strange way of taking blood pressure...!

I had a dr appt a few weeks ago. The nurse that does all the vitals before the dr comes in, took my blood pressure on my right arm, on the forearm--right above the wrist. Put the stethescope on my wrist vein area! I said, what are you doing...? She said oh, it doesnt matter where you put the cuff. I wondered about it..especially since it showed a bit high.but...let it go.
Ive had the flu, and so have been very ill, and have made 2 visits to urgent care in the past month. Both times, my BP was taken the "regular" way. It ran normal or slightly below normal both times.
I am a bigger than average person, so they need the large cuff for me. Its never ever been a problem.
Today, I go see the same Dr..and that same little nurse takes my BP the same way...right arm, above the wrist. Again, it registered slightly high. I didnt say anything to her. I asked the Dr when she came in, and she looked surprised to hear it was taken that way, but recovered quickly and said actually there are many places bloodpressure can be taken...but kind of unusual....she said she probably didnt have the right size cuff in the room to check mine the regular way.
Thats what I think it is---the girl is too darn lazy to go to the next room and get the large cuff!

Anyone else EVER have their blood pressure taken in that way before??? Just curious. Im about ready to change doctors anyways.

[Sirenet]

Hi, I totally understand your concern. I agree with you. I think some nurses due to the repetiveness and bore of doing routine tasks (such as BP) can make those simple tests useless. If they do not intend to do it correctly, no matter how un-earthshattering it is, don't bother writing down a useless number.
  I have been on new meds since leaving the hosp in Jan. Hypotension due to meds has been a major issue. A few weeks ago, a nurse takes my BP and when I ask, she says - "oh it's 134/84".  I say no way, please retake it. She gives me an attitude and says "why". When I tell her that I haven't seen a systolic # since 2007, she acquiecses. After 2nd take, she says - " hmmm" and proceeds to write down 96/57.
  Since no one cares about our health more than ourselves, we have to be our biggest spokesperson.  I for one, no longer plan on accepting inferior medical practices. You make a very valid point - good for you !

[Sirenet]

should have included "systolic # over 100 since 2007"

[momtofourboys]

I was told by my pharmacist and doctor (now this is for my teenager who has to have a BP monitor) that the wrist one is not accurate. the father away from your heart they do it the less accurate it is. our doctor doesn't like the electronic BP cuffs either they can be off he said. our doctor actually takes the BP's if there is a history of high BP. I would simply state to her you need to take it the correct way. and if she can't then to leave now and you will have the doctor do it.  good luck
you need sometimeso be vocal, in a nice but stern way, when you feel something isn't right
Michelle

[momtofourboys]

oops sorry something happened to my computer and didn't type the rest of it

I know i said that sometimes electronic ones aren't accurate but try going to your local grocery store the has a BP monitor and it goes on your arm and try that one to see. I have used the wrist one on myself and my BP is usually 90/52 and the wrist one says it is 135 over 110.
if you have a local visiting nurses assoc. sometimes they offer a free BP screening check that out just to cmpare
good luck
Michelle

[erijon]

A blood pressure reading can be taken at the wrist, the difference is that the wrist needs to be at the level of the heart in order to be accurate. there has been a long discussion about wrist cuffs and if they are accurate, it all depends on the way it's taken as they are very sensitive to both position and movement. I actually have an Omron HEM637 wrist monitor that has a built in position sensor that will not take a reading unless it is positioned correctly. I have taken it to both my doctor and cardiologist to have it check and it is very accurate. The American Hypertensive Council and the British Hypertensive Society have both tested it is the only wrist monitor that they reccommend. You need to be careful about the ones at drug stores and such as they are famous for not being accurate due to their abuse.

In your case, I would be concerned about the way it's being done. If you're not being asked to raise your wrist to your chest it's most likely not being done properly.

Good Luck,

Jon

[maggiemag]

Bp taking is one of my major pet peeves!  I'm glad you brought this up.  I am an RN and know the right way to take it, although most don't.  People are so used to the automatic cuffs now that they really do not know how to take a BP correctly.  I would say that mine is taken incorrectly about 90% of the time.  As some have said,  they are too lazy to take it right, which is letting the cuff pressure down very slowly.  I forget the actual recommendation, but I almost have to laugh at the speed they let it down.  The *nurses* almost always have to take mine twice because they miss it totally, as it is really low and I have a slightly narrow pulse pressure.  I just tell them to let it down slower,and hopefully try to say it with a smile.  
Your arm is supposed to be supported also and at heart level.  I do believe that the further it is taken from the heart, manually, the higher the number.  You can take it many places, like the wrist or on the leg behind the knee, but the site has to always be charted so the person interpreting the BP knows to compensate.
Lastly, you cannot take one BP right after another and expect it to be accurate.  Again, I do forget how long you are supposed to wait, but I think at least 5 minutes, which has never happened in my lifetime.  My internist always takes it himself and sitting and standing also.

[erijon]

You are correct, you need to wait 5 minutes between readings in the same place to give the arteries time to recover back to their original size, otherwise the reading will be understated.

[patientRN]

I was just released from the hospital last night and I have to say that a similar thing happened to me when having my bp taken except that the nurse used an automatic cuff.  One of the times my bp was taken the cuff was placed on my forearm instead of the upper arm.  Since it was an automatic cuff there was no stethoscope involved.  I am hoping the difference is the type of cuff that was used.  Being an RN I plan on looking into this further to see how viable a concern it is.  Kudos to you for being your own patient advocate.  In addition, if you are thinking of changing doctors I encourage you to do your homework if you are not satisfied with your MD. With Health Care changing all the time it is so important that communication and confidence is high with your MD.  

[ed34]

One this Ive noticed with cuffs is when they dont line the sensor up correctly with the artery. When the cuff pumps up I sometimes wonder if its gonna ever stop, my arm feels like a wrestler has me in a hold. They let this happen at least three times before they realise theres a problem. Sometimes the air tube pops off due to the incredible pressure which is a nice relief. Then the nurse suddenly decides the cuff must be on wrong. Then on top of that they wonder why my blood pressure is high, I think anyones would be after their arm was crushed three times.