Requirements for paediatric blood pressure cuffs.

Since recommendations concerning the optimal size of blood pressure cuffs (i.e. bladders) are controversial, we performed arm measurements in 162 patients aged 3 weeks to 19 years. The arm circumferences when using bladders 4 cm to 8 cm wide are considerably longer than previously assumed, e.g. 12.5 to 18.5 cm for a bladder 4 cm wide. The requirements for the inflatable bladder are based on these arm measurements and the recommendations to use a bladder that is as wide as possible and encircles at least 60% of the arm (the 4 cm bladder must overlap). Thus, the optimal (minimal) dimensions are: 12 X 24 (19) cm, 10 X 20 (17) cm, 8 X 18 (16) cm and 4 X 20 cm. The blood pressure cuffs available on the Swiss market were then tested according to these specifications. Eleven of 20 cuffs were rated unsuitable in children, and only 6 can be recommended. Thus, there is an obvious need for improvement.