American Diagnostic Corporation (ADC) ADview Modular Diagnostic Station - Manual (Page 56)

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SPECIAL SITUATIONS
Special Situations
Unique circumstances, such as the patient’s age or physiological disturbances, require you to take special
care while measuring blood pressure or vital signs. The more common examples of such circumstances are
described here, to assist you in using your ADview optimally under such conditions. You can find
recommendations on dealing with each of these special situations in the American Heart Association’s
current scientific statement on recommendations for blood pressure measurement or the British
Hypertension Society’s current guidelines for management of hypertension.
Measuring Blood Pressure in Children
Typically, children exhibit greater variability in blood pressure than do adults. They are more likely to be
crying, eating or restless in a clinical situation, further increasing the potential for variability.
Measuring Blood Pressure in Obese Patients
There appears to be a positive correlation between obesity and hypertension. Due to the increased arm
circumference of obese patients, use of a "standard" cuff may lead to blood pressure being erroneously
elevated – a condition known as "cuff hypertension."
Selecting an Appropriate Cuff for Obese Patients:
• For larger-than-normal upper arms, use a wider and longer cuff than you would otherwise use.
• Prominent biceps in a muscular upper arm require a large cuff.
Measuring Blood Pressure in the Presence of Arrhythmia
Irregular cardiac rhythms can result in a large variation in blood pressure from beat-to-beat. If you are
using the ADview on a patient with known arrhythmia, we recommend that you follow up with a
Sphygmode BP reading as a confirmatory measure.
In patients with severe regular bradycardia, take Sphygmode rather than automatic readings.
Measuring Blood Pressure During Pregnancy
Hypertension is a common medical disorder of pregnancy, occurring in about ten percent of pregnancies.
Detection of elevated blood pressure is essential to optimal prenatal care.
For clinically relevant hypertension in pregnancy, use the ADview to take a Sphygmode measurement.
Measuring Blood Pressure in the Elderly
In the elderly, the combination of hypertension and ageing can manifest as a decrease in arterial
compliance. Variability in blood pressure can lead to a number of circadian blood pressure patterns that are
best identified using ambulatory blood pressure measurement. The clinical consequence of this blood
pressure variability is inaccurate readings.