BPs through clothing

[rpe]

I often am required to obtain BPs through clothing on patients that are moving in noisy surroundings and I often have difficulty with this. Does anyone have a similar experience and if so, what stethoscope has worked for you?

Thanks,

rpe

[Parameduck]

What setting do you work in? If you need a BP in a pinch and it's noisy, consider palpating one. It doesn't give you a diastolic pressure (or even the exact same systolic BP as auscultation), so it's probably not good for obtaining routine BP's.

[rpe]

I work in a correctional facility. The inmates often are wearing heavy sweaters underneath heavy jumpsuits. They often are not able to push up the sweater and jumpsuit sleeves in a way that would not affect the BP reading. They are housed in a cement dorm structure with two televisions going and 40 people talking. Depending on what is going on in the dorm, I have asked to step aside into a side room where I can obtain a "normal" BP. However, sometimes that is not an option. I have threaded my stethoscope up under the sleeve to the antecubital area but that isn't always an option either. I have palpated a systolic when the inmate was in handcuffs and uncooperative and I needed a quick check. However, the case I am referring to in this thread is when I need a fairly accurate BP to use in tracking HTN or detox conditions.

Thanks,

rpe

[KylesScreenName]

I work in a correctional facility. The inmates often are wearing heavy sweaters underneath heavy jumpsuits. They often are not able to push up the sweater and jumpsuit sleeves in a way that would not affect the BP reading. They are housed in a cement dorm structure with two televisions going and 40 people talking. Depending on what is going on in the dorm, I have asked to step aside into a side room where I can obtain a "normal" BP. However, sometimes that is not an option. I have threaded my stethoscope up under the sleeve to the antecubital area but that isn't always an option either. I have palpated a systolic when the inmate was in handcuffs and uncooperative and I needed a quick check. However, the case I am referring to in this thread is when I need a fairly accurate BP to use in tracking HTN or detox conditions.

Thanks,

rpe

I've recently become a big fan of Kila Stethoscopes (http://www.kila.com). Their scopes are good (at least in my ears) for auscultating BPs through hoodies and the like - I work in EMS, so I've done this quite a bit. The other thing to consider is that single-headed stethoscopes block out sound a little bit better then the dual-head varieties.

[mcknis]

I have done this several times and find I peronally can still hear well no matter what. The stethoscope, once again, doesn't mean much to me. I can get a BP with a cheap disposable scope or a high end cardiology scope.

[JaredCNA, CNA]

rpe,

I'd consider palpating the B/P. It's usually pretty accurate.

However, I had a Littman Lightweight II S.E. and I could hear it through clothes.