Monitoring Blood Pressure

Paper Summary:

This paper compares the use of a blood pressure cuff on the forearm, as opposed to the upper arm, for monitoring blood pressure. To make the comparison, the paper looks at a medical case where the blood pressure of a patient had to be obtained on an hourly basis in order to administer her required medication. The paper also reviews current literature about this method of measurement.

From the Paper:

"A clinical case in which blood pressure was measured by placing the cuff on the forearm is N.L.; a 78-year-old widowed African American female from Memphis, TN. She is disabled and dependent on her two daughters, which she lives with, for most of her activities of daily living. N.L. was admitted to the intensive care unit at Baptist Memorial Hospital-Memphis on July 16, 2005 for hemorrhagic cystitis and respiratory distress. She has no known drug allergies. Past medical history includes congestive heart failure, hypertension, myocardial infarction, diabetes mellitus, right below the knee amputation, morbid obesity, and sleep apnea. She has also had a tracheotomy since 2003 to treat her sleep apnea. N.L. was treated for respiratory distress upon admission by mechanical ventilation with a mode of Assist Control and 40 percent oxygen, which she was weaned from on July 18, 2005. She was also placed on Dobutamine drip, July 17, 2005, at three micrograms per kilogram per minute for management of a secondary diagnosis, congestive heart failure. The administration of this drug requires hourly blood pressure measurements. Blood pressure was measured with the cuff placed on the forearm, because large sized cuffs were too small for her upper arm due to her existing state of morbid obesity. "

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