Accuracy of Automatic BP machines? - page 2

by blackvans1234

12,217 Views | 28 Comments

Hey all, just wondering if you ever question the accuracy of the automatic blood pressure machines, especially when compared to manual bp readings. I understand that cuff fit is important, and that with manual, there may also... Read More


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    If the readings are out of whack, I'll check manually. I trust my ears more than the cuffs, however I think the machines are good for showing trends.
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    If I have time, I'll do a manual BP. Why? It's more accurate for me to do it. While I can do a manual BP faster than an auto cuff can do it, in the overall scheme of things, I find it faster to "delegate" the BP taking to the machine. With a manual BP, once the cuff is on, the rest only takes me maybe 20-30 seconds tops. Where I pick up time is that if I'm doing a manual BP, I'm focusing mostly on that, where if I delegate that task out, my attention is focused on that task for as long as it takes me to apply the cuff and press the NIBP button.

    Something that I try to do is take a manual BP and then take an auto BP, then compare the two. If they're close, then I'll trust the machine. As to auto BP machines, I have found that if the machine has EKG leads, they get quite accurate and fast because they'll ignore pressure swings outside a certain timeframe after each QRS.

    I've done (quite literally) about 25,000 manual BP readings over my career so far, so it's not all that surprising that I got good at it. It's only been relatively recently (start of nursing school) that I have been doing more auto cuff than manual.
    LadyFree28 likes this.
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    Yeah.. Manual is definitely more accurate
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    I prefer automatic but it depends on availability of the cuff... they seem to be hidden away in the clean utilities or somewhere always. When I work at MD's office, when I have the chart available I'll quickly review pt condition and prior vital signs. If it is off by 10-15 mmHg I take a manual.
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    Quote from blackvans1234
    Hey all, just wondering if you ever question the accuracy of the automatic blood pressure machines, especially when compared to manual bp readings.

    I understand that cuff fit is important, and that with manual, there may also be user error.

    The reason I ask is that I consistently get 130/90 when taken manually at my doctors office, and consistently get 120/80 via automatic machine - I can take this at school (nursing school), and work (hospital).

    People say white coat syndrome but I don't know how much I believe that, considering I do not feel anxious at my doctors office.

    Assuming there is a discrepancy between the readings of the automatic / manual not caused by white coat syndrome, could this affect our patients readings as well? (assuming your patients are in hospital, having bp taken automatically.

    Opinions?
    While you may dismiss white coat syndrome.....it is a real occurance. YOu are not as relaxed in the MD ofice as you are at home. Yes there are instances that it might affect our patients ....but that is why were don't just treat numbers....we treat the patient.

    If the automatic B/P cuff syas 60/20 and the patient is awake alert oriented color pink skin w/d in no acute distress...I wll be sure to take it manually. Just like if I can't hear the B/P and the pateint looks fine I will double check with the automatic cuff.

    Machines are not infalliable and neither are we......I don't treat numbers, per se, I treat the patient and I will always verifiy an abnormal reading with the cuff and/or in both arms.

    One time I saw the MOST BEAUTIFUL VTach on the monitor... another nurse called a code without checking the patient...when I got to the room.....followed by an Entourage ......the patient had the monitor leads over their arm and the patient was happily brushing their teeth.
    KelRN215 and brownbook like this.
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    Quote from xoemmylouox
    Manual is only as accurate as the person taking it
    That is certainly true. At my PCPs office my BP has always been taken by the same nurse. Every BP taken there over the past 3 years are in the range of 120-124/72-76. Every single one falls in that range. While my BP has always been "good," it certainly has not been perfect. I don't know if she has a lack of confidence in her skills or just a lack of training, but I highly doubt that all my BPs fit in this little box.
    brownbook likes this.
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    I think a Dynamap can be pretty accurate, but if there is an arrythmia I like to take manually as back up to check. Manual, like others say, are only as accurate as the person taking it--their technique, their ears, their sight, seeing previous BPs may make them prejudicial in what they write down. Any large discrepancy should be checked out.
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    They're usually pretty accurate. The only time I've found that they aren't is if the patient has a very irregular heart beat or is overly afraid of the machine.
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    I trust the machines. It can be a pain to find the manual BP cuff so I only use it if I get a wacky reading and want to confirm.
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    Their accuracy improves if used exactly as the directions state. that means putting the device on properly and some of them require the user to hold the arm or wrist in a certain position. and fresh batteries should always be used.

    I do not like them because most people dont use them correctly...so I frequently get calls from home care patients saying things such as: "i need a nurse, my blood pressure is 70/30!!". Nurse has to make a visit to determine if this is actually the patients blood pressure. and of course it isn't.


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