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Advice from the BP Measurement Experts

Check out the latest Blood Pressure + Vitals Measurement related blogs.

A Surprising Number of Clinicians Fail to Accurately Measure Blood Pressure

 

clinician frustrated about blood pressure results

A surprising number of clinicians fail to accurately measure  blood pressure according to a recent joint survey of more than 2,000 healthcare professionals conducted by the AMA and the American Heart Association. One of the most striking highlights were only 1 in 10 medical assistants were able to answer all 6 of the best-practice in blood pressure (BP) measurement questions.

 


According to American Medical Association (AMA) president Dr. Patrice, Harris, “Hypertension is a leading risk factor for heart attacks, strokes and preventable death in the U.S. Inaccurate blood pressure readings can lead to diagnosis errors, which means getting an accurate reading is vital to treating the condition.”

A recent study published in the journal Hypertension found an increase in high blood pressure (hypertension) cases during pregnancy. By reviewing CDC data on >151 million women between 1970 and 2010, the researchers found a 6% yearly increase in hypertension. The implications being complications for the mother, such as preeclampsia, or an increased risk of preterm birth.

Although the need for accurate BP measurement is clear, the joint survey showed the gap in BP knowledge that many healthcare professionals have. The most frequently missed best-practice question was about proper cuff-wrap-inflation, followed by proper brachial artery cuff position. Both factors are critical to getting an accurate BP reading. Even though the healthcare professionals surveyed were aware of the opportunities for error in BP measurement, BP refresher training is reported to be infrequently held.

The same AMA-AHA survey suggested that healthcare professionals believe up to 41% of BP measurements taken across all medical practices are less than 100% accurate. Although the overall error rate was acknowledged, most respondents felt that their practice was better than the norm.

To ensure an accurate reading, consider these 10 factors that can affect blood pressure readings and advice from our Clinical Manager:

  • If you have a wound, do not apply a BP cuff over, as this can cause further injury.
  • If you have had a single mastectomy, do not apply a BP cuff to the arm on that side. In the case of double mastectomy, use the side of the least dominate arm.
  • Too frequent BP measurements can cause injury due to blood flow interference.

Additional Resources:

To learn more about the basics of BP, see this TedEd on How blood pressure works by Wilfred Manzano.

Want to try your hand at taking a BP reading? Check out this BP simulation.

Sources:

https://www.ama-assn.org/press-center/press-releases/new-research-shows-need-re-training-blood-pressure-measurement

https://www.modernhealthcare.com/safety-quality/ama-aha-look-retrain-physicians-measure-blood-pressure

https://www.washingtonpost.com/health/a-growing-problem-pregnancy-vs-high-blood-pressure/2019/11/08/0ff37238-fb52-11e9-ac8c-8eced29ca6ef_story.html

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New Guidelines for Measuring Blood Pressure from the American Heart Association

 

American Heart Association Logo

The American Heart Association just released a scientific statement on blood pressure (BP) measurement that outlines new guidelines for accurately measuring blood pressure. This is the first time the AHA has made significant updates to their recommendations since 2005. In the statement they describe and compare different methods of measuring BP and make many recommendations. What are the key points that a physician should learn from this new paper?

 

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Tips for Better User Interface and User Experience Design for Medical Devices

 

Sketches and Concepts for a UI Design For a Medical Device

Designing a better User Interface (UI) and User Experience (UX) for medical devices presents unique challenges not typically present in other products or applications. If you press the wrong button when ordering your mocha latte, you may not get whipped cream. If you press the wrong button when administering medicine through an infusion pump, your patient may overdose. One study showed that infusion pumps account for up to 35% of medicinal errors that result in significant harm.[1] A large percentage of those errors were attributed to poorly designed user interface. For instance: a clinician might have entered “lbs” instead of “kg” for the weight of the patient, or perhaps they did not see a decimal point on the display, or they selected the incorrect dose mode while administering medicine. That is one of the many reasons medical devices must pass through numerous regulatory tests to make sure user errors are minimized.

 

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Should You Medicate to get 120/80 Blood Pressure?

 

blood pressure medication

Should you take medication in order to acheive a Blood Pressure of 120/80? The SPRINT trial (Systolic Blood Pressure Intervention Trial) originally published in 2015 is the NIH’s landmark blood pressure (BP) lowering trial. According to the NIH press release (bold emphasis mine),

"When SPRINT was designed, the well-established clinical guidelines recommended a systolic blood pressure of less than 140 mm Hg for healthy adults and 130 mm Hg for adults with kidney disease or diabetes. Investigators designed SPRINT to determine the potential benefits of achieving systolic blood pressure of less than 120 mm Hg for hypertensive adults 50 years and older who are at risk for developing heart disease or kidney disease." (1)

 

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Controlling Blood Pressure Could Reduce Cognitive Risk

 

controlling blood pressure could reduce cognitive risk

On top of reducing the risk of cardiovascular disease, aggressive treatment of high blood pressure has shown effectiveness in mitigating risk of mild cognitive impairment. Mild cognitive impairment is viewed as a potential precursor to Alzheimer’s and dementia. A study showed that when treating patients to reduce systolic blood pressure below 120, as opposed to below 140, the past standard target, the risk of mild cognitive impairment was reduced by 19% comparatively.

 

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