Using BP cuff to access certain veins? - page 2

The other day I was at work and saw one of our LPNs using a BP cuff when inserting a peripheral IV catheter. I have seen this done before but can someone explain the rationale for this practice to... Read More

  1. by   suanna
    Leaving the cuff up to just above diastole promotes maximum engorgement of the veins-ALL of the arterial flow gets in, with veins compressed the venous flow is blocked- engorgeing the veins. With a tourniquet you have no clear idea of how much pressure you are exerting. If it is too tight it can partialy obstruct the arterial flow reducing the blood avail. to fill the veins. Also with fragile veins, once the veins are up, you can reduce the pressure on a cuff to reduce the built up pressure in the veins- less likely to "blow" when you insert the I.V. With a cuff you have a smoother, more consistant application of pressure- A tourniquet can bunch up the skin into folds- effectively protecting the veins from being compressed. There is also the comfort factor- a cuff inflated to 60mmHg is a gentle hug for the arm, a tourniquet pulled tight can be very painful for fragile skin. I have been doing this almost 23years and have much better luck with a cuff.
    Last edit by suanna on Oct 28, '07
  2. by   canoehead
    What suanna said
  3. by   anc33
    I used to use the BP cuff method on very fragile patients. Once I had a patient whose skin incurred a minor tear from the tourniquet (even though I placed it over the gown) and I vowed that I would not let that happen again. The cuff method definitely cuts down on bruises, tears etc. I have never tried it in a younger person so I can't compare the effectiveness of both methods.
  4. by   EmmaG
    Quote from pagandeva2000
    I was taught that, also. Thus far, I find the BP cuff to be a bit cumbersome, but that is just me. If I had to, I would. At this time, I have used a glove if no tourniquet was available, but for the hard to reach veins, I have used two with decent results.
    Oh, please reconsider this... a glove hurts sooooo damn bad. I've had them used on me, and you wouldn't believe how painful they are; I'm a pretty compliant patient, but when someone comes at me with a glove I refuse to allow them to stick me until they get a tourniquet.
  5. by   RN007
    Quote from truern
    Personally, I love my quick release belted tourniquet that gets the same results as a BP cuff. It's much more comfortable than the regular disposable elastic tourniquet that comes in an IV start kit.
    What's a belted tourniquet and where do you get one?
  6. by   EmmaG
    Quote from RN007
    What's a belted tourniquet and where do you get one?
    These, perhaps?

    http://www.allheart.com/pm4350.html
  7. by   RN007
    Yeah, cool. Expensive, though. Thanks!
  8. by   EmmaG
    I love allheart!!

  9. by   MA2006
    BP cuff hurts much less than a tourniquet. Especially when you have fat arms. The even distribution of pressure from a BP cuff is much easier to handle than the pinching, painful tourniquet especially if the tourniquet rolls into a skin fold..ouch!!
  10. by   raemon
    bp cuff can support the compression and will not cause trauma to veins and also to skin for those wiht improper placement of touniquets..
  11. by   EricJRN
    I'm a fan of BP cuffs over tourniquets. When I worked in a blood donor center, BP cuffs were standard on our apheresis donors. They're not necessary for routine venipuncture or IV access on your average Joe, but once you get used to the bulkiness, they provide more comfort and better visualization for those tough sticks.
  12. by   cardiacRN2006
    Quote from bill4745
    It works quite well. Our ER monitors actually have a "Venipuncture" button, which holds the cuff at a steady 60mm of pressure. Just be careful you don't pump a manual cuff too high. Check with your hospital policies also.

    Ours too. The benefit to me is that the pt already is connected to the monitor, and likely already has the bp cuff on.


    Quote from SaderNurse05
    To be honest, many years ago (as a med tech) we would occasionally use BP cuffs. For me, as my skills in venipuncture incresed my use of the cuff decreased. I am not saying that people who use a cuff can't stick .

    Using the bp cuff has absolutely nothing to do with phlebotomy skills.
    Last edit by cardiacRN2006 on Oct 27, '07
  13. by   mcmike55
    I've used a BP cuff instead, occasionally, in addition to a regular tourniquet.
    I had my shift supervisor, who I totally respect, tell me years ago that the wider cuff does a better job of compressing an arm than a "rubber band". That's why I always (if possible) put the tourniquet on the humerus, rather than the forearm. In my humble opinion, you can't compress the arm as well because of the ulna and radius, versus one single bone in the upper arm.
    I've used a cuff on people especially larger pts', that others have alread had trouble with.
    I sometime use the multiple tourniquet trick too. Starting with the cuff or touniquet high on the arm, then a second lower down, often above the AC, release the top, moving it below the AC, then "get 'er done".
    I have not used a BP cuff either in some time, partially because I guess I have not needed it, or, with the increased usage of electronic cuffs, the old fashioned BP cuffs are not as easily available!!

    Mike

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