Well-Rounded Mama has been having a series of posts concerning “women of size” (particularly pregnant women) and blood pressure. Extremely informative. I did not realize there were several sizes of sphygmomanometers, nor that it makes a difference to have the right size cuff for your arm. But if your arm is larger than “normal” you may very well need a larger cuff in order to get a correct reading on your blood pressure. If the cuff used is too small, it will register your blood pressure as being too high (one woman included a story of being literally an hour away from having an emergency pre-labor C-section for her BP being way too high, when it was discovered that it was the fault of the too-small cuff — her BP was actually normal); if the cuff is too large, it may register a too-high blood pressure as being normal or even low. How many people — of all sizes, both men and women, pregnant and not — are taking blood pressure medicine when their blood pressure is actually normal, or are actually suffering from hypertension when they think their BP is normal? How many skinny-armed pregnant women are told their blood pressure is normal when they are really in danger of eclampsia? How many full-figured pregnant women are told their blood pressure is dangerously high and they need a C-section before they cause harm to their babies or themselves, when their blood pressure is actually normal (or at least not dangerously high)? How many women gain weight during pregnancy, and may need to have an adjustment in blood-pressure cuff size, but don’t get it, so they are risked out of midwifery care and into the care of a high-risk OB, when their blood pressure was actually normal all along — just their arms got larger but the BP cuff didn’t?
Anyway, here are the articles she’s written so far:
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The Importance of Blood Pressure Cuff Size
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Sharing Our Blood Pressure Miscuffing Stories
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Blood Pressure Cuff Size and Pregnancy
Filed under: pregnancy, safe motherhood Tagged: | blood pressure, blood pressure and pregnancy, bp, eclampsia, hbp, high blood pressure, hypertension, PIH, preeclampsia, pregnancy, pregnancy-induced hypertension, sphygmomanometer
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There may be a lot of things us physicians aren’t taught, but it sure was drilled in to me to use the right size blood pressure cuff at various levels of training.
That’s a relief! Reading these posts, there were so many stories of nurses (primarily) and other medical professionals that acted like it was no big deal what size BP cuff to use. In the story of the woman who was almost rushed off to a C-section for high blood pressure, the surgery was averted when the doctor came in and realized that a too-small cuff was used to take her bp, threw it aside in disgust, and went and bawled out the nurse who had taken the initial bp reading.
I’d never heard of the importance of cuff size, either, and I used to take blood pressure at our pharmacy! (Granted, I wasn’t “trained” to do it, and it was just with an automatic bp monitor that we sold OTC.) I remember one woman in particular, an elderly lady who had a lot of excess skin on her arms, and I could barely fit the cuff around her arm at all; I think the monitor couldn’t even register the blood pressure, returning only an error message. Blood pressure is such an important clinical measurement, that I would think that every nurse or anyone else who takes blood pressure in a medical setting should have that equally drilled into them.