Refering someone to a GP for high heart rate?

[ross997]

So here is my situation...I am a recently qualified gym instructor, and currently studying to be a personal trainer. As a part of my course, I am required to work 80 hours at a gym which is organised between my college and a selected gym. During my time at the gym I gave an induction to a 61 year old lady. One of our requirements is to take their blood pressure and pulse rate. Her blood pressure was fine, reading 123/79, but her pulse was 99 at rest. I was so occupied on the blood pressure that I didn't register the pulse rate in my mind and let her join without questioning it. Anyway, a couple of days later it occurred to me that her pulse rate was high when I read through the PAR Q, so I went straight to my manager to ask him if I should contact her to refer her or at least let her know it was high. However, he said there was nothing to worry about as in his 12 years of work he has never referred someone for a high pulse rate. He even looked at the regulations set by the gym in the work handbook, which stated that you should refer someone with a blood pressure which reads 160/100 or over, but it never stated pulse rate. (In regards to Blood pressure I thought this was to lenient, as I would refer anyone over 140/90)

Before I digress, I couldn't stop worrying about the situation even after the manager reassured me. I even went to my teacher who said that it was fine, (A qualified personal trainer). But at the end of the day, they don't have to worry about it as it wasn't them who took her induction. My time at that gym is now over, but I remember the lady's number. Im tempted to contact her just to inform her that her resting pulse rate was high and that she should maybe get it checked, but my parents and other trainers have advised me not to because it would be breaching the privacy of a PAR Q. Plus I don't want to alarm her  which could cause her a problem!

I believe that a resting pulse rate of 99 for a 61 year old is far to high, I just didn't notice at the time.....she was also sedentary and overweight which leads me to believe she is really at risk.

I want to contact her but im really scared to, but again i don't want to face the guilt if something happened to her.

Any advise please, I really need it?  

[Jerry_NJ]

It is common for people to suffer from the "white coat" syndrome whenever they go into a doctor's office - they have temporary high blood pressure and heart rate.  These are people who need ot check on their own when they are truly at reat.

As Tom said, 60-100, even at full rest, is "normal", does not require any corrective measures.

For my part if I had been presented with the numbers, I would have said to the person:  "your blood pressure is very good, you heat rate is at the high end of normal".  Enough said.  

If I was also educated as a personal training I hope I would also have had some general words of advice on how to move from where the client is to where they might need to be - lose weight, etc.  I think that too would also say something about how hard of a work out they should start with,  how to measure their heart rate,and what range to stay in/under.. stuff a personal training should have a good knowledge of, I don't.

[achillea]

I've been mulling this over, based on what I've seen in decades of going to the gym, and here is a thought that might reduce your worries a bit:

I simply do not know even one 60 year old woman who does *not* have a personal physician.  As people get older, they understand the need for health insurance and they see doctors more often for lots of things--women more frequently than men.  Weight, BP, and pulse get checked right after you go through the door.

The odds are that this lady in fact has a doctor who is quite familiar with both her BP and her heart rate.  I am pretty sure you can relax a little.

[ross997]

Im not very familiar with my doctor so I think I may pay to ask a doctor on this site. But even then im not sure what conclusion they would come to....as you said contacting them is breach of confidentiality so I cant think of a solution to the problem.  A doctor will either tell me that its fine or that I should have told her at the time. That's what I feel is the depressing thing about the situation, I feel helpless. I don't want to feel responsible for somebody's death but it looks like there is no way I can intervene without crossing boundaries that I shouldn't.    

Thank you for your advise though, your the only person who has seen it fro my point of view.

[achillea]

If you know your doctor well, it should be possible to have a brief conversation with him/her about the ethics of the situation and what to do.  It might take a tad of explanation to the office staff, but if you describe the situation to them as well as you have here--about your sense of responsibility--I think it should be possible to get through to them.

[ross997]

I could possibly ask my own doctor about the matter but wouldn't they just disregard me because its not concerning my own health? I'm just so worried about the situation...people keep telling me not to worry about it but my instinct tells me that I have made a terrible mistake.

[tom_h]

Numerous online references from respectable site state 60-100bpm is considered a "normal" pulse range.  Plus, there could have been any number of factors that could have given her a pulse in the high range of normal. The term resting pulse is just that, resting.  Walking into your gym from a parked car, perhaps amped up a little and nervous could raise the average person's heart rate.  Sitting on the sofa and watching TV for the evening to me is a resting pulse.