bp cuffs and obese patients

PedsAtHeart, LPN · Jul 13, 2010

I totally agree about the shape of the cuffs.

I have a nice automatic wrist cuff that I use on people who have really large arms. I would just make sure that you have a good one and check it against a manual BP before actually using it on a patient. Also, you can use a regular cuff on the lower part of the arm to get a BP.

6mostogo · Jul 13, 2010

If it is improperly sized, it definitely will read inaccurately. Cuffs that are too small for the circumference of the arm will read too high. Not sure that the shape makes a difference, but the facility should provide cuffs for bariatric clients for this reason. If I have a larger person and the cuff doesn't fit right, I'll try the forearm if it's within the recommended circumference.

NurseTrishaH · Jul 13, 2010

That is a great idea!!! I have a hard time especially taking a BP on a large person with short arms. Sometimes the cuff goes from armpit to elbow on short women!

cherrybreeze, ADN, RN · Jul 13, 2010

I do forearm pressures on someone with upper arms that make a good fit impossible (or a fit at all impossible). It works well.

rosey2007 · Jul 13, 2010

If it is improperly sized, it definitely will read inaccurately. Cuffs that are too small for the circumference of the arm will read too high. Not sure that the shape makes a difference, but the facility should provide cuffs for bariatric clients for this reason. If I have a larger person and the cuff doesn't fit right, I'll try the forearm if it's within the recommended circumference.[/quote
I wish I could show this comment to a nurse that I had in the ER one time when I was a patient. She put a small cuff on me and it squeezed so had I thought it was going to bust off. Then she told me that my BP was high and I said that using a small cuff on a larger size person would not give a good reason. She told me that I was wrong and I knew better. I have taken many BP's being a CNA so I now a little about what I am talking about lol.

gentlegiver, ASN, LPN, RN · Jul 14, 2010

I have taken BP's on upper & lower arms and on an ankle once (with Dr's permission, patient was huge, only place the x-large cuff would fit). Just be sure to document the location of placement, diferent parts of the body give slightly different readings.

danh3190 · Jul 28, 2010

My facility has some cuffs that are the regular width but are longer so they wrap around bigger arms. The problem with obese cuffs is that a lot of obese people don't have a lot of upper arm so the width of the cuff becomes a problem. The longer but regular width cuffs seem to work well on these folks.

Hoozdo, ADN · Jul 28, 2010

I have had to be extremely creative on where to use a cuff. The only places

I haven't used one is around the trunk, neck, or the high upper thigh. Of

course I know that it isn't accurate. My main concern has been if they have

a "live-able" BP or not.

**canoehead, BSN, RN** · Jul 28, 2010

I have had to be extremely creative on where to use a cuff. The only places
I haven't used one is around the trunk, neck, or the high upper thigh.

I've been wanting to try the around the neck thing, for those LOL that screech and shake that the cuff hurts so bad, and then wiggle so much it's pumping up to 230. I've wanted to, but I usually just pull out the manual cuff.

Yes, I agree it hurts, but the drama gets a little over the top.

lkwashington · Jul 28, 2010

At the facility I work we order different sizes. I have heard using a thigh cuff on a larger arm work well.

Fribblet · Jul 28, 2010

I've been wanting to try the around the neck thing, for those LOL that screech and shake that the cuff hurts so bad, and then wiggle so much it's pumping up to 230. I've wanted to, but I usually just pull out the manual cuff.
Yes, I agree it hurts, but the drama gets a little over the top.

It's been my experience that people who shriek about the BP cuff getting too tight are also the one's claiming their abdominal pain/HA/Hang nail/menstrual cramps are 10/10.