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Is it reliable to measure the forearm blood pressure in children?
Amar M Taksande1, Aishwarya Jadhav1, Jyoti Nair1
1Department of Pediatrics, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India.
Insights
Forearm blood pressure (BP) measurement is an acceptable alternative when the upper arm is inaccessible. Readings are slightly higher in the forearm, but correlation remains strong for both mercury and automated devices.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Medical Devices
Background:
- Upper arm blood pressure (BP) measurement may be challenging due to inaccessibility or lack of standard cuffs.
- Forearm BP measurement is sometimes used as an alternative by healthcare professionals.
Purpose of the Study:
- To evaluate the accuracy and reliability of forearm BP measurements compared to upper arm measurements.
- To determine the correlation between forearm and upper arm BP readings in children.
Main Methods:
- A prospective, randomized study involving 72 children aged 5-15 years.
- Blood pressure was measured from both the upper arm and forearm using mercury and automated (OMRON) devices.
- Measurements were recorded at 2-minute intervals.
Main Results:
- Strong Pearson's correlation coefficients were observed between forearm and upper arm BP measurements (0.782-0.846).
- Forearm readings were approximately 3 mmHg higher for both systolic and diastolic BP compared to upper arm readings.
- A statistically significant difference was found in both systolic and diastolic BP measurements between the two sites.
Conclusions:
- Forearm BP measurement is a viable alternative when upper arm access is not feasible.
- Forearm BP readings tend to be slightly higher than upper arm readings.
- The study supports the use of forearm BP monitoring in pediatric populations when necessary.
Background:
When the upper arm (UA) is inaccessible or a standard-sized blood pressure (BP) cuff is unavailable, some healthcare workers use the forearm (FA) to measure BP with a mercury sphygmomanometer.
Objective:
The objective was to determine the accuracy of BP measurement in the arm and FA.
Design:
Prospective, randomized study.
Setting:
Department of Pediatrics, JNMC, Sawangi (Meghe).
Participants:
A total of 72 children aged 5-15 years.
Measurements:
Mercury and Automatic (OMRON Tokyo, 108-0075 Japan) BP measurements were recorded from the arm and FA at 2 min intervals.
Results:
In our study, 72 children of both sexes were enrolled. The mean age of the children was 10.13 ± 2.82 years, and 48% were females. Pearson's correlation coefficient between FA and UA systolic BP (SBP) measured by mercury was 0.782, and for diastolic BP (DBP) it was 0.824. Similarly, Pearson's correlation coefficient between FA and UA SBP measured with an automated device (OMRON) was 0.843, and for DBP it was 0.846. The average readings for the SBP and DBP were higher in the FA than in the UA by approximately 3 mmHg. There was a statistically significant difference in both SBP and DBP.
Conclusions:
The FA is an acceptable method of BP monitoring when the UA cannot be accessed. The pressure from FA is probably higher than it would be from UA.
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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.
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Prepare for the Procedure: