Patient Monitoring; Nibp Measurement - Riester RVS-100 Manual Del Usuario

5. Patient Monitoring

5.1 NIBP Measurement

The monitor uses the oscillometric method for measuring NIBP. It
is applicable for adult, pediatric and neonatal patients. It is not ap-
plicable for pregnant or pre-eclamptic patients.
The oscillometric method indirectly estimates the systolic and di-
astolic pressures within the blood vessels by measuring pressure
change within the blood pressure cuff. The device senses pressure
waves in the artery when occluded by pressure in the cuff and cal-
culates the average pressure.
NIBP measurement is suitable for use during electrosurgery and
during the discharge of a cardiac defibrillator according to IEC
80601-2-30.
A physician must determine the clinical significance of the NIBP
measurement.
5.1.1 Safety Information
Warnings:
• Check the patient category before monitoring. Incorrect
settings may result in some risk for patient safety. For
example, higher alarm-level settings for adults are not
suitable for pediatric and neonatal patients.
• Do not measure NIBP on patients with sickle-cell disease
or any condition in which skin damage has occurred or is
expected.
• Use clinical judgment to decide whether to perform fre-
quent Auto BP measurements on patients with severe
blood clotting disorders because of the risk of hematoma
in the limb fitted with the cuff.
• Use clinical judgment to decide whether to perform Auto
BP measurement on patients with thrombasthemia.
• Do not use the NIBP cuff on a limb with an intravenous in-
fusion or arterial catheter in place. This could cause tissue
damage around the catheter when the infusion is slowed
or blocked during cuff inflation.
• If you doubt the NIBP measurements, check the patient's
vital signs using another device, and then check the mo-
nitor.
• The NIBP measurement function must be calibrated re-
gularly for safe use.
• The performance of the automated sphygmomanometer
can be affected by extremes of temperature, humidity and
altitude.
• Avoid compression or restriction of the connection tubing,
or the measurement result will be wrong, which may mis-
lead the doctor to make wrong diagnosis, patient may be
hurt.
• When patients cannot take care of themselves, there must
be an operator standing by during auto mode measure-
ment.
• The environmental or operational factors which can affect
the performance of the NIBP module and its BP reading :
◊ Avoid compression or restriction of pressure tubes. Air
must pass unrestricted through the tubing.
◊ The bladder of the cuff is not folded or twisted.
◊ A wrong cuff size, and a folded or twisted bladder, can
cause inaccurate measurements
◊ Do not wrap the cuff too tightly around the limb.
• Continuously high cuff pressure due to compressed or
bent tubing, may have the effect of blood flow interference
and may result in harmful injury to the patient.
• Do not use the cuff over a wound, as this can cause further
injury.
• A pressurized cuff can temporarily cause loss of function
of simultaneously used monitoring equipment on the
same limb.
• Do not use the NIBP cuff on the arm of a mastectomy pa-
tient, we suggest measuring blood pressure on their legs.
• Pressurization of the cuff can temporarily cause loss of
function of simultaneously used monitoring ME EQUIP-
MENT on the same limb.
• The application of the cuff and its pressurization on any
limb where intravascular access, therapy, or an arterio-
venous(A-V) shunt is present, temporary interference to
blood flow and could result in injury to the patient.
• Check the operation of the automated sphygmomanome-
ter regularly to make sure that it does not result in pro-
longed impairment of the circulation of the blood of the
patient.
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5.1.2 NIBP Measurement Limitations
Accurate NIBP measurements cannot be taken when the heart rate
is extremely low (less than 40 bpm) or extremely high (greater than
240 bpm) or if the patient is on a heart-lung machine.
Accurate measurement also cannot be taken when the following
conditions exist:
• excessive and continuous patient movement such as shi-
vering or convulsions;
• difficulty detecting a regular arterial pressure pulse;
• cardiac arrhythmias;
• rapid blood pressure changes;
• severe shock or hypothermia that reduces blood flow to
the peripheries;
• an edematous extremity.
5.1.3 NIBP Measurement Modes
There are four modes of measuring NIBP:
• Manual: a single measurement on demand.
• Auto: continuous repeated measurements with a set in-
terval.
• STAT: rapid series of measurements over a five-minute
period. For use only on supervised patients.
• Averaging: a set number of measurements taken and ave-
raged.
5.1.4 NIBP Monitoring Procedure
Preparing to Measure NIBP
1. Encourage the patient to be still and quiet.
2. Check the patient category. If you want to change the patient
category, select to enter the [Patient Info]
the desired patient category.
3. Select the appropriate cuff according to patient size.
• Check the limb circumference of the patient. (Use the up-
per arm or thigh.)
• Select the appropriate cuff. (The applicable limb circumfe-
rence for the cuff is marked on the cuff). The width of the
cuff should be about 40% of the limb circumference (50%
for neonates), or 2/3 of the upper arm's length. The inflata-
ble part of the cuff should be long enough to encircle 50%
to 80% of the limb.
Note:
• BP measurement accuracy depends on a properly fitted
cuff.
• The following steps should be taken to obtain accurate rou-
tine resting blood pressure measurements for the condition
of hypertension , including:
1) Comfortably seated
2) Legs uncrossed
3) Feet flat on the floor
4) Back and arm supported
5) Middle of the cuff at the level of the right atrium of the
heart.
6) The patient should relax as much as possible and not talk
during the measurement procedure.
7) 5 min should elapse before the first reading is taken;
8) The operator is suggested standing on the right side of the
monitor in normal use.
4. Confirm the cuff has been entirely deflated.
5. Connect one end of the BP cable to the cuff air tube and the
other end to the monitor's NIBP connector. Gently push the tip
of the BP cable over each socket to click the cable securely
in place.
6. Wrap the cuff snugly around the upper arm or thigh of the
patient. On the arm, the bottom of the cuff should be approxi-
mately 1 inch above the elbow joint. Ensure the Artery Marker
menu. Select