BP Cuff Readings vs. Arterial BP - Page 3

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  1. Jun 16, '12 by
    Quote from sockov
    Most institutions have policies NOT to flush an invasive line.
    we flush our arts, RA's, LA's. CVL's, UVC/UAC's whatever you got. How else are you supposed to know it's patent? Even our intra-cardiac lines we have a policy to draw back every morning to make sure we get blood return to be sure it's in good position. The only central lines we don't draw off of are those on our tiny kids (I work peds) where the french size is too small for blood draws. Other wise we check it. And if we ever have a waveform issue the first thing the doc will ask us is if we flushed it/got blood return
  2. Jun 17, '12 by
    Id look at the art line wave form, if it looked like a good wave i would try flushing the line. Many times I would have an art line that was slightly dislodged or had a whip and it made the ABP off by alot. In those scenarios where the cuff pressure was still okay id go with the cuff. Also look at the pt - does the pt look like their SBP is in the toilet? How do they feel? Good question
  3. Jun 18, '12 by
    I meant, "manual" flush like with a syringe. Sometimes you have to flush gently with a 3cc to get it unstuck from the vessel wall. Sorry for confusion.
  4. Jun 18, '12 by
    Sometimes you have to flush rather aggressively (or vigorously, as they like to call it in formal policies). There is no harm in that.
  5. Jul 3, '12 by
    A difference in the aline sbp 70 to cuff of 109 would lead me to believe she had subclavian stenosis. The aline measures pressure and the cuff measures flow. So the flow isn't there because of the stenosis. Our vascluar surgeons have us follow the aline. When once questioning a surgeon about the accuracy of aline vs cuff he said "I put a catheter in the aorta myself and I know it's correct". On a few occasions the doc has given orders when someone had bad stenosis to take the reading and add 50 to the SBP.
  6. Jul 12, '12 by
    I have been in that situation. What I do is, I make sure the A-line is at the phlebostatic axis, I flush the line, move the wrise around to see if it is positional. Sometimes you need to roll up a washcloth and tape an armboard to keep it in a position to get a good reading. If all of those are done and they are still not the same, then I document BOTH. I let the physician know that they are measuring far apart. Let them decide. Usually, the doc says to go with whichever is highest. But still document both, because if you are measuring something on the patient and getting these readings, it should be documented. Protect yourself by stating that the BP cuff and a-line readings are 30mm apart and that the MD is aware.