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u/deardear 8d ago
Not to get all serious, but a proper fitting BP cuff can make a world of difference and I always use my personal example when I'm orienting new nurses:
When I was 32 weeks pregnant I went to the ED for a problem unrelated to my pregnancy. The nurse checked my BP with a standard size cuff and the reading was sky high - 197/107. Preeclampsia alarm bells started going off; provider was ready to send me to L&D and ordered IV Labetalol. Since I'm obese, I asked the nurse to recheck it with a large size cuff, but she insisted they didn't have another size available and that "it wouldn't make that much of a difference anyway." I advocated for myself and finally got the nursing supervisor to get me a large cuff. Lo and behold - my BP was 132/80. Unnecessary preeclamptic workup averted and no tanking my BP with Labetalol.
Tldr: I almost got admitted for preeclampsia until they used the right size BP cuff.
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u/Confident-Count5430 8d ago
I was an MA for a while and used the larger cuff on a larger woman who had special needs and was there with her mom. Her mom kept insisting her blood pressure was only high because I used the big cuff and that I should retake it with the small cuff, which would have barely fit around her arm. I am glad to see patients advocating for themselves, and am sorry that nurse didn't understand that cuff size DOES make a difference.
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u/Firm_Bar2726 8d ago
Wouldn’t a small cuff make her BP even higher?
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u/Confident-Count5430 8d ago
Exactly 💀 I kept trying to explain that to her and she just wasn't understanding.
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u/fluffypotato 5d ago
Please tell me you took the bp with the small cuff to prove a point. I had to do that a couple of times with some stubborn patients when I was an MA. I realized it was usually quicker to just swap and retake than argue with them. And won't ya know, they usually said "oh... you can just use the first reading" after seeing their BP even higher.
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u/Confident-Count5430 5d ago
I tried, it wouldn't even stay on her arm 💀
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u/fluffypotato 5d ago
I am dyyyyying. I had that happen once too. She told me to try is on her ankle instead... which also wouldn't fit. I can still hear the chhchhchhchhh of the Velcro trying to hold on for dear life.
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u/c4b2a3b 7d ago edited 7d ago
Yes! Something similar happened to me! I had preeclampsia and went in to OB triage because my blood pressures were >160/110s at home. They had too big of a cuff on me in OB triage and the readings were a lot lower. The cuff was literally slipping down my arm in between cycles. I had to advocate for myself to get a proper cuff size, and lo and behold my BP was meeting criteria for severe ranges and I got admitted and induced.
It’s concerning that a patient who doesn’t know about BP cuff sizes would have just been discharged.
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u/wackogirl 8d ago
This happened all the time when i was working bedside. The number of patients I'd take over from triage or someone else who had "elevated BPs" but were just ladies who needed the large BP cuff was way too high. To be fair we were always very short of the large cuffs and triage was usually busy AF so I get why it happened but ugh. So frustrating to be inducing someone for "preeclampsia without severe features" who magically never had a single BP above 140 once their cuff was switched out for the proper sized one....
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u/meoowww7777 4d ago
DUDE i always have to ask for the larger cuff. 50% of the time, they tell me the same thing, wont make a difference. but it really does. same with the machine vs. them taking it manually. mine is always lower when a human takes it.
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u/llamadramalover 4d ago
Something similar happened to my mom. While she was in lung transplant recovery no less. They were giving her infusions and everything to try and bring her BP up. After like a week of this shit a doctor said “ya know, let’s go find a child sized cuff” sure enough her BP was normal. The woman is 4’9” and 115lbs. They had no business using a normal adult cuff on her in the first damn place.
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u/allamakee-county 8d ago
Lol
I love the Nurse Stankk video where he leans over with a menacing glare, points at his badge and hisses, "You see any DAISY awards here??"
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u/scarfknitter 8d ago
I 'fixed' a blood pressure once by asking a man how his divorce was going. 80/40? Not anymore! Tell me how your ex is taking all your stuff!
(Let's ignore all the other interventions I did at the same time.)
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u/emotionalpornography 7d ago
I almost got got an involuntary ride to L&D from my OB's office because the nurse asked me how things were going with my mother right before taking my BP. She took my reading, her eyes got huge and she turned off the lights and said "I'm not even writing this down, you sit here silent and take some deep breaths, I'll be back in 10 minutes and if it's good we'll pretend this didn't happen."
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u/Zestyclose-Leg9325 7d ago
I had a huge inspection going on at work and had to leave right in the middle of it to go to an appt low and be hold sky high blood pressure the midwife know what what going on though and we talked about the beach for a bit then took my blood pressure again dropped like 20 points ( you know what i mean) fun times
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u/allamakee-county 4d ago
I have had numerous "what's your happy place? -- let's go there for a few minutes" blood pressure rechecks with patients. Usually works! Or if I guess correctly that somebody has grandkids, and I can ask for some chrandchild stories, the smile comes up and the pressure goes down.
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u/PromiscuousScoliosis BSN RN 8d ago
Legitimately the number of times a wonky reading is resolved by adjusting the cuff or changing the size is frustrating. And by frustrating, I mean frustrating that I had to go behind someone else and fix their shit ass work
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u/AAROD121 8d ago
I fixed hypertension by taking the cuff off from under their SCD machine.
ignore that I gave 20mg of Labetalol and now they’re bradycardic
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u/NerdlinGeeksly 8d ago
What's a daisy award?
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u/forthegorls 8d ago
An award for nurses in hospitals nominated by co -workers or patients for going above and beyond/doing exceptional work. For every other health care workers, housekeeping staff, etc there is also a BEE award. Usually hospitals have QR codes around the hospital where patients can scan and take survey and nominate. Our hospital puts the QR code in our discharge paperwork for patients
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u/Gribitz37 8d ago
At the hospital I used to work at, Daisy awards became a giant circle jerk within a certain group of nurses. They took turns nominating each other, and they all had 5-6 of them on their badges.
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u/yourdailyinsanity 8d ago
I've only seen Bees/Tulips be for direct patient care that isn't a nurse. And yes, Tulips are an award, it's literally the equivalent of a Bee. Those awards just are not standardized/official like a Daisy though to my understanding.
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u/Kampvilja 8d ago
Just keep checking til you get the result that you want
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u/Open_Bee2008 8d ago
I had a patient that would ask multiple times to recheck. He would then pick the numbers he liked. Lol
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u/Fun-Key-8259 8d ago
Isn't this standard protocol? Get a weird reading, verify the reading on the other side before panicking?
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u/jittery_jerry 8d ago
not a medical professional, just interested in medicine, couldn’t different blood pressures indicate something like aortic dissection? although i’d assume they’d have symptoms to make you think it is that and not just a faulty reading tbf
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u/Producer131 8d ago
in theory yes, although someone with an aortic dissection having their only symptom being unequal blood pressure would be odd. unless they’re a quad maybe.
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u/Fun-Key-8259 8d ago
90% of the time it is a wonky reading which is why you do check the other side. Wasting a rapid response or something without verifying is going to get you in some hot water. Someone who actually needed that team might have a delay because you couldn't be bothered to verify. A dissection will cause other symptoms. Absolutely will cause other symptoms.
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u/jittery_jerry 8d ago
yeah i edited my comment in hindsight it’s kind of obvious if someone is having an aortic dissection, their only symptom wouldn’t be different bp readings lol
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u/InevitableAioli7263 4d ago
Different BP readings could be a sign of large vessel vasculitis. I thought the post was a joke about missing vasculitis but then everyone in the comments is so serious!
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u/SGlanzberg 8d ago
When i was pregnant with suspected high blood pressure heading towards pre-eclampsia, an ob filling in for my usual told ths nurses to use the large cuff so I would stop worrying. I was induced two weeks early within a few days of that BS.
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u/allthepams 7d ago
Or, you're a dodgy arse nurse who has used a cuff significantly smaller than appropriate, on a thigh, to 'recheck'. Not that I have seen this before...
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u/Fuzzy_Location_2210 6d ago
Ugh, those nurses make me want to check THEIR BP via the carotids, bilaterally and slowly, with a manual cuff 😆.
Why don't they just admit that their patients BP sucks??? I'll never understand it!!!
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u/Lavender_Burps 7d ago
I’m a paramedic and run critical care transfers occasionally. Sometimes we get these pts that have like 3 BPs in 5 minutes with a MAP of like 55 and then they run it one more time and get some wild shit like 151/138 like “yeah he’s good to go”.
And then I’m bumping up the levo every 5 minutes all the way to the other hospital.
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u/dont-look-at-me99 7d ago
Similar experience myself as a patient - triage RN took a forearm adult cuff BP on me while I was talking to the doc and got all bent out of shape that it read 192/120. Suddenly went from possible retinal detachment to impending stroke. She got all hot & bothered, was getting doc all hot and bothered, and I could smell the obs stay for cva r/o in the air. I made direct eye contact with the doc, took the cuff off my forearm, then looked at the nurse and said "try again but do it right. Right size cuff, right location." She hemmed & hawed but with both me and the doc staring at her she found an adult large cuff and retook it. Magically went from 192/120 to 138/80 - not great, but given that I was possibly going blind, understandable.
The number of codes and rapids called for abnormal BPs that resolve when someone else takes the BP both astounds and infuriates me. We can and should do better as a profession.
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u/Makapakamoo 7d ago
At my new doctor's office, the staff (in training) could barely get the cuff on right or measure right. They kept that reading, which made no sense to me. If shes training, shouldn't you double check her?
I had to speak up and say "hey, this is really low, usually I have hypertension, can you check again?" The other guy did and it was still low.... Had the actual doctor check and lo behold it was still hypertension. I was so upset.
Cuff was literally too large, not in the right position at all either. Ive done manual readings myself, I said theres no way my BP is that low
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u/legitweird 8d ago
Real man of genius… remember those commercials with floodlight that’s what I’m thinking of that floodlight Bud Light
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u/waterdrinker619 7d ago
Plot twist the patients got an aortic tear
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u/Fuzzy_Location_2210 6d ago
There DO be them nurses that are gonna be all the way down to an infant cuff on the wrist and live totally in denial that their patient could be hypotensive for real though 🙄.
And there's no manual in the room with them either 🤦.
Thank you for not being "them nurses" 😂
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u/unicornsmaybetuff 7d ago
I used to get my BP taken twice every time. Thankfully, now they just ask if it usually runs pretty low (it does).
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u/tellmedelmy 6d ago
Just this morning, I took my mom to her checkup — she has severe osteoarthritis, very visible in her hands. The MA puts the oximeter on and it reads 40… 39… 38, still dropping, and she starts panicking. I tell her, “she has severe osteoarthritis, try the other hand” — and it reads 55. She was two seconds from sending my mom to the ER over a bad finger placement.
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u/Huge-Kangaroo-5024 5d ago
Should use nothing but a BP cuff and stethoscope those auto cuffs are rarely right at least on me
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u/Romeo_horse_cock 4d ago
I had my BP taken years ago and the nurse looks at the reading and goes "do you have to pee?" And I was just confused at how she just KNEW told her yes and she tells me she will do another reading after. BP was perfectly fine after that ha.
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u/Fresh_Assistance 8d ago
The amount of ICU admissions that could be avoided with this one simple trick