Urgent question: Blood pressure

[strawberry111]

Hi. Im a student nurse doing my placement at OT.

I noticed that my nurse buddy placed the cuff up side down. That is, the hose is not facing downward and does not face the brachial artery. Instead the nurse places the hose towards the face of the patient.. Is this common in OT and why do they do that ?

i forgot to asked my nurse buddy as the OT got busy.

Thanks

[TakeTwoAspirin, MSN, RN, APRN]

It is common and makes no difference to the reading. It prevents the patient from possibly occluding the lead while they are asleep or during positioning, and it allows anesthesia provider easy access to check lead if there is a problem with pressures during the procedure.

[strawberry111]

thank you soo much for answering my question.

I appreciate the help :)

[Rose_Queen, BSN, MSN, RN]

It really can be affected by the positioning of the patient. Working in cardiac surgery, we routinely tuck the patient's arms at their sides to allow the surgeon room to stand by the chest without the arm in the way. All of the anesthesia monitors are at the head of the bed. If the blood pressure cuff were placed the "normal" way, it is quite possible that the tubing would kink and become obstructed because it would have to double back on itself. As long as the spot marking where the cuff should align with the artery is in the proper orientation, the readings should not be affected.

You may find that due to surgical site, prepping, and draping, many monitors will end up in places that are not the norm. Our EKG leads are also in different places as they cannot be placed on the chest without interfering with both sterility and site access. So, our leads are on the patient's back and very far towards the back of the sides during surgery. We've also had to do O2 sat readings on earlobes or bridge of the nose either because of where the surgery is happening (such as taking vein from one arm to create a graft in the other) or being unable to get a reading from a pulse ox probe on a finger in the middle of a surgery but cannot get under the drapes to try to fix it- earlobe or bridge of the nose becomes plan B so that at least we are getting the vital signs we need.