Rutschmann Olivier T, Sarasin Francois P, Simon Josette, Vermeulen Bernard, Riberdy Louise, Pechere-Bertschi Antoinette
Department of Medicine, Geneva University Hospital, Geneva, Switzerland.
Ann Emerg Med. 2005 Aug;46(2):172-6. doi: 10.1016/j.annemergmed.2004.12.007.
We compare the performance of a wrist blood pressure oscillometer with the mercury standard in the triage process of an emergency department (ED) and evaluate the impact of wrist blood pressure measurement on triage decision.
Blood pressure was successively measured with the standard mercury sphygmomanometer and with the OMRON-RX-I wrist oscillometer in a convenience sample of 2,493 adult patients presenting to the ED with non-life-threatening emergencies. Wrist and mercury measures were compared using criteria of the Association for the Advancement of Medical Instrumentation (AAMI) and the British Hypertension Society (BHS). The impact on triage decisions was evaluated by estimating the rate of changes in triage decisions attributable to blood pressure results obtained with the wrist device.
Wrist oscillometer failed to meet the minimal requirements for recommendation by underestimating diastolic and systolic blood pressure. Mean (+/-SD) differences between mercury and wrist devices were 8.0 mm Hg (+/-14.7) for systolic and 4.2 mm Hg (+/-12.0) for diastolic measures. The cumulative percentage of blood pressure readings within 5, 10, and 15 mm Hg of the mercury standard was 32%, 58%, and 72% for systolic, and 40%, 67%, and 83% for diastolic measures, respectively. Using the wrist device would have erroneously influenced the triage decision in 7.6% of the situations. The acuity level would have been overestimated in 2.2% and underestimated in 5.4% of the triage situations.
The performance of the OMRON-RX-I wrist oscillometer does not fulfill the minimum criteria of AAMI and BHS compared with mercury standard in the ED triage setting.
我们比较了腕式血压示波仪与汞柱式血压计在急诊科（ED）分诊过程中的性能，并评估腕式血压测量对分诊决策的影响。
在一个方便样本中，对2493例因非危及生命的紧急情况前往急诊科就诊的成年患者，先后使用标准汞柱式血压计和欧姆龙RX-I腕式示波仪测量血压。使用美国医学仪器促进协会（AAMI）和英国高血压学会（BHS）的标准比较腕式和汞柱式测量结果。通过估计因腕式设备获得的血压结果导致的分诊决策变化率，评估对分诊决策的影响。
腕式示波仪因低估舒张压和收缩压而未达到推荐的最低要求。汞柱式和腕式设备之间收缩压的平均（±标准差）差异为8.0毫米汞柱（±14.7），舒张压为4.2毫米汞柱（±12.0）。收缩压在汞柱标准的5、10和15毫米汞柱范围内的血压读数累积百分比分别为32%、58%和72%，舒张压分别为40%、67%和83%。在7.6%的情况下，使用腕式设备会错误地影响分诊决策。在2.2%的分诊情况下， acuity水平会被高估，在5.4%的分诊情况下会被低估。
在急诊科分诊环境中，与汞柱标准相比，欧姆龙RX-I腕式示波仪的性能未达到AAMI和BHS的最低标准。
