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Advice from the BP Measurement Experts

Medical Devices that Protect and Serve

EMS takes pulseAt SunTech, blood pressure measurement is our religion. In fact, we have a saying about it: "It's more than just a strength; it's who we are; it's what we do." With this singular focus, we get to see how blood pressure measurement is used across all different clinical applications. We see the nuanced experience that clinicians in different specialties and their patients encounter and that makes a difference in their use of automated BP. While it's rare that one of these nuances becomes the basis for policy, that's exactly what the state of New York is recommending in its advisory on patient care in moving ambulances.

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UC Berkeley Gets Blood Pressure Right

Nurse Reading on BeachSince it’s the summer, we’re doing more reading than writing. We came across this article from the University of California Berkeley School of Public Health and loved how it highlighted a lot of the topics we have written about in the past. From multiple tests to measuring blood pressure in both arms to the appropriate use of gold standard BP testing, it’s good to see agreement between healthcare providers and industry. Now it’s just a matter of putting this into everyday practice so it makes a meaningful impact on people’s lives. Enjoy the summer!

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3 Things to Consider When Measuring Your BP at a Kiosk

Valentine's Day Candy Box with StethoscopeThis Valentine's Day, when you are out making a mad dash to your local pharmacy for the perfect card, you may consider checking your blood pressure at the pharmacy's kiosk. We'd like to whisper sweet nothings in your ear about 3 things to consider while having your BP measurement taken at a kiosk.


While blood pressure checks have historically been standard at community health fairs and elder-care centers, the local branch of your bank is not necessarily where you expect a check up and reminder of tips on healthy living.  But with the trend in the US, the UK, and other countries of raising self-awareness for personal health, healthcare services and organizations are exploring new, proactive ways to bring simple services like education and monitoring to their communities. 

At a public shopping mall, Covenant Health has been running a multi-service kiosk, which uses automated BP monitors for self-measurement.  While this is not so different than the BP kiosks that have been in pharmacies, grocery stores, and other public places for many years, Wegmans, a grocery store chain in the east coast of the USA, understands that these health initiatives need to be supported by educational information and recommendations to see a clinician for credible, actionable diagnosis and treatment.  To aid in the education of this trend, the following are the top three factors to consider when you decide to have your blood pressure taken at a blood pressure kiosk:

  1. Remember that your blood pressure changes just like your heart rate.  Exert yourself by walking up the stairs or even just dealing with the stresses of the workplace, and your BP and heart rate may be higher than what you are used to seeing in a doctor’s office or at home.  Some level of this variability is normal.
  2. One measurement is just that… it’s one instance in time.  It’s one data point.  In fact, clinicians and experts in BP are increasingly placing more emphasis on the average of several measurements over a given period of time instead of focusing on just one measurement.  A single high measurement may be due to dealing with the stress of being in a public place like the mall or being sick.
  3. BP measurement is like any diagnostic test.  It’s not always 100% accurate. While there are standards that BP monitors, including kiosks, must meet in order to be sold on the market, automated BP devices are not fool-proof.  Some of the factors that affect BP measurements are covered in other blog posts:

Given these factors, it’s important to take the right perspective when you have your BP measured in a public place.  In fact, one group who studied the use of a public access kiosk found that over 70% of users had high blood pressure.  While this might be alarming, they came to the following balanced, sensible conclusions:

“These statistics clearly illustrate the heart-health challenges facing our city… However, they also show that the population of people using these downtown kiosks beat the national average in terms of blood pressure. The Wellness Stations are terrific tools in helping people gauge their own health.”

In the end, engaging people about their health in their daily lives is the goal, one for which kiosks may serve as a cost-effective solution.

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iPhone Mania: How and Why OEM Partnerships Work

iphone4In a recent article for MD+DI, we were asked to provide insight on OEM partnerships and what makes them work. In the article, we explain how the developers of the iPhone used OEM partnerships to produce a market-leading product and why those partnerships work; we also detail the numerous benefits and considerations for forming an alliance, such as:

  1. Reducing development time and cost.
  2. Minimizing investment in manufacturing.
  3. Reducing production and material costs.
  4. Helping gain market and product expertise.
    *To see the full article click here

As we have discussed in previous blogs, there’s a process in deciding whether to work with an OEM technology supplier and with whom to choose to partner once you determine that outside expertise is needed.  Combining academic insight with our 20 plus years experience providing OEM blood pressure technologies to the medical device industry, this article delves into how and why we think OEM partnerships work to help create market-changing products.

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My blood pressure monitor isn’t working! It’s reading too high!

patienttechniqueIt’s one of the occasional issues we hear about BP monitors and automated BP technology, ours included.  And while it’s one of the reasons that we blog about the 10 Steps to Accurate Manual Blood Pressure Measurement and the 10 Factors That Can Affect Blood Pressure Readings, sometimes it takes more guidance to diagnose if a monitor is mis-reading.  Comparing BP measurements manually taken by an observer to those from a monitor is a common way of examining the accuracy of a monitor.  Clinical standards1 that determine a monitor's accuracy provide detailed methods for making these comparisons.  Unfortunately, there are so many things done to control the environment and patient in these standards tests that it is not realistically possible to replicate in clinical practice.  However, here are a few of the more important issues that Richard Prowse, our OEM sales manager for Europe, Middle East, and Africa, shares with his customers when they are investigating a monitor that might be reading high.

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Choosing an OEM Partner: 3 Ingredients to a Successful Partnership

oem partnershipIn our last OEM technology blog post, we discussed things to consider when deciding whether to work with an OEM clinical technology vendor.  If thinking through these issues encourages you to investigate further, here are three key ingredients to identifying the right partner who will give you the best chance for your ideas and products to succeed in today’s dynamic healthcare marketplace.
As you might expect from a partnership, the first two ingredients depend largely on the partners!

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Top 5 Factors To Consider When Deciding Whether To Use an OEM Technology Supplier

problem solutionThe SunTech blog was established as a discussion place about blood pressure (BP) measurement because that's what we do. Naturally, we have tried to share our understanding of the clinical application experiences with using automated BP measurement in practicing medicine. However, we also partner with other manufacturers to integrate OEM NIBP technology in their medical devices. Some of these are patient monitors that you see in all parts of the hospital. But some of the more specialized devices are used to save lives in an ambulance or Lifeflight, on commercial airline flights, and even in the battlefield. Regardless of the application, these companies all considered whether they should buy, build, or partner in order to achieve their goals. Here are the top five factors companies should consider when deciding whether to use an OEM technology supplier:

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Regulatory Changes: Are you prepared?

Street sign at the corner of Healthcare End and Reform WayThe regulatory world is changing. Countries are examining and changing the rules and regulations that govern the way businesses interact and make an impact. In the US, with his editorial article in the Wall Street Journal and his State of the Union Address, President Obama makes a clear message about government regulatory systems. He wants balance between commerce & safety, progress & common sense. Obama calls for regulations to be reviewed so that the US “(protects its) safety, health and environment while promoting economic growth.” While the call to update regulations is clear, the balance that is called for lies in a well-known, well-trodden, broad, gray area. It’s this same area that all countries are trying to define, regulate, and enforce for the good of their citizens.

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The Psychology vs the Science of Blood Pressure

guessHave you ever been to a "Guess your age" booth at an amusement park?  If you are able to fool the person guessing the age of passers-by within a couple of years you win a stuffed animal or toy. Well believe it or not, clinicians occasionally do this to their patients.  Not for age, but for blood pressure.  Glenn Nyback, an EMT teacher, recounts a personal experience from one of his classes:

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Does Your New Physician Make Your Blood Pressure Rise

High Blood Pressure MeasurementA recent article in the Journal of Clinical Hypertension does a colorful yet effective job of describing the transient effects of White Coat Hypertension (WCH) when meeting  a new physician.  Studies show that patients who are not hypertensive but show high BP readings when visiting a new doctor for their first time can continue to present with these elevated BP readings for three to six visits.  Although treatment for hypertension based on these measurements is not recommended, the gold standard diagnostic test for WCH, a 24-hour study with an ambulatory blood pressure (ABP) monitor, can more effectively determine whether treatment is, in fact, needed.

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SunTech Partner's Remote Patient Monitor Featured in the Economist

RDT logoWe love to highlight our partners’ achievements.  While some of these have been highly technical BP measurement endeavours in the pursuit of expanding scientific understanding such as experiments on the International Space Station or Mount Everest, the Economist trumpets one which may help anyone who travels by plane. Congratulations to our colleagues at RDT!

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Masked Hypertension: What You Don't Know Could Kill You!

Masked hypertensionWhite-coat hypertension is a familiar term to most clinicians.  Patients with white-coat typically have elevated blood pressure measurements in the clinician’s office, but display normal BP measurements in their everyday environment.  The prevalence of white-coat hypertension varies from 15% to 20% of patients.  Conversely, there is another group of individuals whose hypertension often goes unnoticed by traditional methods of BP measurement.  These patients have normal in-office BP but elevated out-of-office BP.  This phenomenon is referred to as “masked hypertension” and is defined as having in-office BP < 140/90 mm Hg but daytime ambulatory or home BP ≥ 135/85 mmHg.

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Guidelines for Ambulatory Blood Pressure Monitoring in Children

Child patientHaving covered the recently rising awareness of childhood hypertension, we thought it appropriate to highlight the guidelines of using ambulatory blood pressure monitoring (ABPM) in children. The American Heart Association has published comprehensive recommendations on this topic...


 

...Which can be found here.  Additionally, separate commentary by Dr. Bruce Alpert, one of the contributing authors, can be found on the SunTech White Papers section.

In some ways, the guidelines for its use on children is not so different than for adults.  However, you should be aware of the following nuances:

  • Check the monitor’s qualification: While clinical validation to the US standard (AAMI) and to the British standard (BHS) are mandatory before a product is allowed on the market, an ABPM specifically needs to be validated for use on children and adolescents.  Make sure to inquire with the manufacturer or representative that the ABPM has been tested to and passed the validation with children as subjects.
  • Use equipment tuned for children: The ABPM should be lightweight, small, quiet, and well-protected when it is worn by the child.  More importantly, an appropriately-sized cuff must be used.
  • Use ABPM software that analyzes children’s BP readings according to the previously discussed thresholds based on age, gender, and height.

The AHA statement goes into significantly more detail.  However, the three guidelines above are the most important to successfully using ABPM on children in a medical practice.

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Instrument Calibration Adds Error Potential in Manual BP Measurement

Blood pressure instrumentsIn previous posts, we have reviewed the 10 Steps to Accurate Manual Blood Pressure Measurement and 10 Factors That Can Affect Blood Pressure Readings.  As important as these details are, accurate measurement also requires two things:

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Blood Pressure in your Medical Practice

SurveyThanks to the increasing concern regarding cardiovascular disease, blood pressure (BP) is one of the more well-known vital signs. Just about everyone has had their BP measured in a clinic. In the last few years, many track their own BP with the widespread availability and affordability of home monitors. Although experts in cardiology regard ambulatory blood pressure monitoring (ABPM) as the gold standard, it is not as frequently used in regular medical practice as in-office or home BP.
Each method has its benefits and disadvantages.

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Physician Acquired Blood Pressure Measurement is Higher than Nurse Acquired BP

Doctor takes patient's blood pressureThere are several different types of mild and/or episodic hypertension that ambulatory blood pressure monitoring (ABPM) can help a physician diagnose. However, the summary data that ABPM provides, the average daytime or 24-hour blood pressure as two examples, provides significantly different information than the one or two measurements taken in a clinic. Although this difference is one of the reasons that ABPM correlates better to cardiovascular outcomes than in-clinic BP, making it the gold standard for BP measurement, there are few detailed guidelines on the targets or thresholds for ABP like there are for in-clinic BPs like the popular 120/80 as a threshold for normal BP and 140/90 for hypertensive.*

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Damec Uses SunTech OEM NIBP Technology in Space

ABPM in the ISSSunTech Medical has had a long association with space research. Our first ambulatory blood pressure monitor, the Accutracker, and our stress BP monitor, Tango; have been used onboard the NASA space shuttle as far back as 1988. That association continued last year through an OEM partnership with advanced technology company, Damec.

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Blood Pressure Measurement and Dialysis

Dialysis Patient

Dialysis is a medical treatment that performs the job of well-functioning kidneys in ridding the body of waste and helping it to maintain a proper balance of water and minerals. In hemodialysis, this is done by pumping a patient's blood through a dialyzer where the blood is cleansed, and the clean blood is returned to the patient.1 For the over 350,000 US 2and 40,000 UK residents3 who have lost their kidneys and/or kidney function and partake in dialysis regularly, the procedure provides for and defines the normalcy of daily life.

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Blood Pressure Fluctuations: 'Warning Sign for Stroke'

BP fluctuationsLast week we addressed a report from the Institute of Medicine indicating that high blood pressure is not on the minds of the general public. However, in the most recent issue of the Lancet, a different view of hypertension was posted: what if your physician is looking at the wrong BP values? What if there is more to clinic blood pressure, or the measurement that your physician takes, than the average value?

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Blood Pressure Monitoring at 30 Thousand Feet?

RDT Tempus IC in flightBlood pressure is everywhere nowadays. While we are used to seeing it measured in the hospital, clinic, and even at home, what about on an airplane? RDT makes this possible with their product and service called Tempus ICTM, which is used by non-medically trained staff to save lives in remote locations such as in-flight or at sea.

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