Flipping the BP cuff upside down

[runswithneedles]

Ever since working for med pro I have had a habit of taking one manual BP, hooking up the auto BP cuff from my cardiac monitor with 3 three lead for my long haul transfers. Ive noticed though it makes the flow of wires so much more manageable if I flip the cuff upside down so it can just flow to the back of the cot where I keep the monitor. But I never thought until recently if it could possibly change my readings. Any of you guys tried this technique before and had that happen?

Edited February 13, 2012 by runswithneedles

[nypamedic43]

I've never tried flipping it upside down. However I have noticed that if you dont use the proper size cuff it can skew the readings.

[DwayneEMTP]

How does the flipped cuff reading compare to your manual?

[runswithneedles]

Usually it reads within 10 mmHg. As long as its the correct size for the patient. I have had it throw me a few curveballs every once in a while but once I re positioned it would go back to what I was trending before hand and was consistent with my manual bp. But after doing a ride along with the fire department here I got sneered at and chewed by my preceptor saying it doesnt work right if you do it that way. Figured maybe someone else have tried it here and might be able to tell me if it does.

*Edit: whenever it does throw me a curveball first I take a manual than after I re-position the cuff t see if its my cuff or monitor.*

Edited February 13, 2012 by runswithneedles

[Yarbo]

Probably not worth going against your preceptor on that one. Personally, I liked to flip the cuff for manual blood pressures so the tubes weren't in the way, now It doesn't bother me.

[Richard B the EMT]

The only time I see most people flipping the cuff is when they take a manual BP reading from the forearm of someone the cuff won't fit on the bicep. Unfortunately, that patient is usually me.

[paramedicmike]

Fully realizing how hard it is to find, does the user manual for the device in question comment on cuff position? I'm just thinking it might matter depending on where they put the sensor in the cuff.

[tcripp]

Interesting question. Everything I have ever read or been taught has indicated that the tubing run "down" the center of your arm and should remain distally if the cuff is moved below the elbow or to another limb. Unfortunately, I can't seem to find anything that explains why or why not the other way.

Agree with Mike - I'd defer to the manufucaturer's documentation.

Toni

[DwayneEMTP]

Yeah, leave it to a hosemonkey to be an expert on the automated BP cuff...

Yeah man, I don't have any experience with it, but, and mentioned before, as long as it's sized right, I can't really see an issue with it. Did you ask the "preceptor" why it would not work that way, and if you could take 10 BPs of the guys comparing auto to manual?

Dwayne

[scubanurse]

I would look on the manufacturer's website... if they don't say no, then shit hits the fan, you can say well according to the manufacturer's instructions, flipping it upside down is irrelevant and put the liability onto them.

I understand the need for an organized patient, especially in CCT in ICU's...but if it's just for a short trip down the road, it shouldn't be as big of a deal. I have seen ICU nurses flip out on people for moving a line out of place but that is a critical environment where that nurse needs to know exactly where everything is.

**EDIT TO ADD** I have seen this done in the OR before so the wires are leading out of the surgical field.

Edited February 13, 2012 by Kate_826