Blood Pressure & IV???

[coffeefix]

I've tried to look this information up myself, but can't find an answer.

We have been taught not to take a blood pressure in an arm w/ an IV.

So here's my question..... If one arm has an IV, the other arm is in a contraption (sorry- I don't know the name of it, but it's where your fingers/hand is suspended in the air by this metal thing???) and both of your legs are in casts........where do you take the BP?

Thanks for your help!

[AirforceRN, RN]

You can take a blood pressure on an arm with an IV but it is generally considered bad practice and increases the chances of the IV blowing due to the pressure. If at all possible, avoid the IV side...if its not possible you have to do what you have to do.

[r.oxymoron]

If the IV is antecubital, you could try the wrist. I agree you've got to do what you've got to do, but it's still at risk for blowing.

[rotteluvr31, ADN, RN]

Maybe this will help illustrate the concept - based on a personal experience from a couple of days ago.

I managed to dislocate my right arm - went to the ER and because they could not touch my right arm, they used the left for blood pressures, and when they started my IV, they used the L AC.

Sometime during the course of my morning - which is a little foggy from the pain and the pain meds, I believe I flexed my arm while the b/p cuff was going off. I may have done it more then once, but truly don't remember. The upshot is when they d/c'd the IV it was easy to see that not only was it blown, but I have now developed a huge, tender, hematoma at the site. So while you can use the same extremity for b/p's and IV's, just used caution. :nuke:

[Alternator81]

This happens in real life all the time. It may be their hand in a contraption, or a mastectomy, or an infection and you have to use the same arm on the patient for everything. I always stop the IV and occlude the line. Never any problems so far.

[enigmaticorange]

We take a thigh pressure using an oversize cuff if a complete arm is unavailable- if we cant do upper arm we use the forearm.

[beth66335, BSN, RN]

I agree with several people here. First thing I would try is going below the IV site and just stopping the pump for a couple minutes. If I can't do that I will use the thigh. Last resort is to go above the IV while stopping the pump. I have even taken a BP on the leg right at the top of the foot lining up the arrow on the cuff with the pt's shin bone. Sometimes you have to get creative!

[Daytonite, BSN, RN]

Either

• Take the blood pressure on the arm with the IV and then open the IV clamp and allow fluid to flush through the line afterward to clear it of the blood that backed up into it.
  
• Stop the infusion and take the blood pressure. Flush the line with about 3 to 5cc of NS and restart the IV.

The above will assure the IV remains patent.

[coffeefix]

Thanks everyone!! I appreciate all of the advice