[Michellebr]

the place where I work has BP cuffs that say LONG on them.
They do not say Xlarge or anything like for a large person.

They are cumbersome to use and I find I have trouble getting
them TIGHT around the patients upper arm.

So, is the LONG cuff going to affect the accuracey of the BP reading?
Every BP cuff is like this where I work.

[loriangel14]

I was taught that a cuff that doesn't fit properly will give an inaccurate reading. Where I work we have three sizes and just today a student took a bp that was really low. When she was taking the cuff off I noticed that the cuff was the biggest we had. I took the bp with a better fitting cuff and it was fine. I discussed this with a co-worker (that has much more experience than me) and she agreed that the low bp was probably due to the wrong cuff size.

[RN Randy]

I believe they need to cover the middle 50-60% of the upper arm vertically, but more importantly, take a look at the cuff markings. Most all disposables and many permanent cuffs have a white line on them, as thus |__________| , and a small tick-mark on the other side of the cuff. The tick-mark or "artery arrow" must fall within the bracket of that line once the cuff has been wrapped.
The wrong size cuff will definitely give you a wrong reading. Small short cuffs read high, larger longer cuffs read low. Or for practical use, your standard cuff gives bigger people hypertension and stick people hypotension.
I think it has something to do with the physics of large volume/small volume bladders, pessure/volume gradients, in that short bladders don't meet, or fully compress the vessels in equal circumferece and pressure/volume gradient occurs quickly, while larger/overlapped bladders keep compression on longer at lower pressures.

Same principle as your car tire using 32psi while those two story high excavation trucks with six foot tall tires use about 6psi. It's all about percentages.

Or I could be totally wrong.
I hate math... lol.
rb

[nursingis4me]

I was taught in school that to acurately take a BP, use a standard adult cuff if the pt was 100lbs or more and over 15yrs old, but use a large cuff if the pt weighed more than 150lbs. Of course, this theory should be adjusted if the pt is tall in stature (a person can weigh 175 lbs, yet be 6'2"-thereby having a "normal"-sized arm).