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What does it mean when a nurse says your blood pressure

"bottomed out"?...
What does it mean when a nurse says your blood pressure "bottomed out"?
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Answered in 5 minutes by:
9/19/2009
Dr. Abby
Dr. Abby, US Board Certified MD
Category: Medical
Satisfied Customers: 10,330
Experience: Family Physician practicing medicine for over 10 years, United States
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Lady Rose,

Was this in the hospital?
Under what situation did this occur?

Dr Abby
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Customer reply replied 8 years ago

Not in hospital; I was at work. Situation: I donated whole blood at a Red Cross blood drive where I work. I've done this many times, and never had even the slightest reaction. As usual, I had a protein breakfast before donating. After donating, I drank two glasses of apple juice and went back to my office to work. After about an hour of feeling fine (during which I drank a full glass of water and ate some yogurt and berries), I suddenly became very dizzy, and felt like I was going to faint. I guess I blacked out for a moment, because suddenly there was vomit all over my desk, even though I don't recall vomiting that first time. Less than aminute later, I vomited again and began to sweat profusely. I was too weak and dizzy to stand, so coworkers put me in a wheelchair and took me to the company health center, where I vomited a third time. The R.N. on duty took my blood pressure and put me on oxygen. She said she was calling EMS because my blood pressure had "bottomed out" and I was sweating so profusely she thought "it might be cardiac."

When EMS arrived, the nurse said my blood pressure was "back up." EMS took my blood pressure a few times, did an EKG, told me my eyes were "pinpoint" (whatever that means), and asked me questions that I'm also answering here FYI. They asked if I wanted to go to the hospital. I was still pretty weak and "foggy," but since they said I would probably be okay as long as I drank lots of fluids and "got my iron back up," I decided to go home. Coworker called my husband, since I couldn't dirve; husband came and took me home.

I drank lots of water and rested the remainder of the day and next morning. Returned to work the next afternoon and since pressure was back up to 136/80, I took my usualy medication (2.5 mg Lisinopril). Still felt weak and "fuzzy-brained," so I went home after a couple of hours.

It's three days later, and I'm feeling almost back to normal — just tired andstill a bit weak. I'm a 62-year-old femal. Medication I take daily is: Lisinopril 2.5, Armour Thyroid 60 mg, Flonase nasal spray for allergies, and sometimes (not this past week) ibuprofen for back pain.

My questions are:

  • What did the nurse mean by "bottomed out"? When I asked what that meant, she said "very low." When I asked how low, she said "20." Does 20 refer to the top number or the bottom number? (I want to be able to tell my family doctor what happened when I go for my annual physical in November.)
  • And, how serious was this? Will there be any long-term effects from this event?

Should I dontinue donating blood a couple of times a year, as I have been over many years? I have O-negative blood, so am concerned about blood supply shortages, and like to help. Am I just too old now to safely give blood?

Thank you.

Wow, you had quite a reaction! I am glad you are finally feeling almost back to normal.

While I cannot say exactly why this happened, it sounds like you had what is called a vasovagal episode. What this is-an episode that consists of a drop in blood pressure and heart rate. These episodes can be triggered by giving blood, traumatic events, or for some people the cause is unknown. Vomiting and sweating are common symptoms of this type of episode. It is not uncommon, but I understand the nurse being nervous, as usually the reaction occurs right after giving blood, not an hour later.

The drop in blood pressure leads to fainting or near fainting.

A normal, healthy person is able to recover their blood pressure quickly, as you were, and regain consciousness.

When your blood pressure dropped, the nurse termed it as "bottoming out" It did not become zero, but became very low, causing you to pass out. I cannot say which number was 20, but I suspect it was your bottom number.

There should be no long term effects from this event. It was a brief loss of consciousness.

Most likely this was not a cardiac event but your doctor may want to do a cardiac workup due to the fact that it occurred an hour after giving blood.

As far as giving blood...I cannot give you an answer regarding this at this point. You need to have your blood work (thyroid, cbc, etc) done by your doctor, etc. If all turns out ok, it is hard to predict whether you will have the same reaction again.

I hope this is helpful for you. If you have any further questions, let me know.

Dr Abby
Dr. Abby
Dr. Abby, US Board Certified MD
Category: Medical
Satisfied Customers: 10,330
Experience: Family Physician practicing medicine for over 10 years, United States
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Here is a bit of information for you about vasovagal syncope from Mayo for you to read if you like:

http://www.mayoclinic.com/health/vasovagal-syncope/DS00806

Dr Abby
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