non painful Leg Blood Pressures

brownbook · Feb 17, 2012

How do you take a blood pressure on the thigh without hurting the patient? I have had this done on myself and it hurt like crazy. Despite this, I did it on a patient in school because my instructor told me to, and it hurt him so bad I stopped in the middle and never got a reading.

Automatic (I assume you are using automatic) blood pressure machines can squeeze tightly to the point of patients complaining. If the patient's blood pressure is higher than "average" or the cuff/machine is having a hard time getting a pulse it will squeeze tighter on the second try.

Everyone has different levels of sensitivity. Personally I don't like the tight pressure of blood pressure cuffs even on my arm, and I have a pretty high pain threshold and average blood pressure.

It may hurt like heck, as I said everyone experiences pain differently. There might be no way to not have it hurt for less then a minute or so until the machine gets the reading. You need to tell the patient, yes I know it is really squeezing tightly, yes I know it hurts, it will deflate in a few seconds, do not move around that will only make it get tighter.

If you critically need a blood pressure reading you have to give the patient a little pain now to save their life.

Double-Helix, BSN, RN · Feb 18, 2012

1. Why are you taking a blood pressure in the thigh in the first place? The thigh has a large proportion of muscle and fatty tissue, meaning that it's going to take much more pressure to occlude the artery and get an accurate blood pressure than it would in the bicep, the forearm, or the ankle. It's certainly not the best site to use unless you have no other option. So unless you have a really good reason (the patient doesn't have arms or lower legs. Or they have a lot of lymphedema in the arms and PVD, or PVD with a bilateral mastectomy, etc) you shouldn't be using the thigh for blood pressure.

2. Make sure your cuff is the appropriate size. The same rule of fitting a bp cuff applies to the arm as to the thigh. The cuff should wrap around the entire extremity with at least a 25% overlap. That means that if you measure the thigh, the circumference should equal 75% of the length of your bp cuff. For most adult patients you are going to need a much larger cuff than you would use for the arm. A cuff that's too small will give you an inaccurate reading as well as need to pump up much higher to occlude the artery. And it's going to hurt a lot more. Actually, I've never really seen a cuff that big on most units, which makes me wonder if you're using the right size.

3. Position your cuff correctly. Palpate the artery that you're using. The arrow on the cuff should line up with the artery. You should also wrap the cuff so that the edges line up. Again, this will need to be done carefully as the thigh is not the same width the entire way down. If the cuff is wrapped at an angle rather than lined up, your measurement will be off and the cuff won't inflate correctly, causing more pain.

nursegrad · Feb 27, 2012

Thanks y'all! I don't know why I would do thigh instead of ankle. That sounds way less painful.