[johnboy]

It's been a couple of years since I attended the Ahrens class, but I agree I remember him stating that NIBP cuffs measure "flow" and art lines measure "pressures": as said previously, comparing apples and oranges. The square wave test should help in your decision.

Another thing does stick out in my mind that he said: don't put down both NIBP and art line pressures on the chart, because if the chart went to trial, the lawyer might try make you look "unsure" of what you were doing. Pick one, document why you did it over the other, and stick with it. And (i'll be the first to admit i never do this), try to get your square wave test documented on your strip containing the art line waveform! It's just another good piece of documentation about your waveform and BP!!

[icu-nurse]

I think I read one person say a-line measures flow and cuff pressure, and someone else say the opposite. Which is it? It seems to me the cuff would measure pressure and the a-line flow.

[olive2000]

Any news on leveling at phlebostatic axis versus insertion site?

[jbp0529]

We zero everything at the phlebo axis at my place and everywhere else I've worked. As my understanding goes, that's the current school of thought in most literature (I'm not one of those ppl that has a works cited of books to quote off the top of my head, so Im just shooting from the hip per-se).

And in relation to the other posts on the topic of alines vs cuff...at my place we use the aline if there is a good waveform and good square wave test. We typically follow the aline if there is about 5 - 15 mmHg difference higher than the cuff/nibp. However whats neat about our bedside monitors is that in the cases where one has a good waveform but the darn aline doesnt correlate at all no matter what we do to troubleshoot....we can dial up/down the aline reading in the monitor to make it match better. Not sure if I explained that right or not...Im tired and just got off work

Hope that helps!

[cardiacRN2006]

We zero at phlebostatic axis. Did anybody notice the OT is 9 years old? I think this is the oldest thread I've participated in! Amazing how much data is in this website...

As far as cuff vs aline, if there is a big difference between the two, I make sure to get an order as to which one to use for titration (unless it's totally obvious. But, if the Aline is so bad that it's giving me a crappy waveform then maybe we should pull it)

[burn out]

I have found many times after inaccurate readings between A-line and cuff pressures that there has been a problem with the art line catheter itself..mostly bent under the skin thus being the cause of the inaccuracy.
To bad I didn't fine this out until the line was dc'ed. Even with the catheter bent I still got the square waveform when it was leveled and calibrated. Also, we always compare the two- art and cuff- at the beginning of each shift , if there is 10% difference we go with the cuff pressure-may still use the art line to draw blood from though.