Taking BP on infants

[mmm cdiff]

Hi all, I'm a new patient care tech on a pediatric floor. It seems that I have terrible luck getting BPs on the very young patients (under one year); the machine shows up with dashed lines as the result, then inflates again, further upsetting the baby. The cuff is positioned just fine, and I tried leg BPs with the same result. There have only been a few instances where I got a BP on the first try (sheer luck?!). Any helpful hints would be appreciated, thank you

[ChristineN, BSN, RN]

Hi all, I'm a new patient care tech on a pediatric floor. It seems that I have terrible luck getting BPs on the very young patients (under one year); the machine shows up with dashed lines as the result, then inflates again, further upsetting the baby. The cuff is positioned just fine, and I tried leg BPs with the same result. There have only been a few instances where I got a BP on the first try (sheer luck?!). Any helpful hints would be appreciated, thank you

Well first off always make sure you are using the right sized cuff. If they are fighting you/moving around, you may need to hold their limb that the blood pressure cuff is on still for the cycle of the blood pressure machine. If possible, try not to do blood pressures at times when they seem already agitated and crying. Instead, wait until they calm down (perhaps even sleeping) and then try for a blood pressure.

Good luck as a peds nurse one of the things I hate most is trying to get vital signs on small children.

[SteveNNP, MSN, NP]

the only advice I can add is to ensure that the "artery" guide line on the cuff lines up with where the actual artery lies, eg radial or brachial.

[namastegirl]

One thing that definitely helps is to try to put the cuff on and get the BP when the infant is calm...sleeping is best. However, sometimes thats just not realistic. If you can, put the cuff on when the child is agitated, leave it for a bit (cuff on) and then come back and take the pressure when the baby has calmed down. This way, you won't further upset the baby by putting the cuff on again. Legs usually work best, and always make sure the cuff is the right size. Too loose or too tight and you definitely won't get a reading. Good luck!

[Ert2Rn]

well, i dont know how accurate this will be, so further insight will be appreciated. I work in an er, so im sure the cases are different, but we usually wont take a bp on a child under 6, and sometimes still wont unless the cc requires it, ie premie, rsv, etc. have u tried taking it manually? i know this is an obviouls one, but make sure the pt is keeping still, relaxed, happy, (hard as that may be for an infant!)maybe have the parent hold them? hope this helps! =)

[jrivers]

I thought that you're not supposed to take blood pressures on little ones unless it is absolutely necessary or you are taking the neonatal baseline immediately s/p birth. I could be wrong. Otherwise, check the cuff size, wait for a quiet time and have Mom help you.

[PediLove2147, BSN, RN]

I thought that you're not supposed to take blood pressures on little ones unless it is absolutely necessary or you are taking the neonatal baseline immediately s/p birth. I could be wrong. Otherwise, check the cuff size, wait for a quiet time and have Mom help you.

I think it depends. I floated to the pedi floor at my hospital and we did BPs on all the patients, even the little ones.

[ncemt]

I work in a NICU and I find it works best when I unwrap the infant, place the BP cuff, and then reswaddle the baby. That way they calm down quickly and you can even hold them or rock them to keep them calm while the machine is reading the pressure (it won't affect the results).