Blood Pressure Kits for Obese??

  1. I am trying to find a manual blood pressure kit that I can use on obese patients. At my job, the cuffs are against the wall, and the patients must sit on the exam table in order for me to obtain a manual reading. Most of the patients cannot get up on the table and also, there may be a need for this in my home care assignments.

    Does anyone know of a web site on line where I can obtain this? Or a place to purchase this from in the NYC area?

    Thanks...
    •  
  2. 11 Comments

  3. by   traumaRUs
  4. by   Beech1184
    You don't need a special kit. It's been proven that you can take blood pressure accurately on an obese patients forearm. You then use the stethscope over the radial artery. This works with automatic BP machines too.
  5. by   PralineLPN
    Quote from Beech1184
    You don't need a special kit. It's been proven that you can take blood pressure accurately on an obese patients forearm. You then use the stethscope over the radial artery. This works with automatic BP machines too.

    This is what we do, too-Works fine, sometimes the sounds are a little diminished, but just turn off the TV and listen really hard.
    Paul
  6. by   pagandeva2000
    Thank you all for your input. This is what I will do from now on. Now, let me ask, where was it found that we can use the forearm? This way, if I am questioned, I can support why I have done this. I really appreciate it, everyone!
  7. by   pagandeva2000
    Quote from traumaRUs
    Thanks, traumaRUs!
  8. by   Beech1184
    It was tested and proven in a hospital in Canada but like most Nursing interventions it wasn't written up in a professional journal. Best answer for skeptics is to do a comparison test: use a large cuff on the upper arm and a regular cuff on forearm and compare the readings.
  9. by   NRSKarenRN
    Quote from pagandeva2000
    now, let me ask, where was it found that we can use the forearm? this way, if i am questioned, i can support why i have done this. i really appreciate it, everyone!
    forearm info in this link: http://www.plus-size-pregnancy.org/lgbpcuffs.htm
    blood pressure readings on the forearm
  10. by   LovebugLPN
    I think, after reading the information on forearm bp, that it is a good idea to buy a cuff. They even say that it is not as accurate on the forearm.
  11. by   pagandeva2000
    I am hoping that the cuff can come with the sphygomomometer (I know I spelled it wrong, folks...LOL) because the ones that I have seen thus far are just the cuff, but I don't see how it can connect to the manual cuff that I already have. I have such difficulty asking the seriously obese patient to get up, sit on the exam table and then have to struggle with the one on the wall, that the forearm sounds like a good deal to me as long as I can hear the sounds. But, I have to be sure that whatever I do is actually accurate, since in most cases, I am doing b/p readings right before administering clonidine. And, checking later to see if it worked... oh boy.... (it has really been horrible...let me tell you...)
  12. by   Franksters
    Calling all nurse inventors!! Please come up with a cuff/system that makes it easier on the patient and us. I am 5' 4"/117#. I have had to try and lift arms weighing 20#. We have all had those patients so obese we need 2 people to get a B/P.
  13. by   postmortem_cowboy
    Forearms are just as accurate just like thighs are just as accurate, size of BP cuff is what is necessary to ensure an accurate measurement of BP, I've worked for a cardiology clinic for a few months and the docs have said, on obeese patients, with forearms like normal sized patients upper arms, is no different. You wouldn't use a thigh cuff on 90 lb grandma's upper arm and expect her BP to be very much. The reason your sounds are faint is that when you put your steth bell over the radial artery, the bell usually hangs off or isn't directly over the pulse point. If you have alot of obeese patients from this practice and are going to take BP's on wrists alot, it might be a good investment to pick up a ped's steth, the bells are smaller and can usually accomodate a radial artery site, and your sounds will be much better, however, you should cut down the tubing and make them as short as practically possible. The further sound has to travel, the more the tubing will absorb, the less you will hear. I had a pediatric/NICU RN as a clinical instructor who had two peds steths, one was a cut down tubing, and the other the long long tubing, and sounds are better heard with a cut down model. Just go with a cheapie, no need to spend 200 dollars on a master cardiology for BP's.

    There's always a palp BP as well if nothing else works, you'll get the systolic, but no diastolic pressure. At the very least, you'll have the information you need to administer your BP med.


    Wayne.

close