Accuracy of Automatic BP machines?

MrsMig, BSN, RN · Mar 10, 2013

Yeah.. Manual is definitely more accurate

bebbercorn · Mar 10, 2013

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.

Esme12, ASN, BSN, RN · Mar 10, 2013

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.

psu_213, BSN, RN · Mar 10, 2013

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.

DSkelton711 · Mar 10, 2013

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.

lemur00, BSN, RN · Mar 10, 2013

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.

PediLove2147, BSN, RN · Mar 10, 2013

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.

LaRN · Mar 10, 2013

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.

WhereIsMyCallBell · Mar 11, 2013

Don't trust 'em. But, that's just me... =)

cardiacrocks, BSN, RN · Mar 11, 2013

I ONLY take manual BP's on all my patients. I work on a cardiac floor and I do not trust the automatic BP's. Many times I have a care partner come to me with a low BP, when I take it manually it's usually within normal parameters. If you have a pt. that is in A-fib/A-flutter, they have irregular beats and the automatic BP is almost ALWAYS wrong, it can not pick up on those irregular beats. I have to give a lot of cardiac meds, I take my own manual BP's because ultimately I'm the RN and I'm the one responsible if something goes wrong.

Wrench Party · Mar 11, 2013

I'm learning manual BP is always better, and to trust my ears instead of the machine. I use the machine as a backup, especially when I get weird BPs manually like 85/40. Turns out that patient trended in the low 90s for SBP all day.

Wagoosh, RN · Mar 11, 2013

I am currently in the middle of my nursing education, so I am still getting used to being 'skilled' with my skills. For routine vitals at the clinical sites, I often use the machine, but I will check with manual as well. This might be more to do with me trying to see if I'm taking manual accurately, but I do find myself questioning the accuracy of automatic machines in facilities and not just with BP. Along that line, tempanic thermometer use has me questioning even more. How accurate can those possibly be when a pt has a fever that needs to be monitored with accuracy? Even if I wanted to check with a different thermometer, the particular facility I was doing my medsurg rotation at didn't even HAVE another kind of thermometer. So, I think there is certainly validity in questioning the frequent use/reliance of automatic machinery, if only because it worries me that perhaps someday the manual options might not even be available to double check!