Wrist B/P digital cuff vs. old manuel arm type

WingsEarned21, LPN, RN · Oct 27, 2008

I believe in using wrist or electronic cuffs but I also believe that a nurse should have enough common sense that if she gets a weird reading to take the bp by manual cuff not just take the reading for granted.The electronic cuff's have had a tendency to give false readings if not held properly or applied properly or the batteries are dying.

bethin · Oct 27, 2008

I work med surg, but we did a trial for the wrist cuffs. First we tried it on ourselves, me being the first. My bp runs high all the time - as in 135/90 would be good for me. The wrist cuff read my bp as 80/48. Immediately after the reading someone did a manual reading and got something much different. Tried it on all the staff and not one was accurate so needless to say we don't use them.

Even dinamaps run weird sometimes. I can have a walky talky feeling fine pt who gets a reading of 79/38. I do a manual and get a normal reading. You really have to use your judgement.

mondkmondk · Oct 27, 2008

The facility I work with has 2 wrist cuffs but I don't trust their readings. I always take mine using a good old fashioned arm cuff and stethoscope.

Blessings, Michelle

nickos · Oct 27, 2008

When I worked as a caregiver in a group home for a few years we only had the wrist cuff. This was especially frustrating to use to check BPs on a patient with PKU who had major tremors that intensified when he was upset (and trying to take his BP upset him more!) I never felt good about that wrist cuff, but that might be why.

When I worked as a CNA on the main medical unit we had dinamaps for pulse ox, etc but we were never to use the cuff unless the wall cuff was having issues (always doing manual BPs). Now I work as a psych tech in the ED; empty rooms with benches bolted down so needless to say there are no wall cuffs (suicidal patients have creative ideas!). I have been "down" in the ED for about 2.5 months now and am just getting used to using the dinamap. I feel much better about a manual bp though!

annaedRN, RN · Oct 27, 2008

I work in HH, so needless to say all I have is my manual to rely on. But I do often take a BP then have the patient use their automatic one so they can see if it's atleast close. Provides some reassurance for them.

classicdame, MSN, EdD · Oct 27, 2008

Periodically I test the wrist cuffs we use for Health Fairs against the ICU monitors and there is little difference, if any. I believe ALL types of equipment require calibration and good technique.

PedsAtHeart, LPN · Oct 27, 2008

I have a wrist cuff and manual. Mine seems to run pretty close to the same as the manual. Of course, as stated, they all need proper calibration and they need to be put on correctly. You should also have the patient rest their arm on their chest while doing it with the wrist cuff. It comes in really handy with larger people. For the most part I do blood pressures manually because I feel it is the most accurate, however I keep my wrist cuff usually for those larger people.

CoffeeRTC, BSN, RN · Oct 27, 2008

We were just talking about this last night. It seems like all the newer CNAs have their own electric cuffs. Some are wrist and some are arm cuffs. Many a time I get a weird reading and they record them...either really low, really high or just weird. The thing is....I will ask them to retake them using one of the facility's cuff and they look at me like I have 2 heads.

This has me wondering...do they even know how to take a BP? are they taught general ranges for the vitals. (getting a bp of 180/120 and just recording it as if it was okay)?

Long story short...I don't like them much.

norcalRNstudent · Oct 27, 2008

for some reason, they used one on me at my dentist...reading of 164/80. I laughed, and told her she needs a new cuff; I never run more than 110/60. She repositioned my arm, and voila! 110/60. Had I not said anything, she would have been more than happy to record the initial reading.

lovingtheunloved, ASN, RN · Oct 28, 2008

I don't let my aides use them. The time that sticks out is the man who had diarrhea and had been vomiting for 12 hours and refused to drink anything and refused IV fluids...the wrist cuff said 204/116. Manual said 92/48. Far more realistic.

WingsEarned21, LPN, RN · Oct 28, 2008

I was told by some STNA'S that they no longer teach them how to take a manual BP.I feel they surely do not or did not teach them proper parameters or how or why it is so important for these to be right.I have had the same thing happen andI do not get to look at the board where they write it down till the end of my shift when I have time to chart.Then I get irritated because I see really weird readings that should have been addressed sooner .I then have to stop my charting or whatever I am doing adn go do a BP myself manually.(not that I care about doing it myself ,I just wish they would realize that a BP of 70/30 or lower needs addressed as well as 180/120).