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X-Mailman-Approved-At: Mon, 25 Jun 2018 07:41:45 -0700
Subject: Re: [Sepsis Groups] noninvasive BP monitoring
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Tish
The mean from the automated cuff is a direct measurement with extrapolation=
of the SBP and DBP. For the auscultated - it is the other way around and =
you are using a calculated mean. One is not more accurate than the other, =
as long as the procedure for performing the measurement is correct. A few =
years ago we wandered around the hospital and watched people take BPs - ver=
y interesting. Our practice council created an acronym for four key factors=
for accurate BP (PASS - Palpate brachial artery - place sensor line; Arm P=
osition - supported at heart level; Skin (not over pajamas), Size - correct=
ly sized) - the other thing is should be able to slip finger between cuff (=
it needs to be pretty tight) - The AACN (AACN.org) practice alert on BP mea=
surement outlines all of these steps. If you try and compare the two diffe=
rent methods - both are correct - then you end up with the age old question=
- which do I believe (do you want your patient to have a MAP greater than/=
less than 60, etc). Also there is a normal 10% variation in BP (ventilator=
y effect) - so they will never be the same.
Liz Bridges
University of Washington
________________________________
From: Sepsisgroups <sepsisgroups-boun...@lists.sepsisgroups.org> on behalf =
of Tish Poserina <pposer...@stmaryhealthcare.org>
Sent: Thursday, June 21, 2018 4:05:48 AM
To: sepsisgroups@lists.sepsisgroups.org
Subject: [Sepsis Groups] noninvasive BP monitoring
As I review sepsis cases in patients with non-invasive pressure monitoring;=
I am finding that quite often the MAP does not correlate with the standard=
formula (S=3D2D/3); and I understand that non-invasive monitoring relies o=
n pulse amplitude to calculate mean. Should we really be utilizing MAP with=
non-invasive pressure devices? To say we should re-check it manually can h=
ardly be practical when many areas of the hospital use non-invasive devices=
for BP monitoring.
Tish Poserina, RN,MSN, CCRN, CNRN
Sepsis Coordinator
St Mary Medical Center
pposer...@stmaryhealthcare.org<mailto:pposer...@stmaryhealthcare.org>
W 215.710.4347
C 215.710.7644
1201 Langhorne-Newtown Road
Langhorne, Pa 19047
stmaryhealthcare.org| Facebook| Twitter|LinkedIn
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<p style=3D"margin-top:0;margin-bottom:0">Tish</p>
<p style=3D"margin-top:0;margin-bottom:0">The mean from the automated cuff =
is a direct measurement with extrapolation of the SBP and DBP. For th=
e auscultated - it is the other way around and you are using a calculated m=
ean. One is not more accurate than the
other, as long as the procedure for performing the measurement is cor=
rect. A few years ago we wandered around the hospital and watche=
d people take BPs - very interesting. Our practice council created an acron=
ym for four key factors for accurate BP (PASS -
Palpate brachial artery - place sensor line; Arm Position - supported at h=
eart level; Skin (not over pajamas), Size - correctly sized) - the other th=
ing is should be able to slip finger between cuff (it needs to be pretty ti=
ght) - The AACN (AACN.org) practice
alert on BP measurement outlines all of these steps. If you try and =
compare the two different methods - both are correct - then you end up with=
the age old question - which do I believe (do you want your patient to hav=
e a MAP greater than/less than 60, etc).
Also there is a normal 10% variation in BP (ventilatory effect) - so they =
will never be the same. </p>
<p style=3D"margin-top:0;margin-bottom:0"><br>
</p>
<p style=3D"margin-top:0;margin-bottom:0">Liz Bridges</p>
<p style=3D"margin-top:0;margin-bottom:0">University of Washington</p>
<p style=3D"margin-top:0;margin-bottom:0"><br>
</p>
</div>
<hr style=3D"display:inline-block;width:98%" tabindex=3D"-1">
<div id=3D"divRplyFwdMsg" dir=3D"ltr"><font face=3D"Calibri, sans-serif" st=
yle=3D"font-size:11pt" color=3D"#000000"><b>From:</b> Sepsisgroups <seps=
isgroups-boun...@lists.sepsisgroups.org> on behalf of Tish Poserina <=
pposer...@stmaryhealthcare.org><br>
<b>Sent:</b> Thursday, June 21, 2018 4:05:48 AM<br>
<b>To:</b> sepsisgroups@lists.sepsisgroups.org<br>
<b>Subject:</b> [Sepsis Groups] noninvasive BP monitoring</font>
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<p class=3D"x_MsoNormal">As I review sepsis cases in patients with non-inva=
sive pressure monitoring; I am finding that quite often the MAP does not co=
rrelate with the standard formula (S=3D2D/3); and I understand that non-inv=
asive monitoring relies on pulse amplitude
to calculate mean. Should we really be utilizing MAP with non-invasive pre=
ssure devices? To say we should re-check it manually can hardly be practica=
l when many areas of the hospital use non-invasive devices for BP monitorin=
g.
</p>
<p class=3D"x_MsoNormal"> </p>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif"">Tish Poserina, RN,MSN, CCRN, CNRN</sp=
an></p>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif"">Sepsis Coordinator</span></p>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif"">St Mary Medical Center</span></p>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif""> </span></p>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif""><a href=3D"mailto:pposerina@stmaryhea=
lthcare.org">pposer...@stmaryhealthcare.org</a></span></p>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif"">W 215.710.4347</span></p>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif"">C 215.710.7644</span></p>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif""> </span></p>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif"">1201 Langhorne-Newtown Road</span></p=
>
<p class=3D"x_MsoNormal"><span style=3D"font-size:10.0pt; font-family:"=
;Tahoma","sans-serif"">Langhorne, Pa 19047</span></p>
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<p class=3D"x_MsoNormal"><u>stmaryhealthcare.org</u>| <u>Facebook</u>| <u>T=
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