准确的血压记录：困难吗？

Bhalla A, Singh R, D'cruz S, Lehl S S, Sachdev A

Department of Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Indian J Med Sci. 2005 Nov;59(11):480-7.

BACKGROUND

Blood pressure (BP) measurement is a routine procedure but errors are frequently committed during BP recording. AIMS AND SETTINGS: The aim of the study was to look at the prevalent practices in the institute regarding BP recording. The study was conducted in the Medicine Department at Government Medical College, Chandigarh, a teaching institute for MBBS students.

METHODS

A prospective, observational study was performed amongst the 80 doctors in a tertiary care hospital. All of them were observed by a single observer during the act of BP recording. The observer was well versed with the guidelines issued by British Hypertension Society (BHS) and the deviations from the standard set of guidelines issued by BHS were noted. The errors were defined as deviations from these guidelines.

STATISTICAL METHODS

The results were recorded as percentage of doctors committing these errors.

RESULTS

In our study, 90% used mercury type sphygmomanometer. Zero error of the apparatus, hand dominance was not noted by any one. Every one used the standard BP cuff for recording BP. 70% of them did not let the patient rest before recording BP. 80% did not remove the clothing from the arm. None of them recorded BP in both arms. In out patient setting, 80% recorded blood pressure in sitting position and 14% in supine position. In all the patients where BP was recorded in sitting position BP apparatus was below the level of heart and 20% did not have their arm supported. 60% did not use palpatory method for noticing systolic BP and 70% did not raise pressure 30-40 mm Hg above the systolic level before checking the BP by auscultation. 80% lowered the BP at a rate of more than 2 mm/s and 60% rounded off the BP to nearest 5-10 mm Hg. 70% recorded BP only once and 90% of the rest re inflated the cuff without completely deflating and allowing rest before a second reading was obtained.

CONCLUSION

The practice of recording BP in our hospital varies from the standard guidelines issued by the BHS.

背景

血压测量是一项常规操作，但在血压记录过程中经常会出现错误。目的与研究地点：本研究旨在观察该机构中血压记录的普遍做法。研究在昌迪加尔政府医学院的内科进行，该学院是一所面向医学学士学生的教学机构。

方法

在一家三级护理医院对80名医生进行了一项前瞻性观察研究。在他们进行血压记录时，由一名观察者对所有人进行观察。该观察者熟悉英国高血压协会（BHS）发布的指南，并记录了与BHS发布的标准指南的偏差。这些偏差被定义为错误。

统计方法

结果记录为出现这些错误的医生的百分比。

结果

在我们的研究中，90%的人使用汞柱式血压计。没有人注意到仪器的零误差和惯用手。每个人都使用标准血压袖带记录血压。70%的人在记录血压前没有让患者休息。80%的人没有脱掉手臂上的衣物。没有人测量双臂血压。在门诊环境中，80%的人在坐位测量血压，14%的人在仰卧位测量血压。在所有坐位测量血压的患者中，血压计低于心脏水平，20%的患者手臂没有得到支撑。60%的人没有使用触诊法确定收缩压，70%的人在通过听诊检查血压前没有将压力升高到收缩压水平以上30 - 40毫米汞柱。80%的人以超过2毫米/秒的速度降低血压，60%的人将血压四舍五入到最接近的5 - 10毫米汞柱。70%的人只测量一次血压，其余90%的人在未完全放气且未让手臂休息的情况下就重新充气袖带以进行第二次读数。