11: Monitoring NBP
WARNINGS: Do not perform noninvasive blood pressure measurements on patients with sickle-cell disease or any
condition where skin damage has occurred or is expected.
Do not use in a hyperbaric chamber.
Care should be taken when using an oscillometric NBP device on patients with decreased
consciousness, neuropathy, irregular cardiac rhythm, labile high blood pressure, increased arm
activity, or arterial insufficiency especially if the unit is utilized for a prolonged period. A safeguard of
the NBP system is that the device incorporates a softkey that can be pressed to deflate the cuff if the
cuff is causing patient pain. Pay particular attention to unconscious patients since they cannot alert
you if the pain is present.
Use clinical judgement to decide whether or not to perform automatic blood pressure measurements
on patients with severe blood clotting disorders because of the risk of hematoma in the limb wearing
Do not apply the cuff to a limb that has an intravenous infusion or arterial catheter in place. This
could cause tissue damage around the catheter when the infusion is slowed or blocked during cuff
Use only approved cuffs and tubing in order to prevent inaccurate data, injury or damage. All
specified cuffs are protected against the effects of the discharge of a defibrillator.
Prolonged series of NBP measurements in automatic mode may be associated with purpura,
ischemia and neuropathy in the limb wearing the cuff. When monitoring a patient, examine the
extremities of the limb frequently for normal color, warmth and sensitivity. If any abnormality is
observed, stop the blood pressure measurements immediately.
Blood pressure readings may be affected by the position of the patient, their physiologic condition,
the presence of arrhythmia and other factors.
Kinked or otherwise restricted tubing can lead to a continuous cuff pressure, causing blood flow
interference and potentially resulting in injury to the patient.
Do not apply the cuff over a wound as this can cause further injury.
Avoid applying the cuff on the same side as a mastectomy as the pressure increases the risk of
lymphedema. For patients with a bilateral mastectomy, use clinical judgement to decide whether the
benefit of the measurement outweighs the risk.
To obtain accurate blood pressure readings, the cuff must be the correct size and also be correctly
fitted to the patient. Incorrect size or incorrect fitting may result in incorrect readings.
CAUTIONS: Do not compress or restrict pressure tubes during an NBP measurement.
If a spill occurs and liquid appears inside the tubing, contact your service personnel.
NOTE: When utilizing NBP, use your clinical judgment on appropriate application for patient's clinical