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The mercury sphygmomanometer should be abandoned before it is proscribed
N D Markandu1, F Whitcher, A Arnold
1Blood Pressure Unit, Department of Medicine, St George's Hospital Medical School, London SW17 ORE, UK.
Journal of Human Hypertension
|February 16, 2000
Summary
Mercury sphygmomanometers used for blood pressure measurement are often inaccurate due to poor maintenance and lack of staff expertise. Replacing these devices with validated automatic ones is crucial for accurate readings and patient safety.
Area of Science:
- Cardiovascular Medicine
- Medical Devices
- Environmental Health
Background:
- Blood pressure measurement is vital for predicting life expectancy and managing cardiovascular health.
- Accurate blood pressure monitoring is essential for effective treatment of hypertension, reducing risks of stroke, heart attack, and heart failure.
- Mercury sphygmomanometers remain widely used in clinical practice and research despite concerns.
Purpose of the Study:
- To assess the accuracy and maintenance of mercury sphygmomanometers in a large teaching hospital.
- To evaluate the technical proficiency of healthcare professionals in using the auscultatory method for blood pressure measurement.
- To advocate for the replacement of mercury sphygmomanometers with validated automatic devices.
Main Methods:
- Examination of nearly 500 mercury sphygmomanometers and associated cuffs for accuracy.
- Assessment of medical and nursing staff's knowledge of the auscultatory blood pressure measurement technique.
- Review of environmental concerns related to mercury as a pollutant.
Main Results:
- Over 50% of examined mercury sphygmomanometers exhibited significant inaccuracies.
- A considerable lack of technical knowledge regarding blood pressure measurement was observed among healthcare staff.
- Mercury sphygmomanometers are prone to measurement and observer errors, compounded by inadequate maintenance and expertise.
Conclusions:
- Inaccurate blood pressure measurements due to faulty mercury sphygmomanometers and insufficient staff training pose serious health risks.
- The environmental hazard of mercury further supports the discontinuation of its use in blood pressure devices.
- Validated automatic blood pressure devices should be adopted, alongside comprehensive training for healthcare professionals on accurate measurement techniques.