June 29, 2015
The Problem: Mary Jones underwent a cardiac procedure this morning and is under observation for BP instability in CICU. In the cath lab, she needed vasopressors to regulate her blood pressure, and her nurse has orders to treat with vasopressors if her mean arterial pressure (MAP) drops below 60 mmHg for more than 15 minutes. Mary’s oscillometric cuff is set to measure q5 min NIBP for the first 30 minutes post procedure. Systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP) values are recorded in her electronic medical record.
Mary’s nurse does a head-to-toe assessment and double-checks the last MAP value based on her usual calculation method (SBP + 2DBP) / 3.
She discovers that her calculated MAP value doesn’t match the displayed MAP value. and concludes the monitor isn’t working correctly.
The Question: Is something malfunctioning? Can the nurse trust what she sees on the monitor? Why are these values different?
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