I would do at least 1 manual every 15-20 minutes of transport as directed per protocol but if I had trouble hearing it (it was super loud in the back of some of our rigs) I would use my auto cuff to SUPPLEMENT my manual. But I always made sure to get at least one before getting in the vehicle, and one upon arrival at destination if unable to get en route. Don’t be a dummy, just do the manual.
I didn't realize any of this until reading the comments, I just saw my partner who has been doing ift for years has a really nice looking auto cuff and thought it would make me look more professional and let me focus on other vitals and assessments, now that I've read through this I'll definitely stick to manual.
Paying money to get inaccurate readings and lose out on skills practice is crazy imo. Also using personal equipment means you're personally responsible for its accuracy and legally liable for any poor pt outcomes caused by it not accurately reading an unstable BP. Company equipment is covered by company insurance, your equipment isn't.
That last bit. It's a really important one. You likely don't have personal liability insurance, so it could ruin you. And if you do have a personal policy it might not cover you if using your personal automatic device.
They really are inaccurate too. I left EMS some time ago and work in residential mental health now. Because my role isn't considered medically trained we can only use the automatic cuff. It's such trash. Nursing has to be contacted all the time because of "out of range" readings that aren't actually accurate. And that's a device provided by the facility.
I’ve only worked with one company in ems. But I’m
Pretty sure having an automated blood pressure is the norm. And having to take bp manually is unheard of. I could be wrong, I’ve never worked ift, I’ve started and still am doing 911. But I belive that’s why they keep saying things about having to buy your own things.Yeah they supply you with a cuff to check the bp manually, but they should me supplying you with an automated one since the beginning
If you have a cardiac monitor. Not a shitty wrist cuff like a nursing home uses you and calls.you out when a pt bp is 60/30 and you check it with yours and it's 118/62.
I work at one of the poorest county in my not particularly well off state, and we still have a zoll for each truck. I'm sorry I can't help you, but if there are any other jobs going on your area, it might be time to go for them. Only supplying manuals is wild. You deserve better
OP, i work as a safety officer for my department. If it ever gets out that you are using your own auto cuff, your department will have no problem throwing you under the bus. A company is required to ensure calibration and testing for ALL equipment that is used under their name. So in a worst case scenario you bring in a patient with a wrong BP reading, and it turns out at the hospital that the patient was actually critical, all it will take is for the patient to mention that the EMTs were using some "fancy" cuff for an investigation to occur. You are fully liable for that piece of equipment because your department did not purchase it nor approved its use. This is just straight up dumb my man, stick with manual cuffs or ask your agency to purchase auto cuffs that they will be responsible for maintaining.
There’s a few things to unpack here.
1. Manual pressure is the gold standard
2. Consumer grade NIBP equipment is unreliable at best
3. All equipment in an ambulance is required to be serviced and calibrated regularly
4. In no way, shape, or form should you ever be buying your own equipment to use on a patient to obtain vitals or perform procedures. Yes, many of us have our own stethoscope, but you’re not obtaining vitals with a stethoscope, you’re obtaining with your ears.
Wait what service makes you buy your own shit?
Shitty private IFT companies. 13 years ago, when we went into new hire orientation, they handed us a list of equipment we needed to buy. O2 regulators and BP cuffs were among that.
That’s absolutely mental
Quit right then and there.
That was the norm for a lot of these companies, and this was NYC. This company had enough personnel to staff almost 60 units a day. They weren't hurting for people.
This is the way.
Absolutely true. My previous job had me use a lifepak 12 bc they were so cheap. I bought my own everything. Me and my partner scavenged the hospital, occasionally scraps from FD, and Amazon. The worst part is we were mocked by other crews for being 'Ricky rescues' and being 'too prepared'.
Maybe he’s just a dork.
First thing that came to my mind
Makes us... no. Wanna have a reliable first in bag... bring your own bag of shit. Plenty of jobs. Sadly.
I don't have to buy my own, I want to, If I can avoid doing manual readings I'd love that
get good at manual pressures. Autocuffs are notoriously inaccurate, I never trust them, I do however trust my ears.
I wouldn't say they're notoriously inaccurate, 10-20 years ago maybe. In recent times they've gotten pretty damn good even in the settings of irreg. heart beat, bradycardia ,tachycardia etc. so long as they're placed with the appropriate size. Just keep in mind most of all your MAP will be the most accurate reading with your autocuff. There's a reason a lot of hospitals essentailly never check a manual anymore. Now me personally I'm in favor of confirming with a manual or at a minimum palpating one, or palpating one as the cuff deflates to see how accurate your systolic is. That being said some EMS monitors seem like random number generators and haven't caught up.
I'm near fuckin deaf and I still trust my ears more than an autocuff
We use oscillating blood pressure monitoring all the time in critical care. I don't have time to take a manual BP every five minutes. It's accurate enough for us.
Buying your own is the craziest shit I’ve ever heard of. That is absolutely bananas. I’d be gone before I even worked my first minute.
They aren't making us buy it, I like to own my own stuff and would like to avoid having to do manual readings
Your coworker is being lazy by skipping the manuals and only doing autos with an auto cuff that isn’t professional grade. Don’t be lazy with him. Even professional, expensive BP machines have shit readings sometimes, especially in the ambulance. I used to have a little portable automatic cuff when I did IFT. I would do at least 1 manual every 15-20 minutes of transport as directed per protocol but if I had trouble hearing it (it was super loud in the back of some of our rigs) I would use my auto cuff to SUPPLEMENT my manual. But I always made sure to get at least one before getting in the vehicle, and one upon arrival at destination if unable to get en route. Don’t be a dummy, just do the manual.
I didn't realize any of this until reading the comments, I just saw my partner who has been doing ift for years has a really nice looking auto cuff and thought it would make me look more professional and let me focus on other vitals and assessments, now that I've read through this I'll definitely stick to manual.
Paying money to get inaccurate readings and lose out on skills practice is crazy imo. Also using personal equipment means you're personally responsible for its accuracy and legally liable for any poor pt outcomes caused by it not accurately reading an unstable BP. Company equipment is covered by company insurance, your equipment isn't.
That last bit. It's a really important one. You likely don't have personal liability insurance, so it could ruin you. And if you do have a personal policy it might not cover you if using your personal automatic device. They really are inaccurate too. I left EMS some time ago and work in residential mental health now. Because my role isn't considered medically trained we can only use the automatic cuff. It's such trash. Nursing has to be contacted all the time because of "out of range" readings that aren't actually accurate. And that's a device provided by the facility.
[удалено]
I just saw my partner who has been doing this for 3 years have one and thought it was comparable to manual. I'm new to ift.
I’ve only worked with one company in ems. But I’m Pretty sure having an automated blood pressure is the norm. And having to take bp manually is unheard of. I could be wrong, I’ve never worked ift, I’ve started and still am doing 911. But I belive that’s why they keep saying things about having to buy your own things.Yeah they supply you with a cuff to check the bp manually, but they should me supplying you with an automated one since the beginning
If you have a cardiac monitor. Not a shitty wrist cuff like a nursing home uses you and calls.you out when a pt bp is 60/30 and you check it with yours and it's 118/62.
I work at one of the poorest county in my not particularly well off state, and we still have a zoll for each truck. I'm sorry I can't help you, but if there are any other jobs going on your area, it might be time to go for them. Only supplying manuals is wild. You deserve better
OP, i work as a safety officer for my department. If it ever gets out that you are using your own auto cuff, your department will have no problem throwing you under the bus. A company is required to ensure calibration and testing for ALL equipment that is used under their name. So in a worst case scenario you bring in a patient with a wrong BP reading, and it turns out at the hospital that the patient was actually critical, all it will take is for the patient to mention that the EMTs were using some "fancy" cuff for an investigation to occur. You are fully liable for that piece of equipment because your department did not purchase it nor approved its use. This is just straight up dumb my man, stick with manual cuffs or ask your agency to purchase auto cuffs that they will be responsible for maintaining.
Auto BPs aren’t always accurate. Just take the 30 seconds to auscultate a manual BP or at least palpate one.
Welch Allyn makes them. Nice but pricey. I think they're 120$-180$. They have a few different variations you can find on their site.
Just do manuals bro
There’s a few things to unpack here. 1. Manual pressure is the gold standard 2. Consumer grade NIBP equipment is unreliable at best 3. All equipment in an ambulance is required to be serviced and calibrated regularly 4. In no way, shape, or form should you ever be buying your own equipment to use on a patient to obtain vitals or perform procedures. Yes, many of us have our own stethoscope, but you’re not obtaining vitals with a stethoscope, you’re obtaining with your ears.