Which site is preferred for blood pressure measurement in a patient with a left-arm arteriovenous fistula used for hemodialysis?

• A. Right arm
• B. Left arm above the elbow
• C. Left thigh
• D. Left arm below the fistula

Answer: (A)

Avoid placing a blood pressure cuff on the arm with the arteriovenous fistula. The fistula arm is the dialysis access site, and the cuff’s repeated inflation can compress the vessels, disturb flow, and risk injury, thrombosis, or stenosis of the fistula. To protect the access and ensure accurate readings, take blood pressure on the opposite arm. In this case, that means using the right arm. Using any part of the same arm (above or below the fistula) or a thigh would be less reliable and unnecessary when a clean, opposite-arm site is available.