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Blood pressure cuffs have instructions saying to point an arrow or mark over the brachial artery. The center of the cuff BLADDER, both vertically and horizontally is supposed to be over the brachial artery. I see a lot of web videos and all have the indicator pointing toward the anticubital fossa where you will place the stethoscope. However, going from this point toward the heart, the artery itself goes medially into the biceps groove. So shouldn't an arrow designating the center of the cuff bladder be positioned 60 to 90 degrees medially from the stethoscope placement point?
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My Omron machine has a line marked on the cuff with a diagram showing that the line should be lined up with the index finger if your arm is out straight. There's nothing about any horizontal lines on my machine. I think it's blood pressure monitoring for dummies - no stethoscopes involved. It works fine though.
I hope this answers your questions and gives some insight into how the blood pressure cuff should be applied.
Thank you for your question. You are correct that the bladder should be centered over the brachial artery and that the brachial artery is on the inner portion (medial) of the upper arm; between the bicep and tricep. For blood pressure cuffs intended for clinical use on humans there are rules for the artery marker that are stipulated in guidelines and standards adopted by government bodies, such as the FDA in the United States, and the European Commission in Europe.
Both the U.S. and European regulations require that the artery marker refer only to placement of the bladder over the brachial artery—never placement of the stethoscope. However, if a clinician chooses to place the stethoscope just under the edge of the cuff over the brachial artery, then of course the stethoscope location will coincide with the artery marker. So to summarize, if the cuff is placed correctly 1”-2” above the elbow, the artery marker should be on the inside of the upper arm.
The artery marker on all SunTech blood pressure cuffs is located on the center of the cuff bladder (not the center of the entire cuff) to ensure that the cuff bladder is centered on the brachial artery. It is very important to think of the blood pressure cuff not just as a tourniquet used to occlude the brachial artery, but also as an important sensor used to sense minute changes in pressure within the artery once blood flow resumes.
As you have correctly observed, correct cuff placement is critical to obtaining an accurate blood pressure, and that rule applies to automated blood pressure devices as well as traditional auscultatory sphygmomanometers.
Kent Lupino & Denise Witman, Product Managers at SunTech Medical
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