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Advice from the BP Measurement Experts

Beat Down Blood Pressure Video Challenge

BP Beat Down Video Challenge With May being High Blood Pressure Awareness month, The Office of the National Coordinator for Health Information Technology (ONC) in partnership with Million Hearts (an HHS initiative) are holding a video challenge where folks share how they are using technology to help achieve and manage blood pressure control.

Contestants are asked to create short (<2 minutes long), compelling videos that illustrate how they are using health IT or other e-health tools to measure their BP, take their BP medications as prescribed and to maintain a healthy lifestyle that helps keep their blood pressure in control.

For more information, to submit your own video entry or to vote for your favorite, please visit:

http://bloodpressure.challenge.gov/

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Study Shows Off-Roading Can Improve Blood Pressure

ATV could help lower bpLooking for a good excuse for some outdoor adventure? A clinical study published in the European Journal of Applied Physiology found that regularly riding motorized off-road vehicles, like ATV's and dirt bikes, can improve health-related fitness, improve quality of life, and even reduce blood pressure. It goes without saying that for speed-crazed gearheads, tearing around the countryside like a banshee is fun. But who knew that it could also be so...well...healthy? As for me, I think a new ATV is just what the doctor ordered. Happy trails, everyone!

 

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You’re Doing It Wrong: New Study on BP Measurement

Taking Innacurate BP A new study1 published in the Journal of Clinical Hypertension has reached the conclusion that when it comes to proper blood pressure (BP) measurement technique, most clinicians just aren’t very good at it. According to the authors, Minor et al, the purpose of the study was to “assess BP measurement accuracy and the level of adherence to recommended techniques throughout a large academic health science center.” As it turns out, the results were poor on both fronts and their statistical analysis indicates that technique does indeed impact accuracy.

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BP Differences Between Arms Could be an Early Indicator of Serious Health Risks Ahead

Circulatory SystemSunTech has blogged on the importance of BP measurement in both arms before (see: Has My Physician Measured My BP in Both Arms?) and research articles continue to be published on this issue. But now, two new studies have been published showing that the benefits of BP measurement in both right and left arms could be a life saving step in routine care.

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Top 7 Reasons You Should Be Using Automated Blood Pressure for Cardiac Stress Testing

Cardiac Stress Blood PressureAs any cardiologist will tell you, a cardiac stress test is a fundamental step to diagnosing a multitude of heart conditions and is a necessary tool for any cardiac care facility.  The average cardiac stress test lab contains ECG stress systems, Echocardiogram machines, treadmills, ergometers and …. manual blood pressure gauges?  With all of this automated equipment that allows us to remove variability and minimize inherent patient risk, why are we still trying to take blood pressures manually during a stress test?!

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5 Myths About Vital Signs Automation and EHR's

Electronic Medical RecordsAnyone who has been a patient in a doctor’s office knows what it’s like to get their blood pressure (“hold still while I inflate this cuff”), body temperature (“put this under your tongue”), and weight (“don’t worry, I’m sure your clothes add a few pounds”) measured. Historically, the nurse would write all of the measurements down on a paper chart for the doctor to review, and the chart would later go into the patient’s permanent file. But really, paper and pen are so 20th Century. Aren’t they?

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10 Things To Look For When Purchasing Disposable Cuffs

suntech disposable cuffsWith the passing of the new healthcare law in 2010, more emphasis has been placed on reducing Healthcare Acquired Infections (HAIs) throughout acute-care hospitals. Not only does this new healthcare law have financial penalties for hospitals with the highest rates of HAIs, this law also requires mandatory public reporting of HAI rates for all hospitals in the United States.

Hospitals are currently implementing more stringent Infection Control Policies to reduce the spread of HAIs. Our current e-book details the 7 reasons why disposable cuffs should be a part of an effective infection control program. So even though you know your healthcare facility needs to use to disposable cuffs, what should you look for when selecting and purchasing these cuffs?


  1. Patient Identification Line: Disposable blood pressure cuffs have shown to be an effective approach to reducing the transmission of HAIs, when dedicated for single patient use. When a patient’s identification information can be written on the cuff, it verifies that no one else can use that cuff, minimizes the risk of cross contamination, and reduces the risk of acquiring a HAI in the hospital.
  2. Cuff Standardization Program: Does the disposable cuff manufacturer or distributor offer a program to standardize your facility on one connector? Since the purpose of a disposable cuff is to be used on one patient, it is important to make sure that this cuff can be used on any monitor, anywhere in the hospital. There are a variety of connectors used on blood pressure monitors, so standardizing your hospital on one connector not only improves workflow, it reduces inventory and SKU # which lowers cost.
  3. Patient Comfort: Disposable cuffs must be made out of soft materials and rounded edges. If the cuff is uncomfortable, patients will probably let you know and resultant patient movement during a reading may lead to multiple re-inflates or error codes.
  4. Range of Cuff Sizes: It is extremely important to make sure that a disposable cuff manufacturer makes a full range of cuff sizes. There is a big difference in upper arm circumference between a child, a middle-aged man, and an elderly woman, so your hospital should have the proper size cuffs to use on each patient.
  5. Color-Coding: Most cuff manufacturers color-code their cuffs to help medical professional quickly chose the right size cuff for a patient. Most manufacturers follow the same color coding schemes for each size cuff, which is shown in the table below:
    Cuff Size Color
    Infant Orange
    Child/ Child Long Green
    Small Adult / Small Adult Long Light Blue
    Adult / Adult Long Navy Blue
    Large Adult / Large Adult Long Burgundy
    Thigh Brown
  6. Range Markings: A cuff must have range markers on the inside or outside (preferably both), of the cuff to indicate if the correct size is being used on a patient. Using a cuff that is too small on a patient will affect the accuracy of the measurement and the measurement will be too high. On the other hand, using a cuff that is too large on a patient will result in a measurement that is too low.
  7. Durability: It is important that a disposable cuff is made with a durable material that will be able to withstand multiple inflations, multiple times per day since this cuff will stay with a single patient during the entire duration of their hospital stay.
  8. Latex Free: To minimize risk of adverse reactions to latex and to promote patient safety, disposable cuffs should be free of latex.
  9. Reliable Performance: The last thing you want to happen when you purchase a blood pressure cuff is to have it leak. Therefore, look for a cuff manufacturer that leak tests their cuffs on a regular basis.
  10. Regulatory Requirements: All blood pressure cuffs should be designed and validated to the AHA (American Heart Association) and the AAMI (Association for the Advancement of Medical Instrumentation) standards. These standards provide recommendations for cuff sizing, life cycle of the cuff, maximum inflation, etc.

Whether you are a distributor, physician, nurse, or in materials management and responsible for purchasing blood pressure cuffs, it is good to know the features and benefits of disposable cuffs so you can make an informed decision on which brand of cuff you would like to purchase and use at your facility. If you have any additional features you would like to add to the list, please leave us a comment below.

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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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Determining BP Device Accuracy: Who Has It Right?

Bullseye Dart on a Manual StethoscopeAll caregivers need to trust the accuracy of automated blood pressure (BP) devices they use to make clinical decisions. But when considering one specific BP device versus another, how does one establish that trust? Well, an automated BP device that’s used to guide patient treatment is legally considered a medical device, and therefore must adhere to the regulatory guidelines for the markets in which it is sold.

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Deflating Expectations

deflateWe’ve written quite a bit here on the SunTech blog about BP technique. And guess what? We’re going to talk about it again! Maybe it’s not the most fascinating topic in the world of non-invasive blood pressure, but I think there are few as important to the successful treatment of high blood pressure. I must not be the only one, because studies that look at blood pressure technique continue to be published at a pretty good clip.

One of the more recent ones is aptly titled, “Blood Pressure Monitoring Technique Impacts Hypertension Treatment”. Authored by Ray et al and published in the Journal of General Internal Medicine, this study compared the way that BP’s are normally taken during triage check-in on a population of 40 patients at the New Mexico Hospital Adult Internal Medicine Clinic. A study investigator observed the technique used by the clinician, and then took the patient’s BP using the AHA recommendations for blood pressure measurement published in 2005.

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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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Speculation over implementation of NICE Guidelines on ABPM begins

nice-guidelines-abpmThree months ago, the National Institute for Health and Clinical Excellence (NICE) in the UK released new guidelines for managing hypertension in adults. The new recommendations call for the use of Ambulatory Blood Pressure Monitoring (ABPM) to confirm a diagnosis of hypertension when a patient has a clinic BP reading of 140/90 mmHg or above. One of the major questions raised was how this would be implemented.

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New Healthcare Law Means Big Penalties for Hospitals with High HAI Rates

Hospital feesHealthcare Associated Infections (HAIs) are one of the hottest topics in healthcare right now. Over 2,000,000 patients in the United States acquire HAIs, which adds an average of 8 days to the hospital stay and causes approximately 99,000 deaths per year.6 The total annual cost to treat these HAIs in the United States is between $35.7 billion and $45 billion with the average in hospital cost per patient between $20,549 and $25,903.

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Has My Physician Measured My BP in Both Arms?

Doctor taking a BP measurementThat’s the question I pondered while reading an article published earlier this year in the American Journal of Hypertension. In the article “Blood Pressure Measurement Method and Inter-Arm Difference: A Meta-Analysis,"* the authors reviewed studies where BP was measured in both the left and right arm of subjects. The results showed that on average, Systolic pressures differ by 5.4 mmHg between arms while Diastolic pressures showed an average inter-arm difference of 3.6 mmHg.

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Medical Billing Codes Gone Wild!

Orcas spit water at viewersHere on the SunTech blog, we normally aim to provide valuable clinical information and helpful tips related to all things blood pressure. But allow me to wax philosophical for a moment, because…well, you’ll see why.

Right. So, for many of us who work in health-care or a health-care related field, there is significant meaning to be found in doing a job that can positively affect people’s well-being. It’s great to wake up every day knowing that you will indirectly or directly help to cure illnesses, heal wounds, save lives, and treat burns due to water skis on fire…wait, huh?

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Hypertension Diagnosis: Be confident and save money with an ABPM Study

Be confident with an ABPM studyHypertension is a prevalent condition globally and is quickly becoming a focus in the U.K., with particular emphasis on how to best diagnose the condition. In August, a study comparing blood pressure (BP) measurement methods, which was funded by the U.K.’s National Institute for Health and Clinical Excellence (NICE), was published on the same day that NICE announced the release of its new guidelines for hypertension management in adults.

In the study, Cost-effectiveness of options for the diagnosis of high blood pressure in primary care: a modelling study, the research found that “ambulatory monitoring is cost effective compared with further monitoring in the clinic or home for confirming the diagnosis of hypertension” for all age and gender groups considered. Specifically, ABPM provided cost savings ranging from £56 in men aged 75 years to £323 in women aged 40 years (Equivalent to $89 and $511 respectively). Additionally, it was determined that ambulatory blood pressure monitoring (ABPM) “resulted in improved health outcomes for male and female age groups older than 50.”

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Healthcare-Associated Infection (HAI) Rates Influencing Patients’ Hospital Selection

Empty patient waiting roomBeing a part of the healthcare industry, we know that reducing healthcare-associated infections (HAIs), such as MRSA (Methicillinresistant Staphylococcus aureus) and C.Diff (Clostridium Difficile), continues to be a top priority for hospitals everywhere.  What is surprising though is that based on a survey conducted in July 2011, prospective patients are becoming increasingly aware of a hospital’s ability to protect their patients from HAIs and are using this information as a major factor in determining where they seek care.

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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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Should Ambulatory Blood Pressure Monitoring Be Required?

Dr. Henry Black discusses ABPMDr. Henry Black, former President of the American Society of Hypertension, presents this very question in his recent video on Medscape News. While Medscape requires a free login account to view their content, we felt this report rather significant and worthy of sharing.

In the video article, Dr. Black points out that the practices of how we measure blood pressure are changing as technology advances and becomes more available. He also explains that while home monitoring is becoming more commonplace, studies of ambulatory blood pressure monitoring (ABPM) are telling us more about its unique prognostic benefits. 

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Information Overload: Relevant BP Measurement Data

Overwhelmed DoctorI don’t know about you, but I am bombarded daily with more information than I can possibly process or make use of. Yet each day dawns requiring that I sift through it all, applying only what is relevant or helpful to me and my family, and at times the whole process can be exhausting. The miracle of the information age is also its curse. ‘Connected’ devices are proliferating at an astonishing pace, inexorably finding their way into our living rooms, dens, kitchens, bedrooms, vehicles, and belt clips. Not that this is necessarily a bad thing, but how many Twitter messages can a sane person realistically absorb in a given day? And more importantly, which ones are really useful?

This same phenomenon is happening today in health care...

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