The congruity of bladder size with arm circumference for sphygmomanometers used in training hospitals

OBJECTIVES
Selection of a sphygmomanometer with the right bladder size is essential for accurate measurement of blood pressure. We investigated whether the size of the bladders commonly used in clinical practice was appropriate for accurate blood pressure measurements.

STUDY DESIGN
We measured the bladder sizes of sphygmomanometers used in 52 outpatient clinics of university and state training hospitals in Ankara. The size of the bladders was approximated with the closest corresponding size recommended in the guidelines of the American Heart Association for blood pressure measurements. In the second phase, we measured arm circumferences of 100 consecutive hypertensive patients (49 women, 51 men; mean age 34.6±13.9 years; range 19 to 80 years) in our clinic to determine the use of appropriate bladder size according to the guidelines of the American Heart Association.

RESULTS
Of 52 outpatient clinics, only five kept a second sphygmomanometer available. The bladder size was 12x22 cm in 96.5% of the sphygmomanometers and this was the appropriate size for only 39% of the patients. Only 3.5% of the sphygmomanometers had a bladder size of 16x30 cm, which was the proper size for 58% of the patients. Sphygmomanometers with bladder sizes of 16x36 cm and 16x42 cm were not available.

CONCLUSION
As to the bladder size, a significant percentage of sphygmomanometers currently used in clinical practice were not found appropriate for accurate blood pressure measurements. These results suggest that a spare sphygmomanometer with a bladder size of 16x30 cm should be available in outpatient clinics.