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If it is not in the exact proper position with the patient being perfectly still you will never get an accurate reading (Most require the wearer to have palm to chest and arm crossed over chest with hand just above heart and sitting still with no motion during the entire reading.
Personally I found any motion will cause most automated BP machines to re-inflate and thus risking a falsely elevated BP. I had much more success and was faster using a manual BP cuff & scope, especially if a patient had any HR irregularity (most wrist & automatic cuffs are calibrated for a regular heart beat, again the cuff re-inflates and can cause a falsely high BP plus an inaccurate heart rate)
In nursing school, we did an unofficial experiment during clinicals one used the automated wrist cuff, the other student used the manual. Manual was more accurate and quicker especially with the geriatric population hands down.
Many places here are doing away with electronic cuffs for that reason. If you do manuals often enough your speed and skill will improve. The manuals are way more accurate and that is what is most important for the patient.
I agree that manuals are the most accurate.......but
Im a newbie and have 37-43 patients.
Most of the residents get highly agitated and don't even like their BP to be taken with electronic cuff.
I'm slow as it is with med pass, TXs. Finish my 8am by 12 :/
I've tested and retested my wrist cuff compared to my manual. It has consistently read 20 mm lower on my wrist cuff. (This has to do with arterial size.) So I know that when I take a pressure with a wrist cuff, the systolic is most likely 20 mm more. That being said, I would much prefer to use manual. However, as many of us know, supplies can be few and far between. (I've known people who've stashed them for their own use later) because it wastes sooo much time looking for the cuffs. Don't get me started on trying to find the large cuffs. Also, in LTC, there is the issue of all the layers of clothing the residents wear. It is extremely time consuming to find your equipment and then help them get off there 5 layers if sweaters. So its not just a matter if being quick with taking BPs. I'm excellent at it, but all the wait time impedes on my day, leaving my other residents waiting and waiting, and getting angry
To me, as a nurse, if I had an order for a BP medication WITH PARAMETERS, then I would take the patient's BP and HR prior to given the medication. And I would do the same if a resident was also taking Lasix. What is happening, is that most LTCs are not just for patients who are older and at the time in their life when they can no longer care for themselves, but more and more LTCs are now with younger patients who need short term rehab or even long term care. So yes, it is possible to have a patient case load of 30 patients with vitals Q shift in a LTC setting. As far as using a wrist cuff, I personally wouldnt do it. Most of the time, I use the house electric unit but if I get an reading that is off, then I use my manual cuff.
This is why I don't like when I see techs doing BPs on the forearm unnecessarily. Sure, do it if you don't have an option but... don't give me inaccurate numbers for no reason.
Manual was more accurate and quicker especially with the geriatric population hands down.
Against what could you check the accuracy of manual pressures?
jnurse21, BSN, RN
84 Posts
I recently bought the Omron electronic BP wrist monitor, but find it to be somewhat inaccurate. Anyone else have this prob? What is a more accurate electronic BP monitor?
I work in an LTC facility and need quick BPs
Thanks