Factors of error in blood pressure readings

Wright, Irving S.; Schneider, R.; Ungerleider, Harry E.

doi:10.1016/s0002-8703(38)90783-5

Cited by 18 publications

(7 citation statements)

References 3 publications

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“…International literature spanning 60 years confirms deficiencies in teaching and performance of blood pressure measurement by nurses and doctors and of health workers who measure blood pressure for the purpose of data collection in international studies 4–15 …”

Section: Introductionmentioning

confidence: 98%

“…Wright et al in 1938 studied interns, postgraduate medical students and attending physicians in a New York postgraduate hospital and found ‘marked discrepancies in the making and interpreting of blood pressure observations’ 4 . In his address to the American Heart Association, Wright stated that it was clearly a problem for the teaching institutions.…”

Section: Introductionmentioning

confidence: 99%

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Nurses’ knowledge of error in blood pressure measurement technique

Armstrong

2002

Int J of Nursing Practice

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Errors in measuring blood pressure may have significant impact on the investigation and treatment of patients. Errors arise from faults in measurement technique or the equipment used. In Australia, blood pressure measurement technique is taught to nurses during their undergraduate education and may not be reviewed again. This observational, descriptive study surveyed clinical nurses at a metropolitan teaching hospital at shift hand-over time. Participation was voluntary and anonymous by 78 nurses who answered a questionnaire to determine the need and focus for updating blood pressure measurement technique. Sixty-one per cent of participants conformed to currently accepted practice in identifying systolic blood pressure, and 71% diastolic blood pressure; 54% correctly interpreted a description of blood pressure sounds containing an auscultatory gap. Correct answers for assessment of faulty equipment were given by 58%, assessing cuff size by 57%, arm position for seated measurement by 14%, determination of inflation pressure by 29% and deflation rate 62%. Incidence of terminal digit preference was 32%. These findings indicate that knowledge of participants was inadequate to perform blood pressure measurement in a standardized manner, and prevent introduced error.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Nurses’ knowledge of error in blood pressure measurement technique

Armstrong

2002

Int J of Nursing Practice

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“…In daily practice, BP measurements are usually performed by practical nurses without prior specific training for this assignment. Evidence demonstrating that medical personnel, including physicians, have not been adequately trained for accurate BP measurement exists [4]. Even after specific training, only a few of the medical students retained this knowledge and practised as they were taught [5].…”

Section: Introductionmentioning

confidence: 99%

Blood pressure determination by traditionally trained personnel is less reliable and tends to underestimate the severity of moderate to severe hypertension

Roubsanthisuk

Wongsurin

Saravich

et al. 2007

Blood Pressure Monitoring

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A total of 907 participants were enrolled. More than 99% of both systolic and diastolic TT nurse BP ended with zero, demonstrating that they had terminal digit preference. ST nurse BP was in better agreement with digital blood pressure measurement than with TT nurse BP. The number of differences of < or =5 mmHg between ST nurse BP and digital blood pressure measurement was approximately 60% for both systolic and diastolic blood pressure. Overall, traditionally trained nurses overestimated, rather than underestimated, blood pressure. However, systolic blood pressure underestimation was extremely prominent in participants with moderate to severe hypertension. Systolic blood pressure underestimation of >5 mmHg was as high as 57.5% by traditionally trained nurses versus 33.8% by the automatic device, indicating that traditionally trained nurses tended to underestimate blood pressure in participants with more severe hypertension.

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“…(1967) Both implications present Ettinger (1907) Gittings (1910) MacWilliam & Melvin (1914) Norris et al (1928) Pickering (1955) Imply 'transition ' Wright et al, (1938) Smirk (1957) Karvonen et al (1964) (1953) Expert Committee (1962) • Papers which report comparison with intra-arterial pressures Discussion Nomenclature of variation in the arterial sounds became important in the debate . (whose beginnings lay with Korotkov and Krylov themselves) over relationships to diastolic intraarterial pressure.…”

mentioning

confidence: 99%

“…It is unfortunate that Swan's suggestion was not generally adopted. The word 'point' was used by Sewall (1919), Wright et al (1938) and in an American Heart Association report (Kirkendall et al 1967). The terms 'point' and 'level' are both to be found in recommendations by the Committees of the American Heart Association and of the Cardiac Society of Great Britain and Ireland (1939): but 'level' in referring to systolic and diastolic blood pressure, and 'point' in referring to the diastolic.…”

mentioning

confidence: 99%

Arterial Sounds by Phases: An Object Lesson in Terminological Confusion?

Carlisle

1981

J R Soc Med

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Korotkov's name is justly attached to the arterial sounds but it was Krylov who described their variations as phases. Ettinger added a fourth phase and denoted the lower region in which sounds are absent, as well as the boundary between, as a fifth. Thus strictly ‘Korotkov phase 4’ and ‘Korotkov phase 5’ are incorrectly attributed. Further, the variable meaning of ‘phase’ has been perpetuated so that numbering it gives a false impression of precision. Aside from the, unambiguous, systolic pressure, we could better refer to ‘pressures at muffling or at disappearance of sounds’ and indicate which of them is measured - by the use of two strokes in recording readings, e.g. as 180/120/ mmHg or 180//110 mmHg respectively. Better still would be to measure routinely all 3 relevant acoustic divisions of the occluding pressure; and record in the form 180/120/110 mmHg for the example given.

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Factors of error in blood pressure readings

Cited by 18 publications

References 3 publications

Nurses’ knowledge of error in blood pressure measurement technique

Nurses’ knowledge of error in blood pressure measurement technique

Blood pressure determination by traditionally trained personnel is less reliable and tends to underestimate the severity of moderate to severe hypertension

Arterial Sounds by Phases: An Object Lesson in Terminological Confusion?

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