scholarly journals Automated Versus Manual Blood Pressure Measurement: A Randomized Crossover Trial in the Emergency Department of a Tertiary Care Hospital in Karachi, Pakistan: Are Third World Countries Ready for the Change?

2016 ◽  
Vol 4 (3) ◽  
pp. 404-409 ◽  
Author(s):  
Kanaan Mansoor ◽  
Saba Shahnawaz ◽  
Mariam Rasool ◽  
Huwad Chaudhry ◽  
Gul Ahuja ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
P Value ◽  
Care Hospital ◽  
Pressure Measurements ◽  
The Mean ◽  
The Difference ◽  
Manual Blood Pressure ◽  
Mercury Sphygmomanometer

BACKGROUND: Hypertension has proven to be a strong liability with 13.5% of all mortality worldwide being attributed to elevated blood pressures in 2001. An accurate blood pressure measurement lies at the crux of an appropriate diagnosis. Despite the mercury sphygmomanometer being the gold standard, the ongoing deliberation as to whether mercury sphygmomanometers should be replaced with the automated oscillometric devices stems from the risk mercury poses to the environment.AIM: This study was performed to check the validity of automated oscillometric blood pressure measurements as compared to the manual blood pressure measurements in Karachi, Pakistan.MATERIAL AND METHODS: Blood pressure was recorded in 200 individuals aged 15 and above using both, an automated oscillometric blood pressure device (Dinamap Procare 100) and a manual mercury sphygmomanometer concomitantly. Two nurses were assigned to each patient and the device, arm for taking the reading and nurses were randomly determined. SPSS version 20 was used for analysis. Mean and standard deviation of the systolic and diastolic measurements from each modality were compared to each other and P values of 0.05 or less were considered to be significant. Validation criteria of British Hypertension Society (BHS) and the US Association for the Advancement of Medical Instrumentation (AAMI) were used. RESULTS: Two hundred patients were included. The mean of the difference of systolic was 8.54 ± 9.38 while the mean of the difference of diastolic was 4.21 ± 7.88. Patients were further divided into three groups of different systolic blood pressure <= 120, > 120 to = 150 and > 150, their means were 6.27 ± 8.39 (p-value 0.175), 8.91 ± 8.96 (p-value 0.004) and 10.98 ± 10.49 (p-value 0.001) respectively. In our study 89 patients were previously diagnosed with hypertension; their difference of mean systolic was 9.43 ± 9.89 (p-value 0.000) and difference of mean diastolic was 4.26 ± 7.35 (p-value 0.000).CONCLUSIONS: Systolic readings from a previously validated device are not reliable when used in the ER and they show a higher degree of incongruency and inaccuracy when they are used outside validation settings. Also, readings from the right arm tend to be more precise.

Blood Pressure Measurement Error in Children: Lessons in Measurement Reliability

2019 ◽  
Vol 27 (1) ◽  
pp. 114-125 ◽  
Author(s):  
Esther J. Varney ◽  
Ashley M. Van Drunen ◽  
Emily F. Moore ◽  
Kristen Carlin ◽  
Karen Thomas
Keyword(s):  
Blood Pressure ◽  
Measurement Error ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Pressure Measurements ◽  
Noninvasive Blood Pressure ◽  
Measure Blood Pressure ◽  
Noninvasive Blood Pressure Measurement ◽  
Manual Blood Pressure ◽  
Acceptable Agreement

Background and PurposeBlood pressure measurement represents the pressure exerted during heart ejection and filling. There are several ways to measure blood pressure and a valid measure is essential. The purpose of this study was to evaluate the approach to noninvasive blood pressure measurement in children.MethodsBlood pressure measurements were taken using the automatic Phillips MP30 monitor and compared against Welch Allyn blood pressure cuffs with Medline manual sphygmomanometers.ResultsA total of 492 measurements were taken on 82 subjects, and they demonstrated comparability between automatic and manual devices.ConclusionsAlthough our study indicated acceptable agreement between automatic and manual blood pressure measurement, it also revealed measurement error remains a concern, with sample size, study protocol, training, and environment all playing a role.

scholarly journals An analysis of blood pressure measurement in a primary care hospital in Swaziland

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Ganizani Mlawanda ◽  
Michael Pather ◽  
Srini Govender
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Good Clinical Practice ◽  
Clinical Decision ◽  
Care Hospital ◽  
Correct Treatment ◽  
Primary Care Hospital ◽  
The Mean ◽  
The Difference ◽  
The Impact

Background: Measurement of blood pressure (BP) is done poorly because of both human and machine errors.Aim: To assess the difference between BP recorded in a pragmatic way and that recorded using standard guidelines; to assess differences between wrist- and mercury sphygmomanometerbased readings; and to assess the impact on clinical decision-making.Setting: Royal Swaziland Sugar Corporation Mhlume hospital, Swaziland.Method: After obtaining consent, BP was measured in a pragmatic way by a nurse practitioner who made treatment decisions. Thereafter, patients had their BP re-assessed using standard guidelines by mercury (gold standard) and wrist sphygmomanometer.Results: The prevalence of hypertension was 25%. The mean systolic BP was 143 mmHg (pragmatic) and 133 mmHg (standard) using a mercury sphygmomanometer; and 140 mmHg for standard BP assessed using wrist device. The mean diastolic BP was 90 mmHg, 87 mmHg and 91 mmHg for pragmatic, standard mercury and wrist, respectively. Bland Altman analyses showed that pragmatic and standard BP measurements were different and could not be interchanged clinically.Treatment decisions between those based on pragmatic BP and standard BP agreed in 83.3% of cases, whilst 16.7% of participants had their treatment outcomes misclassified. A total of 19.5% of patients were started erroneously on anti-hypertensive therapy based on pragmatic BP.Conclusion: Clinicians need to revert to basic good clinical practice and measure BP more accurately in order to avoid unnecessary additional costs and morbidity associated within correct treatment resulting from disease misclassification. Contrary to existing research,wrist devices need to be used with caution.

scholarly journals Blood pressure measurement in pregnancy: the effect of arm circumference and sphygmomanometer cuff size

2009 ◽  
Vol 2 (3) ◽  
pp. 116-120 ◽  
Author(s):  
Chye L Kho ◽  
Mark A Brown ◽  
Sharon L H Ong ◽  
George J Mangos
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Random Order ◽  
Systematic Difference ◽  
Pressure Measurements ◽  
Cuff Size ◽  
The Difference ◽  
The Individual ◽  
In Pregnancy

This study aimed to assess the difference in blood pressure readings between the standard and large cuff and to determine if such a difference applies over a range of arm circumferences (ACs) in pregnancy. We measured blood pressure on 219 antenatal women. Six blood pressure readings were taken, three with a standard ‘adult’ and three with a ‘large’ cuff, in random order. A random zero sphygmomanometer was used by a trained observer. Women with an AC >33 cm were similar in age, gestational age and parity but were heavier and had more hypertension than those with AC ≤33 cm. There was a systematic difference between the standard and large cuff of 5–7 mmHg with little effect due to AC. We were unable to demonstrate an association between the standard and large cuff blood pressure difference and increasing blood pressure. Our study has shown that both systolic and diastolic blood pressure measurements are more dependent on the cuff size used than AC and for the individual it is difficult to predict the magnitude of effect the different cuff sizes will have on blood pressure measurements. This study has shown the presence of an average difference in blood pressure measurement between standard and large cuffs in pregnancy, and does not support the arbitrary 33 cm ‘cut-off’ recommended in guidelines for the use of a large cuff in pregnancy.

scholarly journals Comparison Between Auscultatory and Oscillometric Reading of Blood Pressure Measurement While in Sitting and Supine Position

2019 ◽  
Vol 12 (2) ◽  
pp. 775-781
Author(s):  
Amirul Fikri Rizfan ◽  
Kalvin Ghosh ◽  
Ahmad Mustaqir ◽  
Resni Mona ◽  
Jannathul Firdous ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medical Students ◽  
Supine Position ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
The Body ◽  
Sitting Position ◽  
Measure Blood Pressure ◽  
The Difference ◽  
Mercury Sphygmomanometer

Due to continuous debate of incompatible results of blood pressure by the two devices such as the automated oscillometer and the traditional mercury sphygmomanometer, a study was carried out to compare the accuracy of the two devices as well as the best position to measure blood pressure. A comparative study regarding the difference in values of BP (mmHg) between traditional auscultatory method and automated oscillometric readings in supine and sitting positions was conducted among medical students. Oscillometer produced high readings than the readings of sphygmomanometer. Besides, the blood pressure readings for systolic and diastolic are higher while sitting when compared to supine position as the blood is unevenly distributed to all part of the body in sitting position. This will lead to the increase in ionotropic effect of the heart to pump blood towards the upper part of the body. The differences between two methods showed there have a major problem or error in measuring blood pressure. It is therefore necessary to improve the method and ways to check the health especially in this area where slight differences may contribute to large errors.

Is It Worth $50 Million?

PEDIATRICS ◽  
1977 ◽  
Vol 59 (5) ◽  
pp. 788-789
Author(s):  
A. Frederick North
Keyword(s):  
Blood Pressure ◽  
Physical Examination ◽  
Clinical Evaluation ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Pressure Measurements ◽  
Fundoscopic Examination

Dr. Shiela Mitchell and her distinguished committee recommended in the July 1975 issue that blood pressure measurements should be a regular and routine part of every physical examination of every child over the age of 2. They recommended that any child with a blood pressure over the 95th percentile for age have a fundoscopic examination and at least one repeated blood pressure measurement and clinical evaluation within a few weeks. They stated that repeated examinations and further investigations are indicated if the blood pressure persists at or above the 95th percentile.

Youtube as a source of information on "Manual Blood Pressure Measurement"

2021 ◽  
Author(s):  
Mehmet Fatih Yılmaz ◽  
Sedat Kalkan
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Health Workers ◽  
Blood Pressure Measurement ◽  
Average Score ◽  
Educational Value ◽  
Manual Blood Pressure ◽  
The Individual ◽  
Source Of Information

Objectives: The aim of the study is to evaluate the quality and reliability of videos on manual blood pressure measurement on Youtube. Patients and Methods: In January 2021, the first 100 videos found as a result of a search with the keywords 'manual blood pressure measurement' on Youtube were watched and evaluated. According to exclusion criteria, 75 videos were included in the study. Duplicate videos, irrelevant videos, and videos in languages other than English were excluded from the study. Each video was scored according to the questions prepared based on the guidelines. The GQS score and the 'Reliability' score were used to assess the quality of the videos. Results: According to the checklist prepared according to the hypertension consensus report, the mean score of the videos was 8.33 ± 2.1. When the videos were evaluated according to their sources, the average score of the videos of the health sites was 9±2.5, the average score of the videos of the individual health workers was 8.66±1.8, the average score of the videos of the unidentified people was 7.54±2.1. Conclusion: Manual blood pressure measurement videos on Youtube have little educational value. Videos of health websites should be preferred for education.

Abstract P333: National Trends in the Quality of Office Blood Pressure Measurements, 2014-2019

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Kathryn Foti ◽  
Lawrence J Appel ◽  
Kunihiro Matsushita ◽  
Josef Coresh ◽  
G Caleb Alexander ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Practice ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Pressure Measurements ◽  
Hypertension Treatment ◽  
Digit Preference ◽  
Provider Characteristics ◽  
Over Time

Introduction: Clinical practice guidelines emphasize the importance of accurate blood pressure measurement and recording to diagnose and treat hypertension. Trends in terminal digit preference (typically manifest by a terminal digit of ‘0’) have not been examined nationally. The growing use of automated blood pressure devices may have reduced terminal digit preference and improved accuracy over time. Objective: To evaluate trends in terminal digit preference in office blood pressure measurements among adults with hypertension by patient and provider characteristics. Methods: We used IQVIA National Disease and Therapeutic Index (NDTI) data from January 2014 through June 2019. The NDTI is designed to be nationally-representative of all patient visits to office-based physicians and uses a two-stage stratified sampling design to sample ~4,000 physicians per quarter who report information on all patient visits on 2 random workdays. We included all hypertension treatment visits (~60M/year) among adults aged ≥18. We examined trends in the proportion of hypertension treatment visits with recorded systolic (SBP) and diastolic (DBP) blood pressure measurements with a terminal digit ‘0’. The expected percent of blood pressures with ‘0’ is 10% for automated and 20% for manual readings. Results: There was a decrease in the percent of visits with SBP (43.0% to 37.4%) or DBP (44.3% to 38.1%) recordings ending in zero ( Table ). The decrease in percent of SBPs with a terminal zero was similar by patient and provider characteristics, though the percentage of SBPs with a terminal ‘0’ was consistently higher among patients aged ≥60, when SBP ≥140 mmHg, and among cardiologists. Conclusions: Terminal digit preference is common indicating systematic error in blood pressure measurement and recording, despite some improvement over time. This may lead to under- and overtreatment of patients with hypertension. Improving the quality of blood pressure measurement is central to improving hypertension diagnosis and control in clinical practice.

Measuring Blood Pressure

Nursing OSCEs ◽  
2012 ◽  
Author(s):  
Kate Devis
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Pressure Measurement ◽  
Gold Standard ◽  
Blood Pressure Measurement ◽  
Maximum Pressure ◽  
Pressure Measurements ◽  
Health Care Settings ◽  
Pressure Cuff ◽  
The Uk

Blood pressure measurements are one part of a circulatory assessment (Docherty and McCallum 2009). Treatments for raised or low blood pressure may be initiated or altered according to blood pressure readings; therefore correct measurement and interpretation of blood pressure is an important nursing skill. Blood pressure should be determined using a standardized technique in order to avoid discrepancies in measurement (Torrance and Serginson 1996). Both manual and automated sphygmomanometers may be used to monitor blood pressure. The manual auscultatory method of taking blood pressure is considered the gold standard (MRHA 2006), as automated monitoring can give false readings (Coe and Houghton 2002), and automated devices produced by different manufacturers may not give consistent figures (MRHA 2006). So, although automated sphygmomanometers are in common use within health care settings in the UK, the skill of taking blood pressure measurement manually is still required by nurses. As a fundamental nursing skill, blood pressure measurement, using manual and automated sphygmomanometers, and interpretation of findings are often assessed via an OSCE. Within this chapter revision of key areas will allow you to prepare thoroughly for your OSCE, in terms of practical skill and understanding of the procedure of taking blood pressure. Blood pressure is defined as the force exerted by blood against the walls of the vessels in which it is contained (Docherty and McCallum 2009). A blood pressure measurement uses two figures—the systolic and diastolic readings. The systolic reading is always the higher figure and represents the maximum pressure of blood against the artery wall during ventricular contraction. The diastolic reading represents the minimum pressure of the blood against the wall of the artery between ventricular contractions (Doughetry and Lister 2008). You will need to be able to accurately identify systolic and diastolic measurements during your OSCE. When a blood pressure cuff is applied to the upper arm and inflated above the level of systolic blood pressure no sounds will be detected when listening to the brachial artery with a stethoscope. The cuff clamps off blood supply. As the cuff is deflated a noise, which is usually a tapping sound, will be heard as the pressure equals the systolic blood pressure —this is the first Korotkoff ’s sound.

Accuracy of the London School of Hygiene and Remler M2000 sphygmomanometers

1981 ◽  
Vol 61 (s7) ◽  
pp. 399s-401s ◽  
Author(s):  
D. J. Fitzgerald ◽  
W. G. O'Callaghan ◽  
K. O'Malley ◽  
E. T. O'Brien
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Calibration Error ◽  
London School ◽  
Lower Blood ◽  
Significant Difference ◽  
Blood Pressures ◽  
The Mean ◽  
Selection Of

1. The accuracy of the Remler M2000, a semiautomatic portable blood pressure recorder, was assessed with the London School of Hygiene (LSH) and Hawkesley random-zero sphygmomanometers used as reference standards. 2. The Remler gave higher recordings than the LSH sphygmomanometer, the mean systolic and diastolic differences being 5.9 mmHg (P &lt; 0.001) and 4.7 mmHg (P &lt; 0.001) respectively. No significant difference was demonstrated between paired Remler and Hawkesley recordings. 3. When simultaneous paired LSH and Hawkesley sphygmomanometer recordings were compared, the LSH gave lower blood pressures: 7.1 mmHg (P &lt; 0.001) for systolic and 3.6 mmHg (P &lt; 0.001) for diastolic recordings. 4. The LSH sphygmomanometer underestimates blood pressure, partly due to a calibration error but also because the selection of end points for this device differs from other methods of blood pressure measurement.

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