[Janet Barclay]

I am interested in finding out if other centers routinely compare art line and cuff pressures q shift. I question the validity of this practice as the method of measurement is quite different. Also, if your directors are anything like the ones I work with, they tend to accept the number that they like better anyway!

[barb o]

We compare cuff and A-line pressures every shift (12 hours). Don't scoff at this practice, because, while it may seem to be extra work, it may make a difference in how you manage patient medications. Many times, especially in patients with vascular disease, there are significant differences between pressures in both extremities. Just yesterday, I cared for a man whose right arm BP was 130/70 and left arm (A-Line arm) BP was 110/66. The left arm cuff reading correlated with the Aline. If you read the literature, there is a general agreement that using the higher pressure is correct procedure. Also, A lines are machines and may not be working properly. It's always best to check.

[bluesboyj]

The standard of practice where I work is always check a cuff pressure for correlation with an art line. The art line may not be working properly and there could be complications if vasoactive gtts are being used. I agree with barb o that the few extra seconds are worth it so the patient is not adversly affected.

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Blues Forever

[Canrckid]

Where I work we generally check an a-line vs. cuff pressure to see how they correlate, then use the discrepancy to "trend" titration of vasoactive drugs................
If the a-line waveform demonstrates catheter "whip", then the cuff BP measurement is what we use as a titration parameter. Sometimes, if you view the a-line waveform against a "scale" on the monitor, (eg. 150 or 200mm/hg), you can usually account for that part of the waveform that is "whip", vs. a "normal" arterial waveform, and then trend according to a presumed "normal" waveform....