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Discussion

Using BP cuff to access certain veins?

The other day I was at work and saw one of our LPNs using a BP cuff when inserting a peripheral IV catheter. I have seen this done before but can someone explain the rationale for this practice to me. Do certain veins "pop out" with this technique, or am I totally off? Also, is there a pro/con to use this over a latex/nitrile tourniquette.

Just a nursing student trying to gain knowledge...

mcknis

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I don't think it works any better than a tourniquet. If I have trouble I use two tournaquets like the paramedics. They tend to get those veins to pop up.

Perhaps someone has a better reason and can enlighten me.

Maisy;)

I've used a BP cuff in place of a tourniqet but honestly only if I don't have one available. I work with one nurse who only uses her cuff but it is cumbersome to me. I prefer the tourniqet. Not really a rationale for you, sorry.

It works quite well. Our ER monitors actually have a "Venipuncture" button, which holds the cuff at a steady 60mm of pressure. Just be careful you don't pump a manual cuff too high. Check with your hospital policies also.

I'm on tomorrow, I will check our monitors to see if we have that button. Do you find the cuff works better than a tourniquet. If so, why?

Maisy;)

To be honest, many years ago (as a med tech) we would occasionally use BP cuffs. For me, as my skills in venipuncture incresed my use of the cuff decreased. I am not saying that people who use a cuff can't stick :uhoh3:. This is just my 0.02 worth. I think the theory is that by compressing a larger area of the arm you will be able to increse the pressure and thus "pop" up the veins. If you stay within to 60mg pressure (for example) I don't think you will get that big of an increase over a tourniquet. MAybe someone else knows more about this.

With a BP cuff you can get a tighter compression without "pinching" like when you use a narrow tourniquet.

Personally, I love my quick release belted tourniquet that gets the same results as a BP cuff. It's much more comfortable than the regular disposable elastic tourniquet that comes in an IV start kit.

  • Author

thanks for the replies guys...I will be waiting to see if any body else has some more info. I have also heard that by pumping up to different pressures, that different veins pop out easier than some others. Maybe something like 60 - 80 - 100 - 120mmHg will bring out more deep veins? dunno...

I'm on tomorrow, I will check our monitors to see if we have that button. Do you find the cuff works better than a tourniquet. If so, why?

We have HP monitors. Yes, it works better on "tough" veins. Why? I dunno.

also in older patients you do not get the bruising with a bp cuff that you can get with the disposable elastic tourniquet

basically the same process

another thing i have seen done is that this nurse always did put the tourniquet on close to the stick

ie. she would put the tourniquet on the arm just above the wrist if she was going to start iv anywhere in back of hand..thumb etc

once when she was doing the iv another nurse walked in and in front of patient and family removed the tourniquet and placed above the elbow

and told her to step out of the room while she did the iv...WOW

i heard a the screaming and yelling, i ran into the room and they were nose to nose screaming and the family and patient were bugeyed

first nurse [most recently hired] transferred to another floor and refused to be pulled to our floor

they would not even ride in the same elevator together

i think if someone can do the job if their way is different than yours you should shut up or at least wait until later to mention it

also in older patients you do not get the bruising with a bp cuff that you can get with the disposable elastic tourniquet

I was taught that, also. Thus far, I find the BP cuff to be a bit cumbersome, but that is just me. If I had to, I would. At this time, I have used a glove if no tourniquet was available, but for the hard to reach veins, I have used two with decent results.

She would put the tourniquet on the arm just above the wrist if she was going to start iv anywhere in back of hand..thumb etc

OK. That worries me a little bit, because the forearm has 2 bones.

And all (well most) of the important stuff, gets run down between them, veins, arteries, nerves etc. Which would make it rather hard for the torniquet to compress them. Unlike the upper arm where it can compress the vein against the single bone.

At least that is my understanding of it.

Levin

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