Taking BP on ankle

[AmericanChai]

I just learned how to take BP on someone's arm. Woo hoo! I remember when my daughter was a baby and in the hospital, her arms were in splints so they took her BP on her ankle instead. I wonder-- in patients (adults and peds) who can't have BP taken on their arm for whatever reason, how accurate is taking BP on an ankle instead? What artery do you use to listen for sounds? I am getting my cuff and stethoscope in the mail soon and dying to practice on people.

[prowlingMA]

I have been taught to find the outer ankle bone and place the scope behind it. I usually have luck getting a good reading that way.

Mayy be slighly lower than arm BP.

[RN1989]

For vs measurements it would be better to try to use a thigh cuff if you cannot use either arm or do not have an invasive line in place.

As people age their peripheral blood vessels harden and narrow. This effect is exagerated in people with medical problems (diabetes, PVD, PAD, CAD, etc.) An ankle bp is not going to give you a very good assessment for vs usage. Particularly if that pt is taking meds that cause vasoconstriction, if they are cold and have vasoconstriction to conserve warmth, or are starting to decompensate and go into shock. You could be missing a subtle change in vs or get upset and call the doc about a low bp by using a reading that is so far away from the body's central core.

Unless a person has AV graft or has had lymph nodes removed with mastectomy, there usually isn't any reason not to take an arm bp. I have known many patients say that they can't have a brachial or radial bp taken because of mastectomy but further investigation reveals that they actually only had a lumpectomy or did not have lymph node surgery.

An ankle bp utilizing the PT and DP pulses is a great non-invasive tool. You can perform an ABI (ankle-brachial index test) and get info regarding the pt's possible need for further exams to check for peripheral artery disease. This will affect their ability to heal from peripheral wounds/surgeries, as well as whether or not they are at risk for arterial ulcers, dry gangrene, etc.

[jessiern, BSN, RN]

The first time I had a pt that had to have ankle bp's, I wondered the same thing. So, me and a fellow coworked went into an empty room, took both of our arms and ankles. The ankles is about 5-10 points lower than the arm.

[Penguin67]

An ankle b/p is used alot in peds, esp with infants and toddlers. I center the arrow on the cuff over the inner ankle bone and wrap the cuff. I use a dinamapp machine, thought, not a manual scope/cuff setup.

[mcknis]

We have used calf pressures before with bilat upper ext amputees, and bilat mastectomies. Difficult to auscultate but can be done with practice. We usually don't use our own stethoscopes for these, and instead use a manual bp cuff with a doppler. But, when using a doppler scope the systolic number is the only number you will get. Written as 126/doppler.