Comparison of Arm and Calf Automatic Noninvasive Blood Pressures in Pediatric Intensive Care Patients

Schell, Kathleen; Briening, Eileen; Lebet, Ruth; Pruden, Kelly; Rawheiser, Steven; Jackson, Barbara

doi:10.1016/j.pedn.2009.11.007

« Previous Next »Journal of Pediatric Nursing
Volume 26, Issue 1 , Pages 3-12, February 2011

Comparison of Arm and Calf Automatic Noninvasive Blood Pressures in Pediatric Intensive Care Patients

Kathleen Schell, RN, PhD, RN
- School of Nursing, University of Delaware, Newark, DE
- Corresponding author: Kathleen Schell, PhD, RN.
Eileen Briening, RN, MSN, PNP-BC
- Department of Anesthesiology and Critical Care, Nemours and Alfred I duPont Hospital for Children, Wilmington, DE
Ruth Lebet, RN, MSN, CCNS
- PICU, Nemours and Alfred I duPont Hospital for Children, Wilmington, DE
Kelly Pruden, RN, MSN, CPNP, CCRN
- Department of General Surgery and Trauma, Nemours and Alfred I duPont Hospital for Children, Wilmington, DE
Steven Rawheiser, RN, BSN
- Pediatric Transport Team, Nemours and Alfred I duPont Hospital for Children, Wilmington, DE
Barbara Jackson, RN, BSN
- PICU, Nemours and Alfred I duPont Hospital for Children, Wilmington, DE

published online 25 January 2010.

The purpose of this study was to compare upper arm and calf automatic blood pressures (BPs) in a convenience sample of 221 children, ages 1 to 8 years, admitted to a pediatric intensive care unit of a 180-bed teaching hospital in the Mid-Atlantic region of the United States. Subjects were positioned in bed, with the head of bed elevated 30° and extremities resting on the bed. BP cuff size was based on arm and calf circumferences. BPs were measured simultaneously using bedside and portable Spacelabs monitors. Calf BPs were greater than arm BPs in approximately 73% of the sample. Paired t tests show statistically significant differences for systolic BPs and mean arterial pressures. Influence of demographics, agitation levels, medical diagnoses, and current medications was explored. Calf and arm BPs were not interchangeable in acutely ill children, ages 1 to 8 years.

Key words: Arm blood pressure, Calf blood pressures, Cuff placement, Oscillometric blood pressures