Difficult BP

Anyone have a good technique for taking a BP on someone who the machine doesn't read and manually you can hardly hear anything, even the arrow doesn't jump clearly. I have tried as well as APRN and charge nurse. I'm pushing lasix on this pt q8h and frequent bp's are really becoming a problem
Get a doppler and a stethoscope. Can you feel a radial/brachial pulse?

I agree with Esme. When all else fails...get the doppler!

You could always get a pressure on the leg. Granted it won't be as accurate as the arm, but it's better than nothing. And at least if you continue to get it on the leg then you can get an idea of the BP trend.

Have you tried the automatic wrist cuff? Sometimes if a pt has Atrial Fib the automatic cuffs will not pick up. I agree that a doppler would be the best option.