Bi-lateral Blood Pressures?? Just thought I would remind everyone that we are supposed to be documenting bilateral blood pressure comparisons on the admission assessment. "Two BPs!?!," you say. Well, yes; there are a few cardiovascular disease states that enter into the differential by a marked discrepancy in BP symmetry, say 20mmHg or more. I have a short mnemonic: "BP CUFF"

B - Birth defects (Congenital Heart Disease)
P - Periveral Vascular Disease
C - Coarctation of the Aorta
U - Unilateral Neuro/Muscular abnormalities
ff - Aortic Dissection (think of the "ff" as a pictogram for the aortic arch with a line through it; the line representing the dissection. Yes, I know, its a stretch.)

If anyone can improve on this, please do. This and the following bullets are from AACNs newsletter this month.

• Can't get a brachial BP, try a supine calf BP (just slightly higher reading), or a prone thigh.
• If you do a forearm BP, it should be at heart level (lower=higherBP; higher=lowerBP).
• If the cuff's too small (Higher BP) if too big (Lower BP)
• Avoid BP's over picc line sites; and only distal to a PIV

Farewell,
Christopher  ¶ 4:05 PM