Cuff shapes for ABPI

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I am 2nd year student, recently required to perform ABPI for clinical assessment. Having nearly caused critical ischemia on a fellow student during practice, and repeating the technique on my 'lucky' clinical educator (he's having a lie down now....before getting toe pressures measured AND a trip to see vascular specialist!) I would like to ask:
-if I am the only person who felt like they needed 3 arms to complete the procedure?
-does anyone have any practical tips?
-other than 'appropriately sized' cuffs, does anyone else think something more 'leg/arm shaped' cuff may improve the patients' comfort?
- is anything more specifically shaped available, and if so is it to an accepted standard to be used for ABPI's? (We strive to attain 'Gold Standard' in every clinical assessment of patients)
There seems to be quite a bit of research about, but I couldn't find anything making a similar observation about the shape of cuffs-I had hoped I'd be working with patients who require this assessment some time in the future and would like to feel a little more knowledgeable and confident about the technique
:dizzy:
Sarah

 

I must ask what it is exactly that you think you did with a BP cuff? Unless this was left on longer than 2-3 hours, which is usually very painful, I can't for the life of my think of anything dangerous you could have actually done.

Please fill us in!

LL

 

Sorry! Melodramatic storytelling in first instance. But fellow students did say cuff was bit uncomfortable, and in excitement of the task quite a few of us did not immediately deflate cuffs...(seconds rather than hours, Honest!)
The second attempt was during my NHS placement, and my educator commented the cuff was uncomfortable. Being encouraged to question everything that we do I did wonder if it was my technique, but my educator seemed happy with the procedure- he let me perform assessment again, we discussed problems with duration of appointments, patients not being able to lie flat and consequences of results. The results from the two ABPI's I did on him varied slightly (hence the Melodramatic 'toe pressures' vs 'vascular specialist' comment)
Our Pod. School encourages us students to question anything and everything, my placement too, so I decided to think about the actual cuff... It looks untidy as it is wrapped around a calf in particular, I looked at the lines pointing to the range and the arrow pointing to the vessel. It all seems very regular in shape whereas something a little more calf shaped may be more comfortable for the patient AND reassure the practitioner that they had relevant parts lined up correctly?
I think I'll stick to podiatry questions and give the humour a miss for now?
I'd appreciate any thoughts regarding cuff shape in particular?