How do you take BP on the forearm?

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Hi, all! New here but enjoying the boards very much. Question: when taking the BP of a larger pt with a standard size cuff on the forearm, where do you place your stethoscope? At the antecubital space or on the radial pulse? We're expected to do this in clinicals, but haven't been shown how. Just a miss by the instructors, I guess. And do you place the cuff on upside down? Stupid question, I know. But one everyone in my class is struggling with. Thanks!!

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Specializes in Everything but psych!.

I always get the correct size cuff.

If you WERE to use a regular size cuff, first recognize it would not be as accurate. Use the radial pulse. The cuff should be placed the same direction as it is placed on the upper arm.

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Specializes in Neurology, Neurosurgerical & Trauma ICU.

I also always try to get the correct cuff size, but at the hospital I used to work at, that wasn't always possible.

When I did take it on the forearm, I used the radial pulse. You have to use a pulse below the cuff.

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Specializes in Trauma/ED.

I agree that sometimes it's just necessary to take it on the forearm...some people are just soooo big or they have limited sites d/t fistulas etc. I would do some patient teaching and have the patient tell the next person taking it to do it in the same place so there is consistent data to see trends. Personally I think the problem with bp's is that they are taken by different people using different techniques(placement, cuffsize, etc). When this is done it makes it a lot harder to catch potential problems early because there are too many variables involved in optaining the data.

Remember in the texts they usually say no forearm-get larger cuff. (not real world)

Hope the others gave you enough info...it will be harder to hear on the radial pulse and i would never compare the values with others taken from the brachial--will be a lot different

good luck,

Larry

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Specializes in Pediatrics, Nursing Education.

i'm not sure, but the placement of the b/p cuff... you can place it upside down if you have the bladder (the thing that fills up with air) positioned correctly over the artery.

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Why do you place it upside down? You just need to have the cuff placed the same way that you would for the upper arm, with the arrow over the artery.

You are using the radial artery...................... :uhoh3:

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upper arm, lower arm, legs....sometimes I wish I could use the neck! =0) As all the others have said, see if you can find the right cuff....but in general, from what I have learned, yes, it may be a bit off from standard bp cuff placement readings...but if your pts bp is 220/130....no matter where you take it..something is wrong... I've had to take Bps on a pts calf before d/t severe skin breakdown on the arms.

Just a little note: adults you can generally use a too big/small cuff..just place is somewhere that fits correctly.... peds? Always demand the proper size cuff!!

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Specializes in Pediatrics, Nursing Education.
Why do you place it upside down? You just need to have the cuff placed the same way that you would for the upper arm, with the arrow over the artery.

You are using the radial artery...................... :uhoh3:

oh, i was just saying in general... if you were to place it upside down, why would it matter as long as you have the cuff over the artery?

i've seen some nurses place the cuff upside down because that way the cords don't smack the patient in the face. i've never had to do it myself-- in peds, we always make sure we use the correct size cuff, and its just easier to put the cuff on the regular way, as we use a roll around b/p cuff instead of using cuffs that are attached to the wall at the head of the bed.

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