Accuracy of forearm BP's
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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)