OT: Blood Pressure Cuffs - Use the Right Size!

If you're checking your own blood pressure at home and also when the doctor's office checks it, make sure it's the right size cuff or you may get false readings.

I always knew there were different size cuffs for larger-than-average arms, but I never really knew that it made a big difference in your readings, but it can. If you use a cuff that's too small you'll normally get false high reading; if you use one that's too big you're get a false low reading. When my larger cuff was messing up, I switched to the smaller one and was panicking at my higher-than-normal reading using the smaller cuff, which of course made it go up even higher! Then I did some research and discovered that by using the too-small cuff, my readings would more than likely be falsely elevated.

And in Internet research, I was amazed to read stories of how some nurses and even doctors don't think it makes any difference as long as the CUFF fits your arm. It's not the cuff that's the issue, but the bladder inside the cuff that's the issue. I later talked with a nurse friend of mine and she verified it all, even the struggle she had trying to get a nurse at a hospital where her husband was admitted to use the right size cuff on him. He was passing out and when the nurse took the reading with a regular cuff, it registered fine. Finally she gave in to my friends insistence and used a larger cuff (on this obviously very large man), which then showed, correctly, that his blood pressure was much lower than it should be.

Anyway, I've ordered a replacement large cuff (store doesn't carry it locally anymore ) and it will be interesting to compare the two!

Oh, it seems if you have an upper arm size over 13 inches, you should use a larger cuff (measured about halfway between shoulder and elbow).

Pam

The American Heart Association guidelines for taking BP also says that sitting in a chair with feet planted on the floor is necessary for a correct reading. How many doctor's offices do this? Not many by my experience. They almost always have their BP reader attached to the wall next to the exam table and ask you to sit up there with your legs and feet dangling. This can make your reading incorrect!

Your arm should be at the same height (level) with your heart.

I will say the VA is very good about making sure we have our feet flat on the floor and usu. do 2-3 readings with pauses in between.

Well, let's see .... I wonder what effect there is when they pump that d*mn cuff bladder up so d*mn tight my arm ACHES, even after they finally take the d*mn thing off!!!!

Usually one end of the cuff has two lines between which the other end falls when proper size cuff is used.

Thank You all, for sharing this very important information with us!

jdm2857 wrote:Usually one end of the cuff has two lines between which the other end falls when proper size cuff is used.

Yes, the ones you buy for home monitoring do (mine do anyway). Do the ones the doctors/nurses use have that, too? If so, there really is NO reason for them not to know they need a bigger (or smaller) one!

But if someone using a home monitor wasn't aware of WHY it needed to fall within that range, they might just go ahead and use the regular size cuff that comes with it so as not to spend the money on a larger cuff (although they aren't that expensive) or just didn't want to fool with trying to find a larger one.

And doctors, I was really surprised at how a lot of them (and nurses) don't seem to realize that if a patient's arm is over a certain size that they need to use a larger cuff to get the appropriate reading!

And you're also supposed to rest at least five minutes before a reading is taken. I like when they talk to me while they're taking it (as long as I don't have to respond!) because it kinda takes my mind off of it.

Pam

WearyOne wrote:Do the ones the doctors/nurses use have that, too? If so, there really is NO reason for them not to know they need a bigger (or smaller) one!

They sure do.

Here is my situation. My doctor's office usually "trains" their nurse (have only one). Meaning she has no formal training to be a nurse, other than possible basic first aid. The doctor has this person take your vital signs and write on the chart your major complaints. The doctor, also, trains that person to draw blood if needed.

For awhile they were using an automatic cuff like you would buy from WalMart or Walgreens that fits on your wrist. I admit I am heavy and wondered how accurate the cuff actually was. Now when I go to the doctor, the "nurse" uses a regular cuff (which is too small) but uses my lower forearm to take my blood pressure reading. When I questioned the nurse about this practice (forgot to ask the doctor) she said it was as good as using your upper arm. But -- it makes me wonder. I do know that I won't let any of the "nurses" she has had draw my blood. I always request that the doctor do it herself. So far, she has always complied and done it without any arguments.

Not many doctor's offices can afford to hire a fully licensed RN, but they do have certified Medical Assistants who have completed a course of study (albeit fairly short and sweet) to do the basics like take BP, temp, record medications and history, and assist the doctor during examinations. Medical Assistants usually have no authority to do invasive procedures such as blood draws. A doctor, nurse, or trained phlebotomist are usually the ones who do that. I have NEVER heard of taking BP on the forearm. Wikipedia says:

Blood pressure (BP) is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure.[1] The mean BP, due to pumping by the heart and resistance to flow in blood vessels, decreases as the circulating blood moves away from the heart through arteries. Blood pressure drops most rapidly along the small arteries and arterioles, and continues to decrease as the blood moves through the capillaries and back to the heart through veins.[2] Gravity, valves in veins, and pumping from contraction of skeletal muscles, are some other influences on BP at various places in the body.
The term blood pressure usually refers to the pressure measured at a person's upper arm. It is measured on the inside of an elbow at the brachial artery, which is the upper arm's major blood vessel that carries blood away from the heart. A person's BP is usually expressed in terms of the systolic pressure and diastolic pressure (mmHg), for example 120/80.

Our old family doctor had an RN that was fantastic. She was of the "old" school and we trusted her opinion as much as the doctor's. We would often ask to see her first, which saved us money. If she was able to take of what ever problem we were having, no need to see the doctor. This was when mom wasn't sure if a cut needed stitches, was getting infected, minor sore throats, etc. If she felt that we needed to see the doctor we would.

Now days things are different. I know my present doctor (the old one retired after 30+ years of practice and the one I am now seeing has been our family doctor for nearly 25) is a one doctor office, where our old doctor was with 2 other doctors.

Thanks for your helpful tip. I will ask the doctor about it tomorrow when I go in to see her.