Special Situations - Riester ri-medic Instructions D'utilisation

10. SPECIAL SITUATIONS

Unique circumstances, such as the patient's age or physiological disturbances, require you to take special care while measu-
ring blood pressure or vital signs. The more common examples of such circumstances are described here, to assist you in
using your Riester ri-medic 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.
a.) 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 rest-
less in a clinical situation, further increasing the potential for variability.
b.) 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 erro-
neously 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.
c.) 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 Riester
ri-medic on a patient with known arrhythmia, we recommend that you follow up with a Manual mode BP reading as
a confirmatory measure.
In patients with severe regular bradycardia, take Manual mode rather than automatic readings.
d.) Measuring Blood Pressure During Pregnancy
Hypertension is a common medical disorder of pregnancy, occurring in about ten percent of pregnancies. Detection of eleva-
ted blood pressure is essential to optimal prenatal care.
For clinically relevant hypertension in pregnancy, use the Riester ri-medic to take a Manual mode measurement.
e.) 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.
f.) Measuring Blood Pressure in the Emergency Room
Measuring blood pressure in the emergency room can be done through automated blood pressure measurements. For critc-
cally ill or injured patients, blood pressure should be measured through the invasive arterial pressure method.
g.) Measuring Blood Pressure in the Presence of Orthostatic Hypotension
Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mmHg or more or diastolic blood pressure of
10 mmHg or more measured after three minutes of standing up from a supine position. Food ingestion, time of day, age, and
hydration can impact this form of hypotension, as can a history of Parkinsonism, diabetes, or multiple myeloma.
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