Difficult BP

[hammerpcp]

I was having a discussion with a colleague this morning about an extremly obese pt she treated with NTG for pumonary edema. My colleague was syaing that the large BP cuff would not fit around the upper arm of this pt so whe put it around the forearm and got the SBP by palp. This made we wonder first, how accurate this is, e.g. is the cuff on the forearm more or less accurate for checking a palpable BP then with the cuff on the upper arm. And also, if one could put the cuff on the forearm and auscultate the radial artery, and how accurate this reading would be. Often when I have a pediatric pt whos arms are too small for our pediatirc BP cuff I will put the cuff on their thigh and auscultate the popleteal artery. I have found this method to work well although I really don't know if there would be a different reading on the arm. Does any one have any insight into this? Or any other techniques for attaining a BP on difficult pts?

[AZCEP]

That is a great question that many don't even consider before they try doing something they've seen once.

Here's a site that might give you the information you are looking for. Be forewarned though, there is a lot you will have to sift through.

[tniuqs]

Just an idea here but why not do your own experiment?

When you get to a facility (that has one) use an large thigh cuff and compare.

Just a side bar try an NIBP in both applications, large arm and forearm.

cheers