2.50
Hdl Handle:
http://hdl.handle.net/10755/183039
Category:
Abstract
Type:
Presentation
Title:
Is There A Difference Between Calf and Brachial Blood Pressures?
Author(s):
Tran, Nhu; Hackett, H.; Cadaver, C.; Fichera, S.
Author Details:
Nhu Tran, RN, MSN, CCRN, Childrens Hospital Los Angeles, Los Angeles, CA, email: Ntran@chla.usc.edu; H. Hackett; C. Cadaver; S. Fichera
Abstract:
The standard of care when obtaining noninvasive blood pressure (NIBP) measurements are from the upper arm. However, in the neonatal intensive care units (NICU) it is common practice to take measurements from the calf. Nurses commonly take calf NIBPs because other extremities are not available, but there is little evidence to support calf blood pressure as a reliable and valid site for BP measurement. Some studies suggest there is no difference between the calf and the upper arm blood pressures, but their findings are limited to babies several days old. Other studies concluded that there is great variability between the two blood pressures. The purpose of this study was to determine if there is a statistical difference between the calf and brachial blood pressure measurements. This was a prospective quasi-experimental study design. The study was approved by the IRB. The subjects were a convenience sample of patients in the NICU, ranging from 3 days to 207 days old, born at 24-40 weeks gestation. The sample size was 52 infants. The inclusion criteria were any neonate (preterm or term) or infant admitted to the NICU and parental consent. The exclusion criteria were severe osteopenia, fractures, arterial or venous clots, thrombus, extremely fragile skin, no arms, and no legs. Three trained registered nurses performed the blood pressure measurements. Blood pressure measurements were taken according to the AHA guidelines on the upper arm and the calf. The instrument to measure the blood pressures was the Philips oscillometer device. The literature supports the validity of blood pressure measurements from the oscillometer device. The same size cuff will be used for the brachial and the calf blood pressures. Three blood pressures will be taken from the arm and the calf. After the first blood pressure is taken, the cuff will be left on the extremity for 2 minutes and a second blood pressure will be taken. The third blood pressure will be taken in the same way. The four levels of activity were noted, either (1) asleep, (2) awake and quiet, (3) awake and sucking, (4) crying.
The second and third blood pressure measurements were used for data analysis. The data was analyzed using a mixed ANOVA. The p-values lower and upper limits have a 95% confidence interval for the difference. The difference is not significant for systolic (p=0.6159) or mean BP (p=0.1298), but it is significant for diastolic (p=0.0263). The data showed no statistical difference between the systolic and mean blood pressures, but did show a difference in the diastolic blood pressures. This study has great clinical significance because most NICUs use the mean BP or the systolic BP. The study supports the current practice of bedside nurses.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2010
Conference Name:
7th Annual Florida Magnet Research Conference
Conference Host:
University of South Florida College of Nursing; Sigma Theta Tau International; Florida Organization of Nurse Executives
Conference Location:
Naples, Florida, USA
Description:
7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleIs There A Difference Between Calf and Brachial Blood Pressures?en_GB
dc.contributor.authorTran, Nhuen_US
dc.contributor.authorHackett, H.en_US
dc.contributor.authorCadaver, C.en_US
dc.contributor.authorFichera, S.en_US
dc.author.detailsNhu Tran, RN, MSN, CCRN, Childrens Hospital Los Angeles, Los Angeles, CA, email: Ntran@chla.usc.edu; H. Hackett; C. Cadaver; S. Ficheraen_US
dc.identifier.urihttp://hdl.handle.net/10755/183039-
dc.description.abstractThe standard of care when obtaining noninvasive blood pressure (NIBP) measurements are from the upper arm. However, in the neonatal intensive care units (NICU) it is common practice to take measurements from the calf. Nurses commonly take calf NIBPs because other extremities are not available, but there is little evidence to support calf blood pressure as a reliable and valid site for BP measurement. Some studies suggest there is no difference between the calf and the upper arm blood pressures, but their findings are limited to babies several days old. Other studies concluded that there is great variability between the two blood pressures. The purpose of this study was to determine if there is a statistical difference between the calf and brachial blood pressure measurements. This was a prospective quasi-experimental study design. The study was approved by the IRB. The subjects were a convenience sample of patients in the NICU, ranging from 3 days to 207 days old, born at 24-40 weeks gestation. The sample size was 52 infants. The inclusion criteria were any neonate (preterm or term) or infant admitted to the NICU and parental consent. The exclusion criteria were severe osteopenia, fractures, arterial or venous clots, thrombus, extremely fragile skin, no arms, and no legs. Three trained registered nurses performed the blood pressure measurements. Blood pressure measurements were taken according to the AHA guidelines on the upper arm and the calf. The instrument to measure the blood pressures was the Philips oscillometer device. The literature supports the validity of blood pressure measurements from the oscillometer device. The same size cuff will be used for the brachial and the calf blood pressures. Three blood pressures will be taken from the arm and the calf. After the first blood pressure is taken, the cuff will be left on the extremity for 2 minutes and a second blood pressure will be taken. The third blood pressure will be taken in the same way. The four levels of activity were noted, either (1) asleep, (2) awake and quiet, (3) awake and sucking, (4) crying. <br/>The second and third blood pressure measurements were used for data analysis. The data was analyzed using a mixed ANOVA. The p-values lower and upper limits have a 95% confidence interval for the difference. The difference is not significant for systolic (p=0.6159) or mean BP (p=0.1298), but it is significant for diastolic (p=0.0263). The data showed no statistical difference between the systolic and mean blood pressures, but did show a difference in the diastolic blood pressures. This study has great clinical significance because most NICUs use the mean BP or the systolic BP. The study supports the current practice of bedside nurses.en_GB
dc.date.available2011-10-28T16:11:57Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T16:11:57Z-
dc.conference.date2010en_US
dc.conference.name7th Annual Florida Magnet Research Conferenceen_US
dc.conference.hostUniversity of South Florida College of Nursingen_US
dc.conference.hostSigma Theta Tau Internationalen_US
dc.conference.hostFlorida Organization of Nurse Executivesen_US
dc.conference.locationNaples, Florida, USAen_US
dc.description7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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