Does Your Blood Pressure Reading Rely on Your Nurses Hearing?
Most doctor offices use the old standard, the manual blood pressure machine (sphygmomanometer and stethoscope).
You know the drill, the nurse manually pumps up the cuff and then listens through the stethoscope for the blood flow sounds to gradually disappear, giving the systolic (heartbeat) pressure and the diastolic or resting heart pressure.
The portable automatic blood pressure machine uses battery power to automatically inflate the cuff.
The machine "listens" for the sounds and then digitally gives a read-out of the systolic pressure, diastolic pressure and heart rate.
Whenever I read comparisons of which type is better, the drawbacks given for the automatic machine are that they require batteries, high cost and variable accuracy.
Drawbacks for the manual is complicated use and the device can be fragile.
I have never seen an article discussing the ability of the nurse to accurately "hear" the blood flow sounds when using the manual machine.
Yes, they are taught how to do this in nursing school but it really isn't that hard - and most people can learn how to do it.
Listening to the sounds gradually disappear through the stethoscope is critical to getting the blood pressure reading correct.
How does the patient know whether the nurse has any kind of hearing impairment or Tinnitus? The nurse may not even be aware of any hearing loss.
Perhaps this is one reason why blood pressure numbers can be so different from one doctor's office to another office.
It is only logical that there are nurses that have some degree of undiagnosed hearing loss - after all, nurses are people too, they listen to MP3 Players -sometimes too loud, they have been around loud lawnmowers, snow blowers, snowmobiles and more throughout their lives the same as the rest of the population.
Should nurses be required to have their hearing tested yearly - that would be an added expense for the doctor's office.
Or, wouldn't it be simpler to just use a high quality automatic blood pressure machine (powered by battery or electricity) that can't have hearing damage? There is something called age-related hearing loss - which means that as we age we are more likely to have developed some hearing loss.
But, I don't think it is necessarily advancing age that should ONLY be considered.
What about the younger nurses that went to loud clubs or rock concerts on weekends during college and perhaps still attend - I highly doubt that many wear hearing protection - and these very loud events can cause hearing damage.
A rock concert can register over 100-130 decibels.
A gunshot usually registers 120 to 150 decibels.
According to research published in Audiology, 2001, those people that were involved in leisure activities with loud noise, such as 90 dB or more, were much more likely to have acquired hearing loss than those that didn't participate in recreational/leisure activities with high noise levels.
Yellowstone safety officer, Brandon Gauthier advised employees "who drive the new four-stroke snowmobiles to wear earplugs because the machines are almost as loud as the two-stroke models, reaching a noise level of 111 decibels during acceleration.
Because the decibel scale is logarithmic, that's many times higher than the 85-decibel level at which medical experts advise the use of hearing protection" As for Personal Watercraft (PWC) such as jet skis (generic) the older Personal Watercraft (PWC) and two-stroke engines can attain extremely high noise levels, ranging from 85 to 102 decibels per unit, according to a 2005 Issue Summary for Colorado State Parks.
The American Hospital Association does recommend using hearing protection above 85 dB.
So, what does this tell us? NOT ONLY is our blood pressure reading dependent on the training of the nurse, but also partly dependent on the quality of hearing of the nurse taking the pressure with a manual machine.
There needs to be a discussion of this issue - no one seems to be paying attention to this question of accuracy.
You know the drill, the nurse manually pumps up the cuff and then listens through the stethoscope for the blood flow sounds to gradually disappear, giving the systolic (heartbeat) pressure and the diastolic or resting heart pressure.
The portable automatic blood pressure machine uses battery power to automatically inflate the cuff.
The machine "listens" for the sounds and then digitally gives a read-out of the systolic pressure, diastolic pressure and heart rate.
Whenever I read comparisons of which type is better, the drawbacks given for the automatic machine are that they require batteries, high cost and variable accuracy.
Drawbacks for the manual is complicated use and the device can be fragile.
I have never seen an article discussing the ability of the nurse to accurately "hear" the blood flow sounds when using the manual machine.
Yes, they are taught how to do this in nursing school but it really isn't that hard - and most people can learn how to do it.
Listening to the sounds gradually disappear through the stethoscope is critical to getting the blood pressure reading correct.
How does the patient know whether the nurse has any kind of hearing impairment or Tinnitus? The nurse may not even be aware of any hearing loss.
Perhaps this is one reason why blood pressure numbers can be so different from one doctor's office to another office.
It is only logical that there are nurses that have some degree of undiagnosed hearing loss - after all, nurses are people too, they listen to MP3 Players -sometimes too loud, they have been around loud lawnmowers, snow blowers, snowmobiles and more throughout their lives the same as the rest of the population.
Should nurses be required to have their hearing tested yearly - that would be an added expense for the doctor's office.
Or, wouldn't it be simpler to just use a high quality automatic blood pressure machine (powered by battery or electricity) that can't have hearing damage? There is something called age-related hearing loss - which means that as we age we are more likely to have developed some hearing loss.
But, I don't think it is necessarily advancing age that should ONLY be considered.
What about the younger nurses that went to loud clubs or rock concerts on weekends during college and perhaps still attend - I highly doubt that many wear hearing protection - and these very loud events can cause hearing damage.
A rock concert can register over 100-130 decibels.
A gunshot usually registers 120 to 150 decibels.
According to research published in Audiology, 2001, those people that were involved in leisure activities with loud noise, such as 90 dB or more, were much more likely to have acquired hearing loss than those that didn't participate in recreational/leisure activities with high noise levels.
Yellowstone safety officer, Brandon Gauthier advised employees "who drive the new four-stroke snowmobiles to wear earplugs because the machines are almost as loud as the two-stroke models, reaching a noise level of 111 decibels during acceleration.
Because the decibel scale is logarithmic, that's many times higher than the 85-decibel level at which medical experts advise the use of hearing protection" As for Personal Watercraft (PWC) such as jet skis (generic) the older Personal Watercraft (PWC) and two-stroke engines can attain extremely high noise levels, ranging from 85 to 102 decibels per unit, according to a 2005 Issue Summary for Colorado State Parks.
The American Hospital Association does recommend using hearing protection above 85 dB.
So, what does this tell us? NOT ONLY is our blood pressure reading dependent on the training of the nurse, but also partly dependent on the quality of hearing of the nurse taking the pressure with a manual machine.
There needs to be a discussion of this issue - no one seems to be paying attention to this question of accuracy.
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