Published Aug 29, 2007
MelodyRNurse
255 Posts
I feel stupid asking this, but I have the most difficult time taking blood pressures in my facility. Mostly when the residents are contracted, uncoopertive, or thier arms are just dead weight whether they can help it or not. I am a little hard at hearing, but I have a pretty decent stethascope. I cannot take BPs on the FA because I can't hear them at all. We are not allowed to use wrist cuffs. Can anyone offer some advice please. Other nurses get really irritated and look at you like an idiot when you ask for help taking a BP-it is a basic skill after all, but it slows me down soooooo much.
catlynLPN
301 Posts
What about a digital b/p cuff, for use on the upper arm, like a regular cuff and a stethescope is not necessary?
I found one at WalMart for about $50.00 and I've compared the readings to manual cuffs and it is quite close.
Dolce, RN
861 Posts
I don't know who sells them but I know there are electronic stethoscopes out there. Could you purchase one of them? Also, I'm sure you know this, but make sure the room is perfectly quiet when you are taking the BPs. You can take a BP on someone with contractures, it is just difficult and requires you to place the stethoscope in the correct place. If you are hard of hearing your facility should be willing to accommodate you and get you the equipment you need. Your facility needs to invest in automated BP cuffs!!
TeresaB930, BSN, RN
138 Posts
Wow, why doesn't you facility have a cart with electronic system that takes heart rates? I don't know how many BPs you have to take, but I would see if they would consider purchasing one.
Just a thought....
CapeCodMermaid, RN
6,092 Posts
Most studies have shown that the electronic blood pressure cuffs are as accurate as the old fashioned kind. That said, taking blood pressures in old people is a skill which requires practice. Give yourself some time and you'll get there.
catslave
71 Posts
I too am somewhat hard of hearing and the facility I work in prohibits the use of automatic BP equipment. I use a Littmann electornic stethoscope model 3000 with ambient noise reduction and an appropriate size BP cuff without any problems at all. The stethoscope will run you around $265, is well worth it and the purchase is tax deductable.
Thankyou for all the suggestions.
Daytonite, BSN, RN
1 Article; 14,604 Posts
I bought a digital wrist cuff for my CNAs to use and finally stopped using it on the patient's with irregular heart rates or pacemakers because I found that it was giving me false readings. I took manual blood pressures on those patients. Even if you can't "hear" the blood pressure with a stethoscope, you can always do a palpated blood pressure. This will get you the systolic reading (top number). All you need to do is find and palpate the pulse (brachial or radial), inflate the cuff on their arm above it until the pulse is obliterated and then release the air in the cuff. When you start to feel the pulse again, you've got the systolic pressure.
We are not allowed to use digital bp cuffs in my facility, and if I could actually palpate a brachial pulse on these residents, chances are I will not have trouble hearing the bp. Its the ones that have pulses that are difficult to find or the ones that are contracted or noncompliant that I am having trouble with. I think its just going to take time and practice, as someone previously posted. I wish I could use digital bp cuffs :angryfire.
Thanks again for all the suggestions .