03 April 2009

Blood Pressure checks

Ten out of Ten has a cool mock-up of an iPhone-blood pressure cuff attachment, with the appended comment, "I just hope the high readings don’t auto-dial 911."

Which reminds me of something that I have marveled about since I got to this part of the country.

Now, everywhere I have ever worked, it was common to see people coming in concerned about their high blood pressure.  Typically, it's anxious old people who obsessively check their blood pressure and write every reading down in a little spiral notebook, but sometimes it's just someone who happened to check it at the drugstore, or with their friend's blood pressure cuff, or what have you.   There's a minimalist work-up I do, maybe I treat them or maybe their blood pressure just regresses to the mean, and with a canned reassurance speech, off they go.

It's easy work but annoying because it really takes a while to convince someone that short-term fluctuations in the pressure are not going to cause them to stroke out and die immediately.

What astonishes me is what is apparently a local custom.  The chief complaint is, of course, "High Blood Pressure."  When I ask them how they came to be in the ER, the response is something along the lines of "Well, I was feeling kind of [insert vague constitutional symptom], so I went down to the fire station to get my blood pressure checked, and they sent/brought me in because it was so high."

Seriously?  You just walked into the fire station and asked them to check your blood pressure?

Apparently, in this neck of the woods, that's the most common thing to do.  Once, when I had occasion to visit a local fire station, I noticed a little triage bay inside the front door, complete with blood pressure equipment there.   They said that "dozens" of people come by for checks every day, and it's just a community service that they've provided here for time out of mind.


In none of the other places I have worked (or lived) have I ever seen this custom.   Growing up, it would never have occurred to us for even a second to "drop in" at the fire house to get checked out.  Not that I'm complaining -- it's a nice service.  

But I still think it's weird.


  1. I volunteered as an EMT for awhile, and while we didn't have people showing up to get checked, we would sometimes set up a table at a town event and offer free blood pressure checks, give out 'vials of life' etc... Though most people with high BP already knew about it.

  2. Agreed. Not even being in the medical profession, I think it's weird. I think its interesting to see how its affected by certain outside influences (i.e. exercise, stress, etc.) but I certainly wouldn't get it checked "for sh*ts and giggles" at my local fire station.

    Re: the iPhone device/software, the bigger concern than if the readings result in a 911 call would seem to be if every elevated reading is automatically sent to the persons primary care doctor.

    Probably result in an uproar...

  3. I'd come in to get my blood pressure checked if the firemen would let me sit on their laps while they did it...

  4. There's a community here where that happens too. Like you said, it's just part of local custom and no one there thinks it's anything but normal.

    Thanks for the link!

  5. I did a short stint with a semi-rural fire department before moving over to the hospital and I enjoyed it when folks would walk over for that kind of thing. As I recall we were usually just watching baseball so it made me feel less guilty to at least be ostensibly taking care of someone.

    It's great when you can do something that simple and make someone feel better.

  6. When a friend of mine was afflicted by high blood pressure (turns out that he hates doctors so much that his normally-normal blood pressure skyrockets into "why aren't you dead?" territory when he goes to see one), the doctor told him to go to the fire station to get it checked. He works across from the fire station, so he'd wander in every few days to have it checked. Evidently firemen, not being doctors, don't trigger his high blood pressure.

    I thought it was weird, too. Maybe it's a regional thing.

  7. At the ambulance service I work for it isn't uncommon for someone to stop in to the base to request a blood pressure check. This is rural EMS up in this part of the country- 60 to 75 miles to the closest hospital in some parts of our service area. It isn't uncommon for people to call the base and ask us to "just come and check me out" and we as EMS providers end up helping them communicate with their primary care provider and occasionally their primary provider. We offer a program where we have patients referred to us by their PCPs and we do a weekly visit with them. It is a weekly well being check during which we help the patients understand their conditions and medications and help them contact any resources they might need.

  8. It is common in Hawaii, in fact they have signs in front of the firestations stating that BP checks are available from 8-4 providing the firefighters are in house.

  9. I live in Seattle, and a couple of years ago when my BP started climbing the same slope my father's did when he was my age, my MD suggested I start to check it several times a week down at the fire station. That seemed like a weird bit of old-timey Americana and I never followed up on it, finding one stationed in my pharmacy.

    It's under control now, but I still need to keep up with it so I don't end up freaking out and huffing and puffing over to the ER myself. I'm thinking about getting a cuff with a digital reader so I can shoot the data over to my MD through HealthVault, but I seem to be putting it off just like the fire station visit. Thanks for reminding me!

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