Taking manual bp on forearm

Roy Hanson · May 12, 2019

no! manual BP...above the elbow, but which arm? Your a nurse? you should know your anatomy of the arm..

Editorial Team / Admin · May 12, 2019

6 minutes ago, Roy Hanson said:
Your a nurse?

Seeing as this is in the student forum, it's reasonable to assume OP is a student and not a nurse.

OP, best practice would be to obtain a larger cuff and get the BP on the upper arm. However, think about what you are using to obtain the BP (sounds). What does the cuff need to occlude? What are you listening for and where would you expect to hear that? Would the way you were setting up have worked?

Zippy83 · May 14, 2019

On 5/11/2019 at 5:31 PM, Roy Hanson said:
no! manual BP...above the elbow, but which arm? Your a nurse? you should know your anatomy of the arm..

Taking a forearm BP on an obese patient is not at all uncommon. In fact, the patient is probably used to this, which is why they directed OP to do so. It also seems pretty clear that the OP understands the anatomy of the arm based on the detailed description of the attempt to take the BP this way.

From AACN journal:

‘Some experts recommend that if the correct size cuff for the upper arm is unavailable or if it is difficult to fit a large adult or thigh cuff, the forearm should be used as an alter- native.3 However, measurements of blood pressure in the forearm have been noted to vary by a mean of 7 to 15 mm Hg.4 Fonseca-Reyes et al2 reported that for each 5-cm increase in arm diameter, systolic blood pressure is overestimated by 2 to 5 mm Hg and diastolic blood pressure is overestimated by 1 to 3 mm Hg when a “standard” cuff is used on the patient’s forearm.’

That might explain why the reading seemed off to you.

ThatChickOmi, ADN, RN · May 14, 2019

On 5/11/2019 at 8:31 PM, Roy Hanson said:
no! manual BP...above the elbow, but which arm? Your a nurse? you should know your anatomy of the arm..

Shouldn't be ridiculing the OP if you can't spell "you're" correctly. ?

And besides, I have seen staff take BPs on the forearm (in a pinch) myself through school. Some people are really big and even a large cuff won't fit. I've also seen BPs taken on legs, but much less frequently.

beachynurse, ASN, BSN · May 14, 2019

On 5/11/2019 at 8:31 PM, Roy Hanson said:
no! manual BP...above the elbow, but which arm? Your a nurse? you should know your anatomy of the arm..

I really didn't think it was necessary to make fun of this OP. She clearly is in the student nurse forum, so it is easy to assume that she is a student, and is learning, just as we all once did. And Roy, I have some bad news for you, in obese patients, BP's can be taken in the lower arm. They may not be as accurate, but it is and can be done that way.

allnurses Guide · May 15, 2019

I work in pych and have a number of patients that require creativity in getting vital signs this is how I take blood pressure on the forearm with manual equipment Place the BP cuff around the forearm just below the elbow. palpate for a radial pulse. place your stethoscope over the flat part of the inner wrist closest to the radial artery side. Inflate your cuff and proceed to get your reading.

Hope this helps

Hppy

Kooky Korky, BSN, RN · May 15, 2019

On 5/11/2019 at 7:31 PM, Roy Hanson said:
no! manual BP...above the elbow, but which arm? Your a nurse? you should know your anatomy of the arm..

Criticism without providing any instruction. Are you a nurse? Why make the situation worse? Short man syndrome?

HelloWish, ADN, BSN · May 15, 2019

BPs often have to be taken in the forearm. If you have a patient with a mastectomy and cannot take the BP in that arm and the patient has a PICC line in the other arm, what do you do? Either the forearm or the calf area. I wouldn't put the BP cuff on the elbow though, move it down all the way to the forearm. I would still take the pulse in the same area as you do when you take a BP on the upper arm or try the radial pulse.