Lunchlady arms kill me. Will an electronic stethoscope revive me?

[42pines]

***A note to Allnurses.com Admin--Please bring back the "inside allnurses.com" search--when I enter "electronic stethoscopes" into the search bar, it bring me to google search but I'm looking for prior posts on the subject which I know exist here.***

I'm an Occupational Health RN in Industry. I have moderately significant hearing loss from prior industrial noise. When I take blood pressure readings occasionally I'll run into a woman whose arms are, well--Rubinesque, and I can't get a good reading. Oddly, this never seems to be the case even with really obese men.

I'm sure others have this problem. Some people's pulse sounds are like jungle drums--delightfully loud and clear, and others muddled, distant, or sometimes not even audible and being honest, I say "sorry but I can't get a decent reading." Oftentimes I can guesstimate by looking at visual cues on the gauge. But patients absolutely hate to hear "I can't get a good reading." I suspect other nurses have this problem and just never say: "I can't..." but rather guess, which is not, in my book, acceptable.

So, I'm wondering, if the Brachial artery runs deep in some people, and/or a hefty layer of adipose tissue dampens the sound--will an electronic stethoscope rescue me?

If you use one in your practice, please identify the model and give us a mini-review.

[CrunchRN, ADN, RN]

Those ex large thigh cuffs are awful. I find in ex small and extra big elevating their arm works. I have them rest their hand on my shoulder. And that ex large cuff must be snug for sure.

[netglow, ASN, RN]

The AN search does bring links, you just need to scroll down some more on that page.

[sirI, MSN, APRN, NP]

netglow is correct. When you do a search, the first 3 or 4 results will be non-AN results. Just scroll down and you will find the AN results. :)

[42pines]

Ah...thank you on the search tip...

[SunshineDaisy, ASN, RN]

Can you sort of hyper extend the elbow a bit? That usually helps me. I have large arms and tell whoever is doing my BP to do it and they get the pulse right away. Hyper extending the elbow kind of helps to push the brachial artery up a bit!

[joanna73, BSN, RN]

With someone who has larger arms, you can also place the BP cuff on their lower arm, near the wrist. Just make sure the cuff is facing so that the rubber bladder is extending up the arm. My preceptor taught me this trick. When you don't have access to a thigh cuff, or a large BP cuff, this method will give you a reading.

[malestunurse]

With someone who has larger arms, you can also place the BP cuff on their lower arm, near the wrist. Just make sure the cuff is facing so that the rubber bladder is extending up the arm. My preceptor taught me this trick. When you don't have access to a thigh cuff, or a large BP cuff, this method will give you a reading.

Is it accurate?

[joanna73, BSN, RN]

Yes actually, it is. You have a pulse at the wrist also. I've checked it this way, and using the proper method to compare.

[merlee]

I began using a battery-operated wrist cuff many years ago. I ask the client to hold their wrist near their heart. I get good readings, surprisingly so.

Best wishes!