BP in arm with PICC?

If I can't take the BP on the opposite arm, I take it on the wrist or the leg.

If I can't take the BP on the opposite arm, I take it on the wrist or the leg.

Yeah, the guy has a shunt in his other arm, so I took it in his leg, but his nurse had been taking it in his forearm...I've heard you're not supposed to do it in that arm at all, or below the PICC- I've yet to hear which is the best one.

Just last week I had a pt with a PICC in her right arm and a DVT in her left, so we were taking bp's in her right forearm. That is where her PCP told her to take them until the DVT resolved, and it was the only place she would allow us to take them.

Alright, another question, not to do with PICC's but arms and BP's, and lab draws. Patient has a bilateral masectomy...where do I do all of the above? And she has EXTREME 3+ BLE edema!! :uhoh21:

Alright, another question, not to do with PICC's but arms and BP's, and lab draws. Patient has a bilateral masectomy...where do I do all of the above? And she has EXTREME 3+ BLE edema!! :uhoh21:

Does the patient know? Usually in that case, the patient can tell you where they normally have all this done. Hopefully the doctors will place some more permanent access (TLC, PICC, mediport, etc) for you. Maybe ask them for suggestions or help...

Well, she did thankfully have a port, however we needed to get blood cultures....hmmm....tricky. The PCA ended up getting the BP on her forarm since her legs were so swollen, she has cancer through and through..so sad.

Considering a PICC is a central line, I would not take a BP in an arm with a PICC. Even taking it in the forearm could increase the pressure above the cuff creating problems for the PICC.

Considering a PICC is a central line, I would not take a BP in an arm with a PICC. Even taking it in the forearm could increase the pressure above the cuff creating problems for the PICC.

It might increase arterial pressure, but since a PICC is venous, would it really be an issue?

Hi- I'm currently half way through nursing school and also work as a CNA in hospitals. We're finishing up learning about central lines/PICCs etc., and I know that you're not supposed to use an arm with a PICC to take the BP, or so I was taught and have always though. But, I'm working with a nurse tonight who said you could take the BP in the arm as long as it's below the PICC, so in the forearm- is this allowed? I've heard differing opinions- what's the right answer?

Your nurse that you were working with is correct. You can take a BP out of the arm BELOW the PICC line, but not over the PICC line. If you think of it in terms of what happens when you squeeze a straw and then let go... a reflux of fluid will be drawn into the straw when you release pressure. This also occurs with open-ended or non-valved IV catheters; A reflux of blood is drawn into the IV catheter and this increases the potential for occlusions. In addition, the squeezing of the arm can increase the contact of the IV catheter with the tunica intima which in turn encourages the possibility of phlebitis and thromus.

DD

I just called the nurse on the IV team here that is certified to insert and work with PICC's. She states that it is not recommended, but not contraindicated if that is the last alternative. The fear is in fracturing the PICC line, but this is a moot point in case of emergency.

We tell our nurses to avoid taking the BP in the PICC arm....but the reality is sometimes we do not have a choice and we take them below the PICC site. We often have bilateral PICCs in or an AV graft in one arm and a PICC in the other and try to find a BP cuff large enough for some of our pts legs...it is not happening.....So make the best decision you can with all the variables thrown at you I have learned that in nursing that is what you have to do sometimes...Get all the facts first and then make the best decision you can