The modern lifestyle has made various health risks such as hypertension, heart disease, and other common cardiovascular conditions increasingly common. Picking the right sphygmomanometer is a smart choice that we should all consider daily, for the good of our healthy bodies.
The first blood pressure measurement was recorded in the year 1733, and the first sphygmomanometer was invented in the year 1881 by Samuel Siegfried Karl Ritter von Basch. The pioneering design consisted of two parts–a rubber bulb filled with water, and a mercury column. The water in the rubber bulb was used to restrict the blood flow in the artery, while the mercury column was connected to the bulb that translated the pressure required to obscure the pulse into millimeters of mercury completely. In 1896, Scipione Riva-Rocci made further improvements in Ritter’s first sphygmomanometer. He added a handcuff that could be fixed around the arm to apply pressure on the limb, to measure the blood pressure. This design became the standard for such devices later on.
In 1905, Dr. Nikolai Korotkoff discovered the difference between systolic blood pressure and diastolic blood pressure. This discovery laid the foundation for modern blood pressure measurement as we know it today. Simply put, when pressure is applied and released, they are accompanied by the appearance or disappearance of sounds within the arteries. These systolic and diastolic sounds are thus used as standards in blood pressure measurement and are known as Korotkoff sounds. The sphygmomanometer apparatus has since then evolved greatly to the available technology offered today, now more commonly known as the BP apparatus.
Types of Sphygmomanometers
Advancements in the sphygmomanometer, or blood pressure gauges as they are also often called, have been quite impressive over the years. Medical devices have become more specialized, and various types of sphygmomanometers have become available in the market. Outlined in our list below are three major types of sphygmomanometers–mercury, aneroid, and digital.
The mercury sphygmomanometer is the most conventional form of blood pressure apparatus, and it can be considered the golden standard in the health industry. Mercury sphygmomanometers are made up of manually inflatable cuffs that are attached to measuring units with mercury-infused tubes. While operating the device, it is important to place the apparatus on a flat surface and in an upright position to get the correct readings. These devices are very delicate and require special care, and if accidentally dropped can cause rupture of mercury, rendering the device useless and potentially hazardous.
The biggest advantage of using mercury sphygmomanometers is that they are quite easy to use, and if used properly, can last a lifetime. The device can produce the most accurate results without requiring much readjustment. Due to the toxic nature of its contents, however, the use of mercury sphygmomanometers have been banned in some countries, and other forms of sphygmomanometers are being used instead.
Aneroid means “without fluid,” and as the name suggests, this type of BP apparatus doesn’t make use of any mercury and is therefore considered the safest alternative to mercury sphygmomanometers. Its recording procedures are pretty similar to that of the mercury sphygmomanometer, except the stethoscope’s attachment to the cuff. In the aneroid device, the cuff is attached to a dial gauge with tubing. The gauge head contains mechanical parts that convert the cuff pressure into gauge-based reading. Additionally, there are various other types of aneroid sphygmomanometers depending on how they are used. These include pocket-aneroid sphygmomanometers, palm aneroid sphygmomanometers, and clock-style aneroid sphygmomanometers. Ultimately, the benefit of using aneroid sphygmomanometers is the affordability of the apparatus, as well as its compact and handy nature. However, similar to other devices used to measure blood pressure, aneroid sphygmomanometers make use of a delicate mechanism and therefore necessitates careful handling. Aneroid sphygmomanometers also require recalibration by experts, to avoid cases of faulty reading.
Automatic Digital Sphygmomanometer
The automatic digital sphygmomanometer is the most technologically-advanced sphygmomanometer design to date. These devices use an electronic pressure sensor to measure the blood pressure, and the readings are presented on a digital display. Similar to mercury and aneroid sphygmomanometers, digital sphygmomanometers also come with inflatable cuffs, but there is a difference in the procedure for measuring blood pressure. Unlike the other two types, automatic digital sphygmomanometers evaluate and measure the fluctuations of arteries. These devices are perfect for home use as they are easiest to operate. To avoid the risk of inaccurate readings, periodic counter checks with conventional mercury sphygmomanometers are recommended.
How to Use Sphygmomanometers
In making use of sphygmomanometers, procedures vary according to the type and variety of sphygmomanometer used, but all varieties operate on a single principle. A bulb increases the pressure by inflating the cuff placed around one’s arm, and a valve releases the pressure. During this process, a stethoscope is used to listen to arterial blood flow sounds. As the heart beats, blood going through the arteries causes a rise in pressure, which quickly decreases when the heart’s ventricles prepare for another beat. This rise and fall are called systolic and diastolic pressure, respectively. Below are the steps to accurately measure one’s blood pressure.
- Know your basic knowledge of blood pressure readings. Blood pressure readings are expressed as systolic over diastolic pressure. The normal blood pressure of an average healthy adult is 120/80.
- Use proper-sized cuffs. Cuffs that are too loose or too tight may influence the accuracy of blood pressure measurements. The cuff should be 80% of the circumference of the upper arm. Be sure not to place the cuff on a clothed arm.
- Properly place the cuff on the arm. While wrapping the cuff around the upper arm, keep the lower edge of the cuff one inch above the antecubital fossa, the region of the arm in front of the elbow.
- Position the stethoscope. Lightly press the stethoscope bell over the brachial artery, just below the lower edge of the cuff.
- Inflate the cuff. Using the bulb, inflate the cuff to 180 mmHg, then release using the valve at a moderate rate of about 3 mm per second.
- Listen and observe. While examining the dial or mercury gauge, listen for a knocking sound with the stethoscope. The first knocking sound represents the systolic blood pressure of the patient. The point when the sound disappears meanwhile signifies the diastolic pressure.
- Repeat the procedure on the other arm. For accurate analysis, it is recommended that the blood pressure of both arms are measured. The difference in measurement of both arms, as well as the patient’s position and cuff size, must be noted.
How to Use Sphygmomanometers
Monitoring one’s blood pressure is a responsibility not just of doctors and physicians, but of every individual alike. Having abnormal blood pressure levels, whether elevated or dropped, are sure warning signs of ill health, and checking for these abnormalities is an important step towards prevention of hypertension, stroke, or heart attack. Therefore, households as much as clinics and hospitals should invest in good quality sphygmomanometers for frequent use. Below is a list of the relevant factors one should consider before choosing what sphygmomanometer to purchase.
- Needs and Price
The right sphygmomanometer is determined by the needs and requirements of its user. Aneroid sphygmomanometers provide readings of high accuracy but require sufficient knowledge and expertise of handling the device. Nurses, physicians, and specialists should, therefore, look for durable, flexible, and high-accuracy devices such as these, that can withstand heavy use. Individuals looking to buy sphygmomanometers for personal use, meanwhile, may consider purchasing sphygmomanometers that are easiest to operate among the many varieties. Digital sphygmomanometers are designed to be very user-friendly, especially for those who do not have any medical background. Price is another determining factor for what sphygmomanometer to purchase, and the allocated budget can highly narrow down one’s decision. The price range of a decent sphygmomanometer varies from 10 to 70 dollars, depending on the type. Devices that fall in the higher price ranges are those designed for specialists who require high-performing instruments.
As with any medical instrument, the accuracy of measurements is of utmost importance. As discussed earlier, the accuracy of sphygmomanometers largely depends on its type–mercury sphygmomanometers provide the standard of measurements and is therefore of highest accuracy; aneroid sphygmomanometers also provide readings of very high accuracy, but require a sufficient knowledge and expertise of handling the device; digital sphygmomanometers tend to sacrifice convenience and ease of use for accuracy of measurements, compared to the other two sphygmomanometer types.
- Quality, Design, and Cuff Size
Sphygmomanometers vary according to their quality of material and design, all of which affect the overall performance of the device. Therefore, all parts of a sphygmomanometer should be of top-notch quality. The cuff material, gauge, inflation bulb and valve should all ideally be well constructed, non-sticking and hypoallergenic. An ideal gauge should have 300 mmHg of pressure, and the bulb part should be made out of latex-free material. For a sphygmomanometer, cuff size is also extremely important. Cuff sizes that are either to too loose- or tight-fit might result in incorrect readings. Therefore, one must make sure that the width of the sphygmomanometer cuff provides a size range that can fit its user perfectly, whether for personal or clinical use. For reference, 80% of the arm should be covered by the air bladder of the cuff. Small cuff sizes are for arm diameters of 17 to 22 cm, medium cuff sizes are for 22 to 32 cm, and large cuff sizes are for 33 to 42 cm arm diameters. For medical professionals, it is advised to purchase a medium sized cuff that can be adjusted to fit patients’ larger and smaller sizes.
- Convenience and Portability
Sphygmomanometers, whether used frequently and in different places or bought for home use, should be evaluated based on convenience and ease of use. Physicians who need an instrument that can keep up with the busy work schedules that bring them to different places should purchase a sphygmomanometer that is lightweight and easy to carry. Those who are looking to buy a sphygmomanometer specifically for home use can opt to save a few bucks and choose a device that does not need to be lightweight or pocket-sized.
Needs and Price
The White Coat Deluxe Aneroid Sphygmomanometer is designed for medical professionals and professionals-in-training. Aneroid sphygmomanometers provide a quick and easy technique for acquiring blood pressure readings among patients. Because it is relatively cheap and easy to use, this product is also perfect for medical students. Available under 20 dollars, this product provides a compromise between quality and affordability. Additionally, the product package also includes a LED penlight and pupil gauge, making it an even more valuable deal.
4 out of 5
Aneroid sphygmomanometers are generally considered high accuracy instruments, as long as a proper protocol is followed for its maintenance. As an alternative to mercury sphygmomanometers, aneroid devices are the top choice.
4 out of 5
Design, Quality, and Cuff Size
The instrument is made of high-quality aluminum alloy and is considered DEHP-free. The cuff is made of nylon, and the air release valve is large and of a taper-end design for easier manipulation. The purchase also comes with a LED penlight and a pupil gauge for other medical check-up processes. The nylon cuff comes in an adjustable adult-sized cuff, so its fit might be limited.
3 out of 5
Convenience and Portability
The White Coat Deluxe Aneroid Sphygmomanometer is an instrument that can be used on-the-go. Because of its lightweight nature, the instrument can easily be brought anywhere in its black carrying case.
5 out of 5
The instrument is a recommended purchase for doctors, nurses, and medical students looking for a sphygmomanometer that they can bring anywhere, around hospitals, and on-the-go, but also one that they can rely on to give accurate readings at a relatively low price.
Needs and Price
MDF Calibra Aneroid Sphygmomanometer is considered the best product available o