I too only use manual because of the accuracy. I have seen the wrist type and automatic types give false readings too often, especially in the elderly who I work with. Most of the cuffs, any kind, are not fitted properly. I have quite the assortment now of different sized cuffs for this purpose.
Most of my residents have these and take them themselves and ask me for a manual one once in a while and we see a difference every time by 5 -20 pts systolically either way (diastolic usually very close).
It really bummed me out, much quicker and easier to do it with these tools, but I keep to the old manual type

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