What’s a clinician to do? Debates about clinical trials, patient populations, and statistical analyses can seem hollow and distant when looking at an anxious patient in an exam room. At that moment, all that matters is what’s best for your patient. Yet clinically relevant data, and more importantly, rigorous discussion of that data, is the means to the end.
Manual blood pressure monitors. You can use manual blood pressure monitors for accuracy. Home blood pressure monitor kits can include a cuff that inflates manually and a stethoscope for hearing your heartbeat. You can choose a manual blood pressure monitor for managing hypertension or as part of preventive health care from brands Lumiscope and BV Medical here at Walgreens.com. 10 Steps to Accurate Manual Blood Pressure Measurement. Monday, 27 July 2009. Kenny Andersen. BP+Vitals Measurement. * However, the AHA goes on to recommend that a properly maintained monitor for manual measurement of blood pressure be available for routine office measurement.
Professional clinicians quite often need the former in order to effectively deliver the latter. To wit, two similar journal articles were recently published that arrived at two very different conclusions. Let’s take a look: The first is entitled, by Dr. Johanna Landgraf, Dr.
Stanley Wishner, and Dr. Robert Kloner, and was published in the American Journal of Cardiology. The authors raise concerns about the use of automated oscillometric BP devices and reported a “significant difference observed in BP readings taken simultaneously using the auscultatory/mercury technique and the automated oscillometric technique.” They reported that manual auscultatory results were typically higher than those using automatic oscillometric devices, particularly in elderly patients (the mean discrepancy between methods was reported to be about 2 mm Hg). The main concern raised is the potential for some hypertensive patients to be undertreated as a result.
The second article, published in the Journal of Clinical Hypertension, is titled, written by Dr. Myers pulls no punches when he states that, “the mercury sphygmomanometer has now become an impediment to optimum care of the patient with hypertension in routine clinical practice.” His argument is based on the myriad number of extraneous factors associated with manual BP measurement in the real world, which result in BP readings of variable quality and accuracy. Automated oscillometric devices which have been independently validated for accuracy, Myers argues, can help eliminate such variability. Scott Scargle, MSEE, is the OEM Technology Manager here at SunTech, and has over 13 years of engineering experience designing and building medical devices. He has some interesting technical observations about the Landgraf, et al article that are worth noting. While the authors claim that the differences between manual and automated methods were significant, Scargle is not so sure. “I am not convinced that an observer mean SYS of 133 +/- 20 mmHg is significantly greater than the device mean SYS of 131 +/- 18 mmHg.
I think these values are quite comparable in most clinical settings, especially when you consider that most auscultatory BPs done by medical staff have much, much faster deflation rates than in this study.” In addition, since the Landgraf, et al study used the same cardiologist for all of the manual readings, Scargle wonders if an observer-to-observer comparison would have shown similar differences. Scargle also notes that there can be differences between the automatic devices themselves.
“Something that is often overlooked is the fact that oscillometric NIBP devices all have their own proprietary algorithms that were developed differently,” he says. Specifically, some devices may use publicly-available data to calculate their algorithms, while others conduct clinical trials on patient populations. The size and makeup of the population therefore affects the accuracy of the resulting algorithm. For example, SunTech has been able to hone its algorithms over two decades of regular clinical testing.
As a result, its devices are quite accurate. “Large differences among devices should not exist because they all have to meet basic regulatory accuracy requirements,” observes Scargle, “but differences do exist—especially on more difficult patient populations.” Scargle makes one last observation about the Landgraf, et al article. “Regarding device-observer comparisons, our own research has shown that many oscillometric devices read ‘low’ on hypertensive patients, so I don’t find their results surprising. SunTech has taken measures to address this and it’s our hope that other automated blood pressure manufacturers would do the same.” In my, I’ll share some excerpts from an interview with Dr. Brian Forrest, M.D., a practicing hypertension specialist here in North Carolina.
He’ll share his own thoughts about automatic versus manual sphygmomanometers. In the mean time, we'd like to hear yours!
More than 32% of American population suffers from high blood pressure. And moreover 1 in 3 adults has prehypertension (numbers higher than normal yet not in the range of high blood pressure). If not taken care off, then it can lead to complications like heart attack, heart failure, memory trouble and aneurysm. If you want to prevent them and manage the blood pressure levels, you have to obtain the reading daily at different times and under several circumstances. This helps in understanding the factors that are causing the blood pressure levels to rise.
Instead of seeing a medical professional multiple times in a day, you can just invest in a manual blood pressure cuff. Also known as sphygmomanometer, these devices helps to take accurate reading without medical experience. Since the market is filled with several options, you can easily get confused which one to choose. Luckily, our experts have assorted a with the help of medical professionals to help you out. And taking a step further, they have even filtered and picked the best one among the best sphygmomanometers after a thorough research of 80 hours.
Top 7 Recommended Manual Blood Pressure Cuffs. Manual Blood Pressure Cuffs Warranty Buy Now 20 years 3 years 3 years 2 years 2 years 1 year Expert Review of Each Manual Blood Pressure Cuff This device is one of the popular blood pressure monitor presented by American Diagnostic. The Japanese-engineered manometer, precision and meticulous Adcuff inflation system makes this product perfect for both professional and home use. The chrome-plated brass air valve contains micro-threads which provide deflation control precisely.
The part of this sphygmonameter is subjected to rigorous testing for accuracy, cuff endurance, gauge endurance and more. The nylon cuff has appropriate sizing guide making in order to prevent mis-cuffing. The black cover will come with nylon zipper. This device meets ANSI SP10 and EN 1060 standards. Things We Liked:.
300 mmHG no-pin stop manometer. Nylon cuff with proper sizing guide.
Meets ANSI/AAMI/ISO 81060-1. Chrome plated brass valve. Assembled and packaged in the U.S.A.
Rugged constriction. 20-year calibration. Things We Didn’t Like:. Not ideal for people with large arms. Bulb is a bit harder to pump as it is made up of heavy rubber. If you want a professional manual blood pressure cuff then this product is the ideal choice.
It has a crack resistant high-density design. This blood monitor undergoes quality stress testing before hitting the market.
This ensures long term accuracy. Only latex-free materials are used for the tubing. It features, high-density inflation bladder and bulb, high contrast gauge, index range, and artery indicatory label. Even with excellent features, the quality is the real factor that makes this product stand out among the crowd. It comes with a 3 year warranty and a lifetime calibration guaranteed. Things We Liked:.
Reliable and accurate readings. Not expensive. Latex free tubing and nylon cuff. High-contrast dialing.
Stress-tested and calibrated. Things We Didn’t Like:. Not good for pediatrics. Sensitive to sudden movements. This product is a reliable and high quality manual blood pressure cuff which helps you track blood pressure levels. Along with BP monitor, a stethoscope and a portable carrying case is provided. The extra double zinc alloy case makes it capable enough to operate even in harsh conditions.
The length of the nylon cuff is 22 – 42cms which makes it comfortable to wear. An improved version of blower check valve (controls pressure in cuff) is provided in this product. The gauze filter present in this monitor will prevent dust from accumulating as it may disrupt the performance of the device. It will work without any hassles for really a long time. Both left and right handed individuals can use it without any hassle.
The large dial makes it easy to read the contrasting numbers so it is ideal for even seniors. The high quality Velcro guarantees maximum comfort and it is suitable for both large and small diameter arms. Things We Liked:.
Water resistant and durable. Light in weight and easy to travel. Large LED display for contrasting numbers. Lifetime calibration and 3 year warranty for parts. Chrome-plated brass screw valve.
Accurate deflation and compression. Things We Didn’t Like:. Less comfortable than other models. In order to meet American Standards, this blood pressure monitor is precisely calibrated by American Standards Institute.
This model is one of the best sphygmomanometer from the prestige brand. Many users have backed the durability and build-quality of this device. Heavy duty latex free nylon is used for the cuff which lasts long than other materials. It features index and range markings, artery indicator, gauge holder, air release valve, and inflation rubber bulb. A nylon carry case is provided for easy transport. Things We Liked:.
Interchangeable cuff sizes: pediatric, adult and large adult. Lifetime calibration. Latex free nylon cuff.
Carrying case. Affordable priced.
Things We Didn’t Like:. Assembly is required but not overly complicated. This product is best suited for medical students, nurses and people who are trained in it. This blood pressure monitor is FDA approved so, you can happily trust on it. In order to make it accurate, dependable and durable, you can stress-test it over a thousand times.
A certified 300 mmHg manometer is provided which has the accuracy of +-3 mmHg. It has an identifiable high-contrast dial. The cuff is constructed of high-molecular polymer nylon which is resistant to abrasion, chemicals and moisture. The seamless inflation bag is non-sticky, crack resistant and high density PVC. The chrome plated valve delivers deflation control rate. Things We Liked:.
FDA approved. Stress-tested over thousand times. Durable and accurate. 300 mmHg certified gauge.
Sized to meet American Heart Association. Things We Didn’t Liked:. People without medical background or proper training may find it complicated. This is a complete kit of stethoscope, blood pressure monitor and carrying pouch. The carrying pouch contains two pairs of ear buds, three bells and 2 diaphragms.
The stethoscope contains a 22-inch tubing. The deluxe inflation system contains a heavy latex bladder and large air release valve which provides precision deflation. The carrying case pouch and stethoscope come in 10 different colors like black, pink, blue and others. Things We Liked:. Choice of 10 colors. Complete kit of BP monitor and stethoscope.
Very helpful for medical professionals and nurses. Extra accessories are also provided. Things We Didn’t Like:. The ear pieces of the stethoscope are uncomfortable. This device is an aluminum alloy manometer which has to be operated manually. Its compact design makes it feasible for carrying it around wherever you go.
The adult-sized black cuff is made up of latex free nylon. This product features a 2 tube adult size PVC bladder, large air-release valve, and taper end valve. The dial reads up to 300 mmHg with a no-pin stop. A carrying case is provided for on-the-go readings.
As it has double tube bladder, if means you will get more reliable and accurate readings. A pupil gauge printed pen light is provided for health monitoring apart from blood pressure readings. Things We Liked:.
Comfortable nylon cuff. Easy to operate. Hypoallergenic Velcro strap.
Carrying case is provided. LLED pen light.
Quality construction. 2 tube adult size PVC bladder. Things We Didn’t Like:. No D ring for Velcro attachment. Less breathability.
What is a Sphygmomanometer? They are also known as manual blood pressure cuffs, blood pressure gauge or BP monitor/meter. It contains an inflatable cuff, a monitor/gauge and a rubber bulb. The inflatable cuff collapses and releases the artery in a controlled manner using the rubber bulb. The mechanical manometer or mercury will measure at the blood flow pressure.
Factors to Consider While Choosing a Manual Pressure Cuff Requirements have a great influence on which BP monitor you have to purchase. If you are new to buying a sphygmomanometer then you may easily get confused with several features. Below, we have provided key factors you have to consider while selecting a blood pressure gauge. Cuff Size or Fitting One of the major reasons for inaccurate results is wrong cuff size. This can be vulnerable as wrong reading can be over-medication or avoiding treatment.
That is why, it is very critical to know the right cuff size. Below are the steps you can consider for selecting the right cuff size. Using a tape, measure the diameter of arm (between the shoulder and elbow). If the circumference is in between 13 – 17 inches you have to choose large adult cuff. For 9 – 13, go with standard size and for 7 – 9 inches, choose small adult cuff. Reading Accuracy As already mentioned inaccurate results can be dangerous.
So, make sure to choose the one which determines the best in terms of accuracy. Don’t fall the tactics that state instant reading or comfortability. A stress-tested model has highest amount of accuracy level.
Quality Most of the manual blood pressure cuffs are made up of materials like nylon cuffs, metal gauges, rubber bulb pumps and tubing. However, quality and constriction of the BP monitor can greatly affected the accuracy. So, don’t settle for lower quality or second grade quality materials. Depending on the brand, you can analyze the quality of the product. Hypoallergenic Property If the material used for making cuff contains latex then it can cause allergies.
So, we recommend for going hypoallergenic or non-latex forms. Memory Storage For preventing risk factors, you may take blood pressure levels at different times. A memory reading can be helpful in terms of recording or charting. Most of the BP monitors available in the market have at least 100 memory readings. However, some of them can even store up to 500 readings. If you have to record measurement over a period of long time then choose the one with highest memory storage. Backlit Screen For those who have vision problems, it is difficult to read the measure on the BP monitor.
Backlit screen can be helpful for seeing the reading even while you are in outdoor or have low lighting. Portability If you are frequent traveler then some at-home manual blood pressure monitors may not be suitable for you. Check out for a model which is light in weight, compact and comes with a travel case. Due to simple design, portable blood pressure monitors are easy to use as well.
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How to Use a Blood Pressure Cuff? If you want to determine the accurate reading every time, then it is very important to use the device properly and carefully. Below are few guidelines.
Firstly, sit on an upright chair and make sure the feet rest flat on the chair. Sit quietly for 5 minutes before taking the blood pressure readings. Place your arm so that upper area of the hand is at heart level. The arm has to be bare or has a light fabric sleeve when you are taking the blood pressure. Wrap or place the cuff on the arm.
Make sure the marker and brachial artery lineup. You can either place the stethoscope under the cuff or at a point where you can feel the pulse. Using the bulb, inflate the cuff so that the gauge measures higher than typical blood pressure reading (30 – 40mm HG) to 170mm HG. Now slowly deflate the cuff and look for systolic reading (the number when you hear the first heartbeat. Again continue to deflate the cuff until the heartbeat is not heard. The reading now signals diastolic reading. Take another reading after 5 – 10 minutes on another arm.
Take an average of these readings. For more accurate readings, measure the BP at different times and under several circumstances. Words of Note before Leaving Maintaining a record of blood pressure readings is very important if you are suffering from low/high BP.
Instead of visiting a doctor multiple times in a day, investing in a BP monitor is a good choice. As you may not have experience and knowledge of which one to choose so we recommend reading our buying guide to make an informed choice.
Further, if you have any queries related to manual blood pressure monitors then write to us in the comment section below. Our experts will clarify them as soon as possible.
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