[openheartmom3]

Recently I had a 207kg pt that our staff had been using a NBP (proper size for arm) around her forearm..They were obtaining SBP pressures >200's and DBP's 70 - 90's. Physicians were going to start a vasoactive drip on her until I noticed a BP of 237/44.... the significant drop in her DBP made me question the accuracy of the pressure... A physician and myself found a thigh cuff that we could just barely get on her upper arm and manually with stethoscope ( and verified by doppler) we obtained SBP of 130. Does anyone have know of literature supporting the accuracy of forearm cuffs. (multiple attempts to start an arterial line were unsuccessful)

[glasgow3]

Originally Posted by openheartmom3

Recently I had a 207kg pt that our staff had been using a NBP (proper size for arm) around her forearm..They were obtaining SBP pressures >200's and DBP's 70 - 90's. Physicians were going to start a vasoactive drip on her until I noticed a BP of 237/44.... the significant drop in her DBP made me question the accuracy of the pressure... A physician and myself found a thigh cuff that we could just barely get on her upper arm and manually with stethoscope ( and verified by doppler) we obtained SBP of 130. Does anyone have know of literature supporting the accuracy of forearm cuffs. (multiple attempts to start an arterial line were unsuccessful)

The AACN has issued a Practice Alert on this very topic; the supporting literature for the expected practice is cited. You may visit that portion of their website without being a member. Hope that helps.

[openheartmom3]

Thank you ... I do have that practice alert......still going to look for research on the accuracy of forearm BP's.

[glasgow3]

Originally Posted by openheartmom3

Thank you ... I do have that practice alert......still going to look for research on the accuracy of forearm BP's.

Ok OK..lolol


How bout Singer,A J Comparison of Forearm and Upper Arm Blood Pressures Prehosp Emerg Care Apr-June 1999