Dr. Jeffrey Elliot Field HBSc, D.D.S., Diplomat of the National dental Board of Anesthesia, Fellow of The American Dental Society of Anesthesia

 NIBP blood pressure determination values will vary by as much as 37 mm Hg from the direct arterial values.  This large discrepancy indicates that treatment should never be made based on a single NIBP determination without comparison to an auscultatory blood pressure determination or several consecutive measurements performed by an NIBP monitor.

 Cuff width = 40% of arm circumference in order to obtain a proper reading.  American Heart Association recommended sizes for blood pressure cuffs based on arm circumference.  Extremity circumference* (cm) Cuff name  Newborn  7.5 – 13Infant  13 – 20Child  17 – 25Small adult  24 – 32Adult  32 – 42Large Adult  42 – 50Thigh

 Using a cuff that is too small will lead to falsely high readings.  Using a cuff that is too large will lead to falsely low readings.

 Several circumstances can prevent accurate determination of blood pressure with NIBP devices.  Highly irregular or rapid cardiac rhythms.  Excessive patient movement such as shivering, restlessness, or external movement such as that from a helicopter, ambulance transport, or a rapid cycling ventilator can interfere with detection of cardiac oscillations by the NIBP monitor.

 Adverse health effects associated with high blood pressure are stroke, heart attack, kidney failure or heart failure.

systolicdiastolic Desirable11575 Pre-hypertension Hypertension stage one Hypertension stage two160-or over100 or over

 The generally acceptable blood pressure fluctuation under sedation or general anesthesia is: + or -20% of the baseline.