Obtaining Accurate Noninvasive Blood Pressure Measurements in Adults

Scope and Impact of the Problem

Blood pressure (BP) is measured in virtually all patients receiving health care. Accurate measurement of BP is essential to guide management decisions and prevent adverse outcomes. Noninvasive BP (NIBP) monitoring is considered a safe practice; however, complications can occur. Bruising and skin irritation from compression are the most commonly occurring complications.¹ Prolonged periods of frequent NIBP measurements have been associated with rare complications, including pain, limb edema,² phlebitis,³ compartment syndrome, peripheral neuropathy, thrombophlebitis, venous stasis, ecchymosis, and petechiae.^2,3 Conditions that place patients at high risk for complications include diabetes,^4,5 arterial or venous insufficiency, preexisting peripheral neuropathies, decreased limb perfusion, thrombolytic therapy, anticoagulation therapy,² increased arm activity (eg, seizures, shivering), irregular cardiac rhythms, and decreased level of consciousness.³