tag:blogger.com,1999:blog-9045015217135885587.post3115011732025686183..comments2024-03-27T04:05:09.556-04:00Comments on Intermediate Physics for Medicine and Biology: Measurement of Blood PressureIntermediate Physics for Medicine and Biologyhttp://www.blogger.com/profile/11077661160486900345noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-9045015217135885587.post-3640633679095306742012-02-17T11:48:25.406-05:002012-02-17T11:48:25.406-05:00Hope you are feeling better. "Long Live IPMB...Hope you are feeling better. "Long Live IPMB!"<br /><br />I would bet large--but not the farm--that more life years have been saved by antibiotic than by blood pressure management. Though not infrequently, both are imperative in caring for the critically ill patient with septic shock. It is an oustounding number of bacteria--friend and foe--that we live with in this universe.<br /><br />While your results may have varied, the old DINAMAP (which predates modern, pulse oximetry) is the prototypical, automated blood pressure cuff upon which which most of these devices are based. These can be had for a song at Walgreens (disclosure: I am long Walgreens ); and they function by an acoustic rather than optical means. The algorithms vary, are straighforward, and rather clever engineering, but are not our patient's very reasonable solution.<br /><br />The patient's discussion is valid, however, and underlies why, in the operating room, we generally place the pulse oximetry probe on an opposite extremity to that of the blood pressure cuff: when the cuff inflates to occlusion pressure, the pulse oximeter squaks a distracting but discountable alarm. <br /><br />A related phenomenon, and perhaps root cause in this admission, is when the patient squirms around or the surgeon leans on the blood pressure cuff while its cycling, the acoustic algorithm computes a number which is not the intravascular pressure, but a confounded and spurious one. Lesson learned: always treat the patient, not the monitor.Frankiehttps://www.blogger.com/profile/04110767257813391750noreply@blogger.com