Other ways to get BP?

First, what are the reasons that the pressure is being done on a thigh to begin with? If you can't easily palpate a radial pulse, then your BP is low, and your patient is hypotensive, of course, unless you have some type of arterial damage in that arm.

What type of unit are you working on? I remember working on the Navajo Rservation many years ago and having a patient with a systolic BP in the 40s over the weekend, then she died on the Monday. But she was alert and talking the entire weekend.

Have you tried putting the BP cuff around the patient's calf, and checking for a BP in their foot with the pedal pulse. If there is a pedal pulse, then they are perfusing okay.

suzanne4, she did mention the patient does have pedal pulses, so he is likely not as hypotensive as the old rule of thumb would say he should be.

bbq, have you tried putting a cuff on the ankle or wrist and using a machine like a dynamap?

Other than that? Nope, no ideas beyond an indwelling line...

Faith

I already suggested that they put the cuff around the calf, and use the pedal pulse. If the patient has a pedal pulse that is of good quality, then yes, they are not hypotensive.

But why isn't the cuff being used on an arm? Is she too small and you don't have one in the right size?

What other history does she have besides CHF?

If you are able to easily palpate a pedal pulse, then it means that there is a popliteal pulse there. Farinkott makes an excellent suggestion, what type of stethescope are you using? Is the cuff being properly positioned, with the trinagle or whatever marking that yours has, over the actual pulse? Just sounds quite odd that you have a pedal but can't get a BP even with a doppler.