BP: Left VS Right

[TreySpooner65]

I have had a few people suggest to me that the right arm is better for taking BP on. Is this true?

For bonus points, what things do you know that can affect BP (other than medication.) Things like time since last meal etc..

 

[JPINFV]

Various diseases that span multiple systems can affect BP, as well as the body simply just because ("idiopathic").

Things like aneurisms of the aortic arch can result in differences in blood pressure between left and right arms, but these are pathological differences so one side isn't "right" or "wrong."

The one thing about R vs L that I can think of is you don't want to do it on the side with vascular access if you can avoid it, and definitely do not do it over the side with a PICC line or over a fistula.

 

[mycrofft]

1. Serial BP's should be on the same arm for reproduciblity/comparison.
2. If it seems fishy on one side, do both, and document.

 

[xxTriNakedxx]

The one thing about R vs L that I can think of is you don't want to do it on the side with vascular access if you can avoid it, and definitely do not do it over the side with a PICC line or over a fistula.

You also don't want to do a BP on the same side of the procedure if a woman has had a mastectomy.

 

[Veneficus]

in my first year

I was told to always take a bp on both arms of patients I suspected of hypertension or vascular abnormalities.

It seemed really silly to me.

In my 5th year I saw a patient with subclavian steal syndrome with controlled hypertension.

It is no longer silly and I frequently take a BP on both arms. If I cannot conscript an ultrasound, I am also very fond of the A/B index.