Hi, I have a question about taking blood pressures.
On the floor that I am completing clinical on we use fairly new Welch Allyn all-in-one automated vital machines. As with most blood pressure cuffs these come with an artery marking on the blood pressure cuff. When I see the nurses take blood pressures they just throw the cuff on the arm and I dont believe they put alot of thought into placing the artery marking on the artery. When I take blood pressures I always try to get the artery marker over the artery as best as I can but sometimes I find it hard to get it over the artery on some patients and other times I put on the cuff and forget the pay attention to the artery line. The pressures I get are pretty consistant to what the patient has been getting, I havnt really ever gotten a really odd pressure for that patient. As mentioned above, these are automated devices that are fairly new.
I am kind of worried that sometime when I take a blood pressure the artery line isnt exactly over the artery Is this going to significantly alter my values? I am worried now....
Mar 24, '07
The newer machines are very sensitive so you don't have to fit the A marker on the cuff exactly over the artery to get a good reading. If you get a weird reading, wait a few minutes and do it again, then check it in the other arm, or you could do it manually.
Mar 25, '07
I wonder the same thing myself sometime, sometimes I forget about the A-Marker.
Mar 26, '07
I don't totally trust the auto machines. If I find a pressure is not what I anticipated or seems "odd" I take it manually. I also take it manually on certain pt's to begin with because I: 1) know they have a soft pulse and the machine can't always read it 2) irregular HR can alter the machines result 3) some little old ladies really don't like how hard the auto's squeeze! For these reasons I always carry a manual and stethoscope with me when taking vitals. I even mention in report if I have found a manual works better with a particular pt. If I find I have a difference in the result between a manual cuff and an auto one I include this in report as well as too what my rational is. I find the other nurses pay more attention and will also use the manual if I have given them a reason to go with my recommendation.
I think cuff size is by far more important than making sure the arrow is properly placed. If you have the arrow on the inside of the arm... you're good. Same is true for manual cuffs.
~ BTW ~ my Unit doesn't have any CNA's so we do a lot of BP's...
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