Using BP cuff to access certain veins?

[mcknis]

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

[Levin]

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

[suanna]

Leaving the cuff up to just above diastole promotes maximum engorgement of the veins-ALL of the arterial flow gets in, with veins compressed the venous flow is blocked- engorgeing the veins. With a tourniquet you have no clear idea of how much pressure you are exerting. If it is too tight it can partialy obstruct the arterial flow reducing the blood avail. to fill the veins. Also with fragile veins, once the veins are up, you can reduce the pressure on a cuff to reduce the built up pressure in the veins- less likely to "blow" when you insert the I.V. With a cuff you have a smoother, more consistant application of pressure- A tourniquet can bunch up the skin into folds- effectively protecting the veins from being compressed. There is also the comfort factor- a cuff inflated to 60mmHg is a gentle hug for the arm, a tourniquet pulled tight can be very painful for fragile skin. I have been doing this almost 23years and have much better luck with a cuff.

[canoehead, BSN, RN]

What suanna said

[anc33]

I used to use the BP cuff method on very fragile patients. Once I had a patient whose skin incurred a minor tear from the tourniquet (even though I placed it over the gown) and I vowed that I would not let that happen again. The cuff method definitely cuts down on bruises, tears etc. I have never tried it in a younger person so I can't compare the effectiveness of both methods.

[EmmaG, RN]

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.

Oh, please reconsider this... a glove hurts sooooo damn bad. I've had them used on me, and you wouldn't believe how painful they are; I'm a pretty compliant patient, but when someone comes at me with a glove I refuse to allow them to stick me until they get a tourniquet.

[RN007]

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.

What's a belted tourniquet and where do you get one?

[EmmaG, RN]

What's a belted tourniquet and where do you get one?

These, perhaps?

http://www.allheart.com/pm4350.html

[RN007]

Yeah, cool. Expensive, though. Thanks!

[EmmaG, RN]

I love allheart!!

[MA2006]

BP cuff hurts much less than a tourniquet. Especially when you have fat arms. The even distribution of pressure from a BP cuff is much easier to handle than the pinching, painful tourniquet especially if the tourniquet rolls into a skin fold..ouch!!

[raemon]

bp cuff can support the compression and will not cause trauma to veins and also to skin for those wiht improper placement of touniquets..

[EricJRN, MSN, RN]

I'm a fan of BP cuffs over tourniquets. When I worked in a blood donor center, BP cuffs were standard on our apheresis donors. They're not necessary for routine venipuncture or IV access on your average Joe, but once you get used to the bulkiness, they provide more comfort and better visualization for those tough sticks.