The difficulty of measuring blood pressure in patients whose upper arms are too large for a blood pressure cuff poses a challenge to nurses, but it should be easy enough for manufacturers to resolve (“Clinical Comparison of Automatic, Noninvasive Measurements of Blood Pressure in the Forearm and Upper Arm With the Patient Supine or With the Head of the Bed Raised 45°: A Follow-Up Study,” March 2006:196-205).

Picture a blood pressure cuff laid out flat on a table. Keep in mind that the length of the cuff is what goes around not the length of the patient’s arm but its width or circumference; the width of the cuff is what covers the length of the patient’s arm. In my experience, every set of manual or automatic cuffs has the same problem: the cuffs that are longer also are made...

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