11 Monitoring NBP
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Mastectomy: Avoid applying the cuff on the side of the mastectomy, as the pressure increases the risk
of lymphedema. For patients with a bilateral mastectomy, use clinical judgement to decide whether the
the benefit of the measurement outweighs the risk.
Unattended Measurement: Use clinical judgement to decide whether to perform frequent
unattended blood pressure measurements. Too frequent measurements can cause blood flow
interference potentially resulting in injury to the patient. In cases of severe blood clotting disorders
frequent measurements increase the risk of hematoma in the limb fitted with the cuff.
Temporary Loss of Function: The pressurization of the cuff can temporarily cause loss of function
of monitoring equipment used simultaneously on the same limb.
CAUTION
If you spill liquid onto the equipment or accessories, particularly if there is a chance that it can get
inside the tubing or the measurement device, contact your service personnel.
Measurement Limitations
NBP readings can be affected by the position of the patient, their physiological condition, the
measurement site, and physical exercise. Thus a physician must determine the clinical significance of
the NBP information.
Measurements are impossible with heart rate extremes of less than 40 bpm or greater than 300 bpm, or
if the patient is on a heart-lung machine.
The measurement may be inaccurate or impossible:
• with excessive and continuous patient movement such as shivering or convulsions
• if a regular arterial pressure pulse is hard to detect with cardiac arrhythmias
• with rapid blood pressure changes
• with severe shock or hypothermia that reduces blood flow to the peripheries
• with obesity, where a thick layer of fat surrounding a limb dampens the oscillations coming from
the artery
• on an edematous extremity.
Measurement Modes
There are four modes for measuring NBP:
•
Manual - measurement on demand.
•
Auto - continually repeated measurements (between one minute and 24 hours adjustable interval).
•
Sequence - up to four measurement cycles which will run consecutively, with number of
measurements and interval between them configurable for each cycle.
•
STAT - rapid series of measurements over a five minute period, then the monitor returns to the
previous mode. Use only on supervised patients.
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