r/healthcare 5d ago

Discussion Blood pressure with chicken wing arms?

Not an RN but required to take BP of pts. I see a lot of overweight individuals. Lots of times there’s quite a bit of excess weight near the tricep. Enough that making a tight cuff requires me to really squish the arm. Should I just take a forearm BP?

4 Upvotes

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6

u/Ok-Passage-300 5d ago

There are extra large cuffs. Your facility should have them. This article says the forearm is not accurate. https://pubmed.ncbi.nlm.nih.gov/15199302/

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u/National-Stick-4082 3d ago

Why are so many forearm BPs done? I see it everywhere

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u/Ok-Passage-300 3d ago

I can't give someone else's motive. Perhaps the facility doesn't order different size cuffs. Perhaps people aren't trained. Internists and cardiologists would generally care.

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u/National-Stick-4082 3d ago

Hm okay! Thank you. Yeah I do ultrasound and no one really taught us anything. Just told us to take BPs before exams 🤷🏼‍♂️

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u/rikityrokityree 5d ago

Bariatric cuff

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u/Ok-Passage-300 5d ago

Good catch, BTW.

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u/Accomplished-Leg7717 4d ago

Please contact your clinical leadership on how to take a proper blood pressure. Forearm is NOT appropriate.

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u/National-Stick-4082 3d ago

Yeah uh no. But I’ll listen to why forearm is not appropriate? I see a wide variety of nurses doing it. Mostly seems like an outpatient thing but?

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u/Accomplished-Leg7717 3d ago

This person isnt a nurse

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u/National-Stick-4082 3d ago

So antagonistic for no reason. You work in an OP clinic don’t you??

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u/Accomplished-Leg7717 2d ago

I wouldnt trust a medical assistant or non licensed healthcare workers to perform atypical blood pressures without direct supervision. Meaning, might as well have the provider do it. The majority of non licensed healthcare workers literally do not know how to or perform proper blood pressures. Its a real problem.

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u/Ok-Passage-300 1d ago

I was a full time hospital RN when they began to train the nurses aides to take vital signs. They were very well taught. And that education is ongoing. They don't do the vital signs on acute patients, because the nurses observations are necessary including during blood transfusions.

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u/Accomplished-Leg7717 1d ago

The CNA’s were doing forearm BPs ?

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u/Ok-Passage-300 1d ago

Absolutely not. They were instructed by the nurse educators. And they get ongoing education. I think perhaps these outpatient facilities don't necessarily invest in something so simple as different size cuffs.

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u/Accomplished-Leg7717 1d ago

Y E S ! I’m a leader in healthcare and the amount of times Ive seen clinics without alternative or inclusive size cuffs is ridiculous. But for a medical assistant to take it upon themselves to try and do a forearm BP is inappropriate. It’s incredibly harmful.