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Noninvasive blood pressure cuff causing humerus fracture
Gopalkrishna G Verma1, Vishal Sahni
1Orthopaedic Department, Southport and Ormskirk General Hospital NHS Trust, PR8 6PN Southport, United Kingdom. gopal134@yahoo.co.uk
Abstract:
Blood pressure recording is a part of the routine set of initial observations for any patient. It is performed by variety of medical and paramedical personnel universally. Bone metastases and pathologic fracture of the bone are common in the elderly patient. Noninvasive blood pressure recording is innocuous procedure, although on rare occasions can cause iatrogenic fracture of the asymptomatic pathologic bone. This case report highlights the importance of vigilance to look for pain and tender area over the site of blood pressure cuff placement and before its inflation to record blood pressure, as it can be "traumatic" for the asymptomatic weak pathologic bone leading to a fracture. Iatrogenic fracture can add to the burden of a patient's medical problem, necessitating secondary surgical procedure, delaying recovery, and having the possibility of medicolegal problems.
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Pre-Procedural Guidelines for Assessing Blood Pressure
Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
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Prepare for the Procedure:
Assessment of blood pressure in brachial artery(two-step method)
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Equipments Used To Measure Blood Pressure
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...