Chapter 6: UE segmental pressures Flashcards
UE segmental pressure capabilities and limitations
same as lower extremity
UE segmental pressure patient positioning
supine
arms relaxed at sides
cuffs should be snug but not tight
UE segmental pressure technique
12 x 40 cm cuff places on upper arms bilat
10 x 40 cm cuff on forearms bilat
brachial art used to obtain upper arm BP
radial and ulnar arteries used to obtain forearm pressure
The Allen test is
a test to evaluate patency of the palmar arch
allen test technique
manual compression of radial artery by tech
pt clenches the same fist <1min to induce pallor and increase resistance
pt then relaxes wrist while keeping radial artery compression
Allen test: Normal results
reappearance of the normal color to indicate the ulnar artery is providing flow to palmar arch
Allen Test: abnormal results
color does not reappear
indicates ulnar artery occlusion or palmar arch obstruction
Allen test limitations
excessive dorsiflexion of wrist may compress radial an ulnar arteries leading to false positive
is hand is open skin stretching could lead to pallor due to compression of small vessels
Allen test documentation
use a PPG on the index finger to document arterial pulsations before and after clenching
can also eval ulnar artery this way
what suggests a >50% stenosis of subclavian artery or vessel under the BP cuff in UE seg pressures
a 15-20 mmHg difference from one brachial pressure to the other
a 15-20 mmHg drop from upper arm to forearm suggests
brachial artery obstruction distal to upper cuff
obstruction of radial and ulnar arteries
obstruction in single forearm artery which
a difference of > than or = 20 mmHg between ulnra and radial pressures suggests
an obstruction in vessel with lower pressure
