Tips For Nibp Measurement - Dräger Cicero EM Instructions For Use Manual

Tips for NiBP measurement

Applying the sphygmomanometer cuff
Correct application of the cuff and use of the correct
size are essential prerequisites for reliable measurement
without artefacts.
– Only use Dräger cuffs!
– The cuff is normally applied to the upper arm. It can
also be applied to the forearm or ankle for prolonged
monitoring (less patient discomfort).
– Use the largest possible cuff size.
– Press the remaining air out of the cuff.
– The inflatable part of the cuff must enclose the limb
completely (overlapping has only a marginal effect on
the measurement), otherwise a disproportionately
high systolic pressure will be obtained.
– The cuff must fit snugly in order to minimize tissue
movement under the cuff.
– Apply the cuff horizontally level with the heart. If this is
not possible, the difference in level must be corrected
by adding/subtracting 0.75 mmHg per cm above/
below the level of the heart.
– If the cuff is applied to the upper arm, ensure that it
does not compress the ulnar nerve.
– If the arm rests beside the patient, turn the palm of the
hand upwards to reduce the pressure on the elbow
and ulnar nerves and vessels.
– Ensure that the patient does not speak or move his
arm during the measurement. Movement of every kind
extends the measuring time and may lead to incorrect
results.
– Ensure that nothing presses, knocks or bumps
against the cuff or hose during measurement.
– The cuff has a negative effect on an SpO
applied to the same limb. Measure the blood pressure
at a different point or activate »Interlock« to avoid a
false alarm (see pages 93).
– Do not inflate the cuff while loose.
– The cuff must not be applied to a limb that is required
for an intravascular canula.
– The hose length must not be changed. Only use the
original Dräger hose material.
Limitations of the method
The oscillometric method used here is based on
measuring the change of pressure in an inflated cuff
due to blood streaming through a partly occluded artery.
This means that the change in pressure must be
sufficiently large for measurement to be reliable and
due exclusively to pulsation in the artery.
Unreliable results or no results at all are therefore to be
expected in the following cases:
– Patients in a state of severe shock (low blood and
pulse pressure with vasoconstriction).
– Patients whose blood pressure changes rapidly and
considerably during the measurement.
– Patients with arrhythmias. These can have a negative
effect on measurement if the pressure pulses per
heart beat vary considerably. Such changes in oscil-
lation may also be due to spontaneous breathing/
assisted ventilation, hypovolaemia or talking.
– Patients with conically shaped arms (use a different
site, such as the forearm or ankle).
– Patients with sclerotic arteries.
– Patients who move violently or tremble constantly
(try to stabilize the limb).173
sensor
2
Description
Non-invasive blood pressure (NiBP)
171