Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-25T13:40:05.327Z Has data issue: false hasContentIssue false
  • English
  • Français

Out-of-Hospital Use of a Pulse Oximeter to Determine Systolic Blood Pressures

Published online by Cambridge University Press:  28 June 2012

Brendan McCluskey ,
Michael Addis ,
Bartholomew J. Tortella  and
Robert F. Lavery
Brendan McCluskey
Affiliation:
Section of Trauma and EMS, Department of Surgery, The New Jersey Trauma Center, University Hospital and the University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Michael Addis
Affiliation:
Section of Trauma and EMS, Department of Surgery, The New Jersey Trauma Center, University Hospital and the University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Bartholomew J. Tortella*
Affiliation:
Section of Trauma and EMS, Department of Surgery, The New Jersey Trauma Center, University Hospital and the University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Robert F. Lavery
Affiliation:
Section of Trauma and EMS, Department of Surgery, The New Jersey Trauma Center, University Hospital and the University of Medicine and Dentistry of New Jersey, Newark, New Jersey
*
UMDNJ-University Hospital, Division of Trauma and EMS, 150 Bergen Street, J-204, Newark, NJ 07103USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Study objective:

Blood pressure (BP) in the out-of-hospital setting is one of the most important diagnostic tools used by emergency medical services (EMS) providers. Conventional methods of palpation and auscultation can be time consuming, and the measurements often are inaccurate because of the adverse working conditions encountered. Pulse oximetry waveform systolic blood pressure (POWSBP) measurement has been used successfully in emergency departments to monitor BP. The objective of this study was to compare the accuracy of field POWSBP measurements obtained by noninvasive electronic BP measurement (NIBPM), auscultation, and palpation in the out-of-hospital environment.

Design:

Blood pressure measurements used for this study were obtained by POWSBP, NIBPM (PROPAQ model 102; Protocol Systems, Beaverton, Oregon USA), auscultation, and palpation on patients in moving ambulances. Measurement of POWSBP was accomplished by observing the return of the waveform on the pulse oximeter at the time of cuff deflation. The order in which the readings were obtained as well as the arm chosen for measurement were randomized.

Setting and participants:

Paramedics and emergency medical technicians in an urban, inner-city emergency medical services (EMS) system.

Measurements and main results:

Bloopressure measurements were sampled from 69 patients. Regression analysis identified significant correlation between POWSBP and the four methods utilized, with r = 0.92 for NIPBM, r = 0.95 for auscultation, and r = 0.97 for palpation, all significant at p<0.0001.

Conclusions:

The use of POWSBP measurement is a fast, easy, and accurate technique with which to measure systolic BP in the field. It may have special importance for noisy environments and moving vehicles in which conventional methods of auscultation or palpation may be difficult.

Keywords

auscultationblood pressureoscillometrypulse oximetry
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 11 , Issue 2 , June 1996 , pp. 105 - 107
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Yelderman, M, New, W: Evaluation of pulse oximetry. Anesthesiology 1983;59:349–352.CrossRefGoogle ScholarPubMed
2. Lawson, D, Norley, I, Korbon, G, et al. : Blood flow limits and pulse oximeter signal detection. Anesthesiology 1987;67:599–603.CrossRefGoogle ScholarPubMed
3. McGuire, T, Pointer, J: Evaluation of a pulse oximeter in the prehospital setting. Ann Emerg Med 1988;17:1058–1062.CrossRefGoogle ScholarPubMed
4. Talke, P: Measurement of systolic blood pressure using pulse oximetry during helicopter flight. Crit Care Med 1991;19:934–937.CrossRefGoogle ScholarPubMed
5. Wallace, C, Baker, J, Alpert, C, et al. : Comparison of blood pressure measurement by Doppler and by pulse oximeter techniques. Anesth Analog 1987;66:1018–1019.CrossRefGoogle Scholar
6. Korbon, G, Wills, M, D'Lauro, F, Lawson, D: Systolic blood pressure measurement: Doppler versus pulse oximeter. Anesthesiology 1987;67:A188. Abstract.CrossRefGoogle Scholar
7. Carlin, D, Althoff, M, Rancatore, E, Cody, R: Use of the pulse oximeter wave display to determine systolic blood pressure in the ED. Ann Emerg Med 1991;20:493. Abstract.Google Scholar
8. Meade, D, Farrell, K: Pulse oximetry in the field, a breath of fresh air? Journal of Emergency Medical Services 1994;19:50–56.Google Scholar
9. Low, R, Prasad, N, Vore, S, et al. : Low cardiac output and a moving ambulance—How will they affect pulse oximetry and capnometry? Prehospital and Disaster Medicine 1993;8:S69. Abstract.CrossRefGoogle Scholar
10. Gourdeau, M, Martin, R, Lamarche, Y, Tetreault, L: Oscillometry and direct blood pressure: A comparative clinical study during deliberate hypotension. Canadian Anaesthesiology Society Journal 1986;33:300–307.CrossRefGoogle ScholarPubMed
11. Rutten, A, Ilsley, A, Skowronski, G, Runciman, W: A comparative study of the measurement of mean arterial blood pressure using automatic oscillometers, arterial cannulation, and auscultation. Anaesth Intensive Care 1986;14:58–65.CrossRefGoogle ScholarPubMed
12. Prasad, N, Brown, L, Ausband, S, et al. : Prehospital blood pressures: Inaccuracies due to ambulance noise. Journal of Emergency Medical Services 1994;S13:79. Abstract.Google Scholar
13. Doctor, A, Wolfson, A, Menegazzi, J, Platt, T: Discrepancy between palpated and auscultated systolic blood pressures. Prehospital and Disaster Medicine 1991;6:392. Abstract.Google Scholar
14. Low, R, Martin, D: Accuracy of blood pressure measurements made aboard helicopters. Ann Emerg Med 1988;17:604–612.CrossRefGoogle ScholarPubMed
15. East, T, Pace, N, Sorenson, R, et al. : Effect of peripheral vascular disease on accuracy of noninvasive, continuous, blood pressure measurement from the finger (finapres). Anesthesiology 1987;67:A186. Abstract.CrossRefGoogle Scholar
16. Severinghaus, J, Spellman, M: Pulse oximeter failure thresholds in hypotension and vasoconstriction. Anesthesiology 1990;73:532–537.CrossRefGoogle ScholarPubMed