Automatic blood pressure cuffs...

[JJR512]

I'm looking for a recommendation for an automatic blood pressure cuff with a certain set of features. I'm talking about the devices that just take a blood pressure (most also display a pulse but that's not important), some of which can be found in a Wal-Mart or local pharmacy for $50-70. But these units come with a cuff, and usually you can get a larger cuff, but I think the cuffs made for them are the only ones that will work, because they don't use regular connectors.

So I'm wondering if anyone knows of a device that inflates a cuff, deflates it, and displays a blood pressure, uses a standard type of cuff connector so that multiple sizes of cuffs can be used or disposable cuffs can be used for isolation patients, and, if possible, can be set to automatically take the BP at defined time intervals. I can live without automatic operation at timed intervals feature, and I can probably live without the automatic inflation feature (these use a standard bulb and are inflated manually, but deflated automatically during the measurement phase). Also, the device has to be durable enough for ambulance use, and, of course, it has to work on batteries.

A full-blown vitals monitor (even without cardiac monitoring) is too expensive for me (these devices usually start at about $2500), and I already have a decent pulse oximeter, anyway.

I want an automatic BP cuff device to use at my pay job with a commercial ambulance company, where most patients are routine taxi rides. We are required (by company policy) to take two sets of vitals, even if the trip is just one minute across the street (which actually happens a lot). Sometimes I can get vitals at the originating or destination facility, but there isn't always an actual medical facility at either end of the trip, or it's not always possible, so I'm just looking for a way to make my work easier.

 

[Jon]

I've seen co-workers at transport Co's use the inexpensive ones from Wal-Mart... I've never been impressed with them, though. I know that ADC has a digital B/P display that is supposed to "assist" in getting a B/P.

My favorite thing is to work with a medic... then I get to use the LP12 for vitals

 

[Grady_emt]

I say use the full LifePack12 and put them on the 12lead, SpO2, ETCO, and NIBP, then you get a full set of vitals, and you could have one of those little Stat blood-gas meters to!!! And then you could put in an arterial line and get a "live" bp once you had them all hooked up.

Whats wrong with actually taking a manual BP, and actually checking their pulse?

 

[KEVD18]

sure, get an auto bp cuff from walmart and proceed to take and record inaccurate bp's until the end of time all the while losing the skill of actually taking a manual bp.

 

[medicdan]

I am not going to argue about skills, but I have seen what you are looking for...

http://www.nonin.com/products.asp?ID=9&sec=5&sub=3
http://www.casmed.com/740.html

 

[MMiz]

I worked for a private ambulance service that required two BPs per transport. Critical patients got one every five minutes, and normal transports got one every fifteen.

Is it really that hard to grab a BP? I'd grab one BP before we left, using the NH's or hospital's machine, and then one in the rig. If it was a long transport, then I'd leave the BP cuff on the pt until we got to the location. I think your money could be better spent on many other devices, but automated BP cuffs are inaccurate and expensive.

 

[JJR512]

Whats wrong with actually taking a manual BP, and actually checking their pulse?

There's nothing wrong with doing either; I never said there was. Actually I never even said anything about checking the pulse at all. No machine that I know of can tell me if a pulse is regular, irregular, strong, weak, etc. But while manually checking the pulse can tell me the quality of the pulse, manually checking the BP doesn't tell me anything other than the numbers, which can be gotten easier and faster with a machine. Provided the machine is accurate...

sure, get an auto bp cuff from walmart and proceed to take and record inaccurate bp's until the end of time all the while losing the skill of actually taking a manual bp.

Well, I think I made it pretty clear that I didn't want a cheap unit from Wal-Mart, but in case I didn't: I don't want a cheap unit from Wal-Mart. Or a cheap unit from anywhere. Talking about cheap as in low quality. I do need something relatively inexpensive; I'd love to get either of the units emt-student found, but I don't have $2500 to spend.

I don't think that taking an automatic BP on many of my patients will erode my skill at taking a manual BP. Furthermore, as I'm not looking for a cheap low-quality unit, I doubt the accuracy will be too far off, and, more to the point, the accuracy of the unit is of very little importance. The vital signs I take are not seen by any medical staff handling the patient; the staff at the receiving facility, if they care what the vitals are at all in the first place, will use the vitals on the patient's discharge summary from the hospital. Most of my patients are discharges from hospitals to nursing homes. On the other hand, if I'm taking a patient to a hospital, or for any reason I suspect the patient is not medically stable, I would do a full set of vitals manually. But for the vast majority of my taxi rides...Saving some time with the BP gives me more time to do the BS paperwork. Callous? Maybe. But I transported 30 patients over the last three days of 12-hour shifts. Even if only a quarter of them get manual vital signs taken, I'm probably still taking more manual vitals signs in a week than the average volunteer EMT-B takes in a week, so I doubt my skills are eroding.

 

[KEVD18]

i know your not setting out to get a cheap pos, but for what you want to spend, thats what your going to get. nobody makes an accurate, durable auto bp cuff for short money. the cheap ones do not stand up well to being bounced aroun the ambulance and quickly lose their calibration(if they were accuratley calibrated to begin with)

what you want is an automatic vitalsigns monitor that you hook your pt up to, set the parameters as to when to take signs and what not. thats 2g's or better.

your fighting a losing battle. you cant get what you want for waht your willing to spend.

 

[Flight-LP]

There's nothing wrong with doing either; I never said there was. Actually I never even said anything about checking the pulse at all. No machine that I know of can tell me if a pulse is regular, irregular, strong, weak, etc. But while manually checking the pulse can tell me the quality of the pulse, manually checking the BP doesn't tell me anything other than the numbers, which can be gotten easier and faster with a machine. Provided the machine is accurate...


Well, I think I made it pretty clear that I didn't want a cheap unit from Wal-Mart, but in case I didn't: I don't want a cheap unit from Wal-Mart. Or a cheap unit from anywhere. Talking about cheap as in low quality. I do need something relatively inexpensive; I'd love to get either of the units emt-student found, but I don't have $2500 to spend.

I don't think that taking an automatic BP on many of my patients will erode my skill at taking a manual BP. Furthermore, as I'm not looking for a cheap low-quality unit, I doubt the accuracy will be too far off, and, more to the point, the accuracy of the unit is of very little importance. The vital signs I take are not seen by any medical staff handling the patient; the staff at the receiving facility, if they care what the vitals are at all in the first place, will use the vitals on the patient's discharge summary from the hospital. Most of my patients are discharges from hospitals to nursing homes. On the other hand, if I'm taking a patient to a hospital, or for any reason I suspect the patient is not medically stable, I would do a full set of vitals manually. But for the vast majority of my taxi rides...Saving some time with the BP gives me more time to do the BS paperwork. Callous? Maybe. But I transported 30 patients over the last three days of 12-hour shifts. Even if only a quarter of them get manual vital signs taken, I'm probably still taking more manual vitals signs in a week than the average volunteer EMT-B takes in a week, so I doubt my skills are eroding.

Wow, someone is not loving their job today!

Look, you can't have your cake and eat it too. If your not willing to be proficient in your skills and rely on some machine to tell you what you want to know, then you WILL have to pay for accuracy. If not, you get the Walmart POS. Live with it or do your job. If your employer wanted automatic BP's, then they probably would have provided you with the appropriate machine. I think your just being lazy. It takes less than a minute to get vitals, you save ZERO time by using a machine and it WILL water down your skill and ability to PROPERLY assess vitals. Using paperwork as an excuse is just pathetic. Your a Basic, you work for a private company, you do horizontal taxi rides; therefore you will have a high rate calls. If its too much for you, you can always make more working in another industry...........

Take a moment and read the "Progression of EMS thread". You may witness some correlation.................

 

[JJR512]

Flight LP, I think there is a slight miscommunication or misunderstanding somewhere. "If your not willing to be proficient in your skills and rely on some machine to tell you what you want to know" -- I don't think the two (manual skill vs. automated) are mutually exclusive as is implied here. Taking a BP manually is so easy; it's like turning on a TV with the button on the set vs. the button on the remote. If you use the remote all the time, do you forget how to turn it on from the button on the set? I don't think so. Using the remote is a couple seconds faster. Using an automatic BP cuff is a couple seconds (maybe 10 to 15?) faster, despite continued insistence to the contrary ("you save ZERO time by using a machine")--Putting the cuff on the patient and taking it off takes the same amount of time either way, and the actual reading of an automatic unit may actually be somewhat slower than what you or I could do manually, but my point is that while the automatic unit is doing it's thing, I'm free to do something else, like count respirations or get a history or meds list from the patient. That's a time savings, and it's real.

"If your employer wanted automatic BP's, then they probably would have provided you with the appropriate machine."-- Oh please. They want us to wear blue pants and black shoes or boots, but they don't supply those. They want us to to turn in nice and neat paperwork, but they don't supply clipboards. They want us to come to work clean and shaved, but they don't give us soap or razors. They want us to maintain our skills and education, but they don't pay for that.

"...therefore you will have a high rate calls. If its too much for you..." I wasn't complaining about my high call rate. I get extra money for every call I do beyond a certain quota. Rather, I was using my call volume to illustrate my point that despite wanting to take automatic vitals for a certain percent of my patients, I still see so many patients, and would get manual vitals on a certain percent of them that probably comes out to more patients than the average volunteer sees in the same time period. The overall point there is that I'm taking manual vitals at least as often, possibly more often, than the average volunteer EMT, thus begging the question: How will my skills erode when they're being practiced so often?

KEVD18, I'm beginning to suspect you are right that there is nothing better than a $50 simple automatic BP unit without stepping up to a full $2500 vital signs monitor.

 

[emtrubal]

Auto Bp

Well leave it to EMS perfessionals to insult a person's skill level when they just want to make life a little easier on themselves. In fact the second Korotkoff phase is commonly inaudible (meaing your systolic an be up to 40mmHg off) and maunal B/P's are very supseble to error. This is especially true in prehospital care when your trying to listen to a B/P in a ambulance that hasn't had a tune up in 20 years with sirens going.

In fact the reason that clincs (which are a nice stable, quiet environment) use auto B/P cuffs is to eleminate the error of missing the first to Korotkoff phases. And have a more standardized care because no two people take BPs the same( leading to differences of about 15mmHg).

So to answer your question, without questioning your skill level, I have yet to see a reliable, cost effective Automated BP cuff. If you find one let me know.

 

[Explorer127]

automatic bp cuffs

do any of u use them? what do you think of them and how accurate are they, also...just out of curiosity does any1 know how they work?

 

[mikie]

We personally don't use them but I would always trust my ears over a machine like that, especially in the back of a moving ambulance.

Treat the pt not the monitor

 

[KEVD18]

hey. i notice your a fairly new member, so just to be sure your aware of it, i though i'd pass this along.

theres a search feature activated by the search button on the toolbar at the top of the page(fourth from the right). some of the more common topics have been brought up, hashed out, buried and brought up again so many times its nauseating. some of our forum member are very intelligent men and women representing every level of medical provider across the world. their combined knowledge is staggering. but some people will only take the time to answer a question so many times before they begin to ignore it, thus depriving a new member of their vast experience and knowledge. i suggest you try to search for threads concerning your topic. you'll find we've been all through this one dozens of times.

and welcome to the nut house.

 

[skyemt]

in a nutshell,

they can be wildly inaccurate...

should never be used for baseline vitals, and we almost never use them at all...

 

[Explorer127]

hey. i notice your a fairly new member, so just to be sure your aware of it, i though i'd pass this along.

theres a search feature activated by the search button on the toolbar at the top of the page(fourth from the right). some of the more common topics have been brought up, hashed out, buried and brought up again so many times its nauseating. some of our forum member are very intelligent men and women representing every level of medical provider across the world. their combined knowledge is staggering. but some people will only take the time to answer a question so many times before they begin to ignore it, thus depriving a new member of their vast experience and knowledge. i suggest you try to search for threads concerning your topic. you'll find we've been all through this one dozens of times.

and welcome to the nut house.

oo ok, thanks. i actually never noticed that search button before..

 

[emtwacker710]

yea, we have a lifepack12 and we usually get a manual BP on scene then hook them up to the BP cuff and pulse ox on the lifepack12 and if we notice the BP that the machine takes os way off from our manual we will do manuals the rest of the transport, we have had it go wrong a few times but it was actually the cuff that went bad...

 

[KEVD18]

please dont in any way let what i had to say deter you from asking questions and participating. that wasnt my intention at all. but if you search first, you'll get more info and the same topic wont be dragged out again.

rereading my previous post it seemed a little harsh to me, so if it was read that way, i apologize.

 

[Airwaygoddess]

Automatic blood pressure machines

Automatic BP machines can have their place and be used as part of patient care, but the fact is this, if the machine gives a reading that is considered critical, it must be rechecked manually. It is important to always start with a manual set of vital signs. As mentioned before, automatic machines can malfunction, giving readings that are completely off. This can be due to many reasons, the blood pressure cuff not properly placed on the arm, wrong size cuff placed on the patient, batteries not properly charged, leaks in the bladder of the cuff,( this happens quite often especially with disposable cuffs that are "patient one time use only") or the connector tubing itself. It is important to have machines calibrated on a regular bases, especially if the machine has been dropped accidentally.
If there is any question of accuracy of the patient"s vital signs, then you must recheck them manually, if this means the patient requires vital signs rechecked Q five minutes then that is what needs to be done. Part of providing good patient care, starts with a strong patient assessment with manual vital signs.

 

[lfsvr0114]

We must get an auscultated baseline pressure first. The monitors can not tell the difference between someone moving and heartbeat like a real live person can. If we are the least bit doubting on the pressure, we do them all manually.