Get a wrist cuff. Easier.I do a blood pressure if one hasn't been documented in the chart recently. One of these days I'll get a stethoscope to replace the one I lost halfway thru intern year to just do it manually since my auto-cuff gives crappy readings on anyone with a large arm.
It's not easier because you have to be even more attentive to positioning than with a brachial monitor. But I guess it could save having to buy a larger brachial cuff. They're so inexpensive that I don't see the issue with having multiple cuffs.Get a wrist cuff. Easier.
yes all the points you make are important in making an actual diagnosis of hypertension, it definitely isn't done on a spot readingIt's not easier because you have to be even more attentive to positioning than with a brachial monitor. But I guess it could save having to buy a larger brachial cuff. They're so inexpensive that I don't see the issue with having multiple cuffs.
But a single spot reading with a wrist monitor with a high degree of variability in positioning seems nearly useless to me. There is already blood pressure variation during a day to begin with that I'm not sure any singular reading is useful by itself, but the wrist especially so.
I've found that some nurses do not take blood pressure properly (don't support the arm, take it immediately after patient sits down) and also will sometimes jab a thermometer in your mouth at the same time as starting BP measurement and a pulse ox on the hand of the arm the BP is taken on (the perfusion index of the hand of the arm where BP is being taken will drastically reduce making the pulse ox reading less reliable). This makes all the readings haywire, as the thermometer is nearly falling out of the mouth and the patient may have to adjust to keep it from falling out.
I've found that for myself using an Omron 10 786n brachial monitor, I can get consistent results per situation because I can control for factors such as proper positioning, arm support, sitting upright for several minutes quietly without a lot of other prodding etc. I'm also able to experiment to see how different factors affect BP readings. I may be a bit obsessive in how many readings I've taken, but having taken a large number of readings in various settings (lying, sitting, standing; immediately after change in posture vs. waiting; arm level) has made me not take a great deal of stock in a single reading taken at a doctor's office when a lot of weird variables are at play. There is consistency in how those variables affect BP, but knowing my range is more important to me when deciding on treatment than a single reading.
Some articles about recent research on BP range and its relevance to stroke:
High blood pressure: New research suggests see-sawing readings are the key danger sign for strokes... | Daily Mail Online
Blood pressure changes before stroke