Reviewed and revised 11th July 2014
- non-invasive blood pressure measurement involves the applcation of a pressure cuff and can be performed manually (listening for Korotkoff sounds as the pressure is realeased
- 0 or automatically (by the oscillometric method)
- measurement of systemic arterial blood pressure
METHOD OF USE
Automatic oscillometric method
- apply an appropriately sized cuff to upper arm
- push start
- single cuff inflated above systolic and then incrementally deflated while the amplitudes of cuff pressure oscillations measured by pressure transducer
- cuff should be near level of heart
- cuff pressure at which the amplitudes start to increase to 25-50% of maximum = systolic
- the point of maximum oscillation = MAP (most reliable measurement)
- cuff pressure at which the amplitudes decrease by 80% or disappear = diastolic
Disadvantages of the oscillometric method
- inaccurate: the 95% confidence interval for blood pressure in the normal range is +/- 15mmHg!
- can’t be easily calibrated
- inaccurate hypovolaemic
- cuff small -> high BP
- can’t be used in helicopter
- Underestimates high blood pressures
- Overestimates low blood pressure
- the accuracy is even worse if dysrhythmia is present
- muscle tremors
- pain, limb oedema, nerve trauma
References and Links
- Axler O. Measuring mean or systolic arterial pressure in critically ill patients? Invasively or noninvasively? Does it matter? Crit Care Med. 2013 Jan;41(1):333-4. doi: 10.1097/CCM.0b013e318270dfa7. PubMed PMID: 23269136.
- Beevers G, Lip GY, O’Brien E. ABC of hypertension. Blood pressure measurement. Part I-sphygmomanometry: factors common to all techniques. BMJ. 2001 Apr 21;322(7292):981-5. Review. PubMed PMID: 11312235; PubMed Central PMCID: PMC1120141.
- Beevers G, Lip GY, O’Brien E. ABC of hypertension: Blood pressure measurement. Part II-conventional sphygmomanometry: technique of auscultatory blood pressure measurement. BMJ. 2001 Apr 28;322(7293):1043-7. Review. PubMed PMID: 11325773; PubMed Central PMCID: PMC1120188.
- Dieterle T. Blood pressure measurement–an overview. Swiss Med Wkly. 2012 Jan 27;142:w13517. doi: 10.4414/smw.2012.13517. Review. PubMed PMID: 22287317. [Free Full Text]
- Fred HL. Accurate blood pressure measurements and the other arm: the doctor is ultimately responsible. Tex Heart Inst J. 2013;40(3):217-9. PubMed PMID: 23914007; PubMed Central PMCID: PMC3709227.
- O’Brien E, Beevers G, Lip GY. ABC of hypertension. Blood pressure measurement. Part III-automated sphygmomanometry: ambulatory blood pressure measurement. BMJ. 2001 May 5;322(7294):1110-4. Review. PubMed PMID: 11337446; PubMed Central PMCID: PMC1120240.
- O’Brien E, Beevers G, Lip GY. ABC of hypertension: Blood pressure measurement. Part IV-automated sphygmomanometry: self blood pressure measurement. BMJ. 2001 May 12;322(7295):1167-70. Review. PubMed PMID: 11348915; PubMed Central PMCID: PMC1120288.
- Ogedegbe G, Pickering T. Principles and techniques of blood pressure measurement. Cardiol Clin. 2010 Nov;28(4):571-86. doi: 10.1016/j.ccl.2010.07.006. Review. PubMed PMID: 20937442; PubMed Central PMCID: PMC3639494.