Comparing Femstop With Manual Pressure
RESULTSThe mean systolic blood pressure (SBP) was 124.526 mmHg, with minimum and maximum of 123.111 and 125.940 mmHg, respectively (Cronbach’s alpha = 0.893); furthermore, mean diastolic blood pressure (DBP) was 73.496 mmHg, with minimum and maximum of 72.718 and 74.247 mmHg, respectively (Cronbach’s alpha = 0.852). SBP was significantly different between the two methods, and especially in patients below 60 years, hospitalized in ICU ward, overweight, mid-upper arm circumference below 27 cm, and with neurosurgery problems, it was higher by manual method (P. IntroductionAccuracy of blood pressure (BP) measurement in clinical settings is one of the most concerns despite of considerable promotion in measurement techniques., Manual BP measurement can be so accurate when using a device such as the mercury manometer which is similar to the mean awake ambulatory blood pressure (AABP).Recent studies demonstrate that an accurate BP measurement requires at least 14 minutes, including a period of rest and a conversation between physician and patient to reduce the white coat anxiety, which had low likelihood in routine clinics. This may lead to overestimate BP in healthy individuals.-In recognizing the concerns about manual office blood pressure (MOBP) measurement, new techniques have been recommended.
Proposals for improve assessment of BP status include greater reliance on home and 24 hours ambulatory BP monitoring., This protocol eliminates white coat anxiety and receiving unnecessary drug treatment for hypertension in healthy individuals. Advances in automated office blood pressure (AOBP) measurement provide a third option for accurate measurement of BP status which eliminates many factors influencing imprecise BP.-Suokhrie et al. Showed that automated readings were averaged 3.9 points higher than manual method; and, based on these findings, a protocol was recommended in an acute care psychiatry unit that BP must be measured manually for each patient. In another study performed by Myers et al. Showed that the prevalence of masked hypertension was lower with AOBP compared with MOBP.We sought to evaluate the difference between automated and manual BP measurement in various clinical conditions among our patients over a 1-year period. Materials and MethodsThis cross-sectional study was conducted in Shariati Hospital of Isfahan, center of Iran, from August to December 2014.
Complication
Patients hospitalized in intensive care unit (ICU) and coronary care unit (CCU) and emergency department were enrolled to study. Exclusion criteria were lack of patients’ consent to participate to study.Totally, 125 patients in ICU, CCU, and emergency department who had been hospitalized for different chief complaint had considered for the study. The rifles no love lost torrent. Eight patients refused consent for entering the study, so the study accomplished with 117 patients.Demographic information for each patient was recorded, as well as height, weight, BP and mid-upper arm circumference (MUAC), and body mass index (BMI).
Standardized questionnaire was used to obtain the information of alcohol consumption, smoking, and medications status.The cardioset heart monitoring device was used for measuring BP with noninvasive BP cuff. Meanwhile, BPs were measured manually, by an adult size cuff and standard sphygmomanometer. BP of patients was measured based on American Heart Association (AHA) recommendation, and after 5-minute rest, BP was measured by automated machine. In manual method of measurement, appropriate cuff was chosen. In adults with MUAC.
Comparing Femostop With Manual Pressure Switch
ResultsDuring the enrollment period, 117 adults were seen in the CCU, ICU, and emergency department, and agreed to participate in our study. The mean age of patients was 60.9 ± 16.84. A total of 66.7% (n = 78) of patients were male.The mean difference between SBP was 3.47 ± 0.89 mmHg (Cronbach’s alpha = 0.893), furthermore, mean difference between DBP was 1.55 ± 0.93 mmHg, (Cronbach’s alpha = 0.852). As obtained, SBP in patients below 60 years was significantly more in manual method compared to automatic method (P = 0.016), but not for cases over 60 years (P = 0.090), and DBP shows a significant difference between two methods in patients below 60 years too (P = 0.004), but not for cases over 60 years (P = 0.463). BPDiseaseMean differenceStandard error meanPSBPHeart disease (n = 56)0.320.990.748Internal and orthopedic disease (n = 18)2.382.290.312General surgery (n = 9)4.442.790.150Neurosurgery (n = 22)10.92.24. BP: Blood pressure; DBP: Diastolic blood pressure; SBP: Systolic blood pressureOn the strength of table of ranking base on differences between the two methods of measurement, automated SBP was higher mostly in obese patient, patients admitted in CCU and ones with cardiac complaint; on the other hand, manual SBP was higher mostly in overweight patients, patients admitted in ICU and ones with neurosurgery complaints.
In this manner, automated DBP was higher in cases with multiple trauma, while, manual DBP was higher in neurosurgery cases, that almost all of them were ICU admitted. DiscussionBased on our knowledge, this is the first independent, prospective, observational study on the potential association between BP measurement method and BP levels in Iran. The mean SBP was 124.526 mmHg, with minimum and maximum of 123.111 mmHg and 125.940 mmHg, respectively (Cronbach’s alpha = 0.893). SBP was significantly different between the two methods, especially in patients below 60 years, hospitalized in ICU ward, overweight, MUAC below 27 cm, and with neurosurgery problems.
Moreover, DBPs were more in manual method in patients with female gender, hospitalized in ICU ward, and with neurosurgery problems. In addition, on the basis of result of ranking table, more disagreement between two method was in critical cases.Suokhrie et al. Revealed a significant difference between manual and automatic SBP readings (P.
This study compared two techniques, the FemoStop device (RADI Medical Systems, Uppsala, Sweden) and manual pressure, currently used by nurses to achieve haemostasis at the groin puncture site following removal of femoral arterial sheaths in patients following coronary angioplasty and coronary stent placement. Participants were randomly allocated the FemoStop device or manual pressure.
Participants' groins were observed for evidence of complications including haemorrhage, haematoma formation and pseudoaneurysm following removal of the femoral arterial sheath and the following day. Of the 274 participants recruited into the study, 5.5% (n = 15) were unable to be included as a result of the absence of data on the Angioplasty Record of Care Form (n = 5) or excessive bleeding at the groin puncture site (n = 10). This left 259 eligible participants. Of these, 18.1% (n = 47) did not have their groin puncture site inspected by a post-procedural observer, thereby reducing the number of participants eligible to complete all stages of the study to 212. The results showed that the presence of a haematoma on removal of the femoral arterial sheath had a significant relationship with the type of treatment used, with those participants in the FemoStop device group showing a greater incidence of haematoma development at the time of sheath removal than those in the manual pressure group. No significant difference was detected in haematoma formation or bleeding between the two groups as a result of the risk factors identified in the literature, including participant anxiety, weight or anticoagulant therapy. There was not any significant difference between the two groups in reported pain during removal of the femoral arterial sheath; however, there was a significant distinction in the amount of time taken to achieve haemostasis.
The results showed that haemostasis was achieved more quickly in those participants in the manual pressure group than those in the FemoStop group. The results of this research study indicate that although manual pressure achieved haemostasis more quickly than the FemoStop device, both methods are as effective in reducing groin complications in patients following removal of the femoral arterial sheath following coronary angioplasty and stent placement.