A large adult blood pressure cuff is appropriate for a patient with an arm circumference of

Using a wrong-size blood pressure cuff can affect accuracy by up to 30 mmHg. The American Heart Association recommends a cuff bladder width of 40% of the arm circumference and a cuff bladder length of 80% of the arm circumference. This poster tells how to choose the right cuff, position it properly, and avoid common sources of BP monitoring error.

GE Healthcare Jun 25, 2020 5 min read

34likes

1. Begin by measuring the patient’s mid upper arm circumference.
2. Using the sizing chart below, determine what size cuff should be used based on the measurement reading.
   If a patient’s cm measurement is overlapping between sizes, default to the larger cuff if width is appropriate.
3. Place the artery mark located on the cuff over the patient’s brachial artery.
4. Wrap the cuff snugly and securely, allowing space for two fingers to fit between patient and cuff.

Common sources of error in blood pressure monitoring¹

The American Heart Association recommends that a cuff bladder width be 40% of the arm circumference and that a cuff bladder length be 80% of the arm circumference.¹

References

1. Pickering, T., et al. Recommendations for Blood Pressure Measurement in Humans: An AHA Scientific Statement from the Council on High Blood Pressure Research Professional and Public Education Subcommittee. Hypertension 45, 142-161 (2005).
2. Manning, D.M., et al. Miscuffing: Inappropriate blood pressure cuff application. Circulation 68(4), 763-6 (1983).

• Cuffs Posterpdf (101.8 KB)

Our Picks

• Image

  

  White paper 5 min read

  DINAMAP SuperSTAT Algorithm: Setting Target Inflation Pressure

  The DINAMAP SuperSTAT non-invasive blood pressure (NIBP) algorithm in the CARESCAPE Patient Data Module and Dash and CARESCAPE...

  Department of Postgraduate Medicine, University of Keele, Stoke-on-Trent, Staffordshire, United Kingdom.

  Copyright notice

  Abstract

  STUDY OBJECTIVE--The aim of the study was to determine whether a single size of cuff for adult blood pressure measurements is appropriate for general clinical practice. DESIGN--The study was a prospective survey of a sample of adult blood pressure measurements using two cuffs with different bladder sizes (12 X 23 cm and 15 X 33 cm) in a randomised design using a random zero sphygmomanometer. SETTING--Blood pressures were measured in a general practice and in a hospital outpatient clinic. PARTICIPANTS--The participants were 35-60 year old men and women invited to attend a blood pressure screening programme in the general practice (n = 170), and 35-74 year old patients attending a general medical outpatients (n = 72). MEASUREMENTS AND MAIN RESULTS--The small cuff gave higher readings of systolic blood pressure than the large cuff (mean difference 4.4 mm Hg). The difference increased as systolic pressure increased but did not show a clear association with arm circumference. The small cuff also gave higher diastolic pressure readings (mean difference 3.0 mm Hg), but only when arm circumference exceeded 30 cm. The variability of the differences between readings from the two cuffs was wide, little affected by arm circumference, and was similar to the variability between measurements using the same cuff size. CONCLUSIONS--In terms of precision there is no basis for using two different cuff sizes unless it is physically difficult to obtain a reading with one or the other. Since readings with large cuffs are closer to intraarterial pressures in large arms, and the large cuff used here did not underestimate diastolic pressure in small arms, the large cuff alone could be recommended for general use.

  Full text

  Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (712K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

  How do you determine the correct cuff size for a patient when doing blood pressure?

  The width of the bladder of the blood pressure cuff should be approximately 40% of the circumference of the upper arm midway between the olecranon and the acromion. The length of the bladder of the cuff should encircle 80 to 100% of the circumference of the upper arm at the same position.

  What size is an extra large blood pressure cuff?

  Designed for clinical use, the durable extra large cuff (HEM-907-CX19) fits arms 17 to 20 inches (42 cm to 50 cm) in circumference. The cuff is compatible only with the OMRON IntelliSense Professional Digital Blood Pressure Monitor (HEM-907XL).

  Which cuff size will be used with an arm circumference of 50 cm?

  According to the AHA recommendations, for arm circumferences ranging from 35 to 44 cm, a bladder measuring 16 cm in width should be used. For circumferences from 45 to 52 cm the bladder width should be 20 cm, but in subjects with short upper arm length, a 16 cm wide cuff can be used.

  Who needs a large BP cuff?

  In obese patients, longer, wider cuffs are needed to compress the brachial artery adequately. In children, cuff bladder width should be at least 40 percent of the arm circumference halfway between the olecranon and acromion; the cuff should then cover 80 percent or more of the arm circumference.