9

Even though there is no mention of this in the french team first-aid guidelines, instructors, teams chiefs and doctors all instruct us rescuers not to monitor the blood pressure1 of a victim who has or had a breast cancer on the arm located on the side of the affected area.

So we never do that, but why? I found no clear explanation when searching (but plenty of forums or discussions all stating the same).


1- We use either a manual aneroid sphygmomanometer or a multi-parameters monitor. Both use a biceps cuff.

8

Many patients who have been diagnosed with breast cancer have their axillary lymph nodes removed.

One of the main roles of the lymphatic system is to assist in draining extra-cellular fluid to the thoracic duct and ultimately back into the blood stream. Therefore, when axillary lymph nodes are removed, there is risk of developing lymphodema (swelling) in the corresponding arm. This puts the arm at a greater risk of infection.

When a blood pressure cuff is applied to the arm, the pressure of the cuff may further inhibit the drainage of the extra-cellular fluid in the arm, further enhancing the risk of the patient developing lymphodema.

Therefore as a precuationary measure, it is not recommended to use a blood pressure cuff on the arm of the side effected by breast cancer.

It is also recommended that injections are not given, and blood not taken from the affected arm. This is because the removal of axillary lymph nodes results in a higher risk of infection in that arm.

References:

  1. Petrek JA, Pressman PI, Smith RA. Lymphedema: current issues in research and management. CA Cancer J Clin. 2000 Sep-Oct;50(5):292–307. quiz 308-211.

  2. Loudon L, Petrek J. Lymphedema in women treated for breast cancer. Cancer Pract. 2000 Mar-Apr;8(2):65–71.

  3. Preventative measures for lymphedema: Separating fact from fiction

  • 3
    Good answer! Answers without any references (not hard to find), though, are like long comments. Editing in references would make it an even better answer! Thanks. :) – anongoodnurse Apr 27 '15 at 17:04
  • Thanks! 3. tends to mitigate rather than supporting. Is this why you explain this is a precautionary measure? – Shlublu Apr 28 '15 at 6:27
  • @Shlublu, yes spot on. There isn't a lot of evidence that there will be increased lymphodema, but I described the reasoning behind the practice as a precautionary measure. – Kenshin Apr 28 '15 at 6:36
  • That's even better like this. "Why" is one thing, but "this is why, and here are the boudaries" is way more interesting. – Shlublu Apr 28 '15 at 6:41

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