Blood pressure measurement - automated vs manual method

@gravity3

All my experience has been with nurses, in a doctors office setting, who obtain a manual BP measurement versus those who obtain a BP with an automatic BP machine, again in a doctor’s office setting.

@handera Unfortunately, in most office settings, your blood pressure is probably not being taken by a nurse - usually these are medical assistants with a minimal amount of training. They may not have been trained to take a manual blood pressure - this is very common now.

Recently, my daughter had to retrain a nurse in her school health office how to use a manual cuff - the hospital where he had worked for years used automatic cuffs exclusively. She has instituted a policy of manual cuffs only because, in her words, "automatic cuffs are only as accurate as the last time they were dropped" - which was frequent when working with kids in medical crises.

In my cardiologist's office, I am invited to bring my home unit to my annual visit so they can compare the reading with a manual one taken by the nurse or physician's assistant.

This is all just a reminder that we must always be our own best advocate!

Doctor's offices are busy, and not the most pleasant places to be. Coughing, groaning, people coming and going, names being called...it's not your living room or den. Then, you get called in, you rise on your hind legs, grab your coat, and shuffle into the office. Then, you wait. Wait some more. Then the door opens and a strong breeze walks in. The room is suddenly loud, and your brain has to begin to think on its feet. Questions peppered at you. You're told to sit on the elevated 'shelf', paper rustling under you, and the physician takes your BP if that wasn't already done. How in God's name is my BP supposed to be anything but elevated?!?!?

It has been suggested that you calibrate your home device. This can be done at your doctor's office if they'll allow it. At least that way you know the two devices, if one isn't changed without your knowing it, should be working in concert. Neither may be quite right, or they both are, but whatever the case, they'll at least agree between them. Or, look for a neighbour who also has a home cuff and compare them. A cuff on each arm, each carefully placed and oriented according to each unit's instructions, with you calm and having not moved for a few minutes, and then activate both machines. Do this three times. Then compare. If it's more than about 4 mm of mercury difference, diastolic or systolic, then one of them is 'out'. Which one?

Doctor's know that your BP is likely to be significantly elevated when they to a measurement of yours. Often they'll ask you to keep a record of your own, measuring once or twice a day, for a month to see what the difference is. My wife's GP does that because she has had high BP.

@sueinmn

…another result of big pharma pushing medical equipment which is demonstrably erroneous, to the place where essential medical training suffers markedly.

Completely agree that the patient MUST question results and advocate for themselves….unfortunately many folks are not capable or simply don’t know that this has become essential with today’s medical establishment.

It is important to note in this conversation, that blood pressure changes throughout the day.

Long-time, seasoned Nurse and hold very little stock in the automated B/P cuffs and most of the time the people that take the pressure reading. So I take my B/P at home about a week before my appointment with a physician and show them the readings. I could go to town on my soap box about how B/P's are taken in physician's office...

@ronludington

For sure. I noticed they have to concentrate more with a manual monitor. With an automated monitor--they talk, blah, blah and pay very little attention to whether your bp goes up with talking, which mine does.