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February 2, 2005

BehindTheMedspeak: 'A man with one sphygmomanometer always knows his blood pressure; a man with two is never sure'

Ew3002w

Originally said of a guy with more than one watch or clock, it applies equally well to measuring anything: use one device, get a number, that's the result; use two devices, you'll almost always get two different numbers - sometimes varying by a lot - and then what do you do?

Who ya gonna believe - me, or your lying-eyes sphygmomanometer?

So let us explore for a moment home blood pressure measurement.

So-called "white coat hypertension" - the phenomenon whereby simply entering a doctor's office raises one's otherwise perfectly normal blood pressure to a level requiring treatment - is a real entity.

So what to do?

Obviously: take your blood pressure at home, where you're nice and relaxed.

But how can you be sure the numbers you get are valid?

Well, that's why you pay me the big bucks, isn't it?

I mean, if you didn't feel you were getting the best medical advice money can't buy you'd be outa here in a New York minute.

So I'm here to report that there is excellent - and for a change, relatively economical news - on the blood pressure front.

No $125,000 devices here today, no ma'am.

Rather, I present a most excellent, beautifully engineered wrist sphygmomanometer (top) from Panasonic ($60 list).

Their great engineers have taken the cumbersome apparatus used to measure blood pressure, shrunk it into a little box and made it easy to use by anyone who can push a button - that, to me, is wizardry.

You push the yellow button, the cuff squeezes your wrist and then deflates, showing your blood pressure in a nice, easy-to-read digital readout along with your heart rate.

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It measures 2.5" x 2" x 1"; uses two AAA batteries.

It's model number EW3002W; Amazon sells it for $42.

But is it valid, the blood pressure you see?

Unequivocally, yes.

I took my little Panasonic into the OR last year and put it on the wrist of my patients, on the same arm on which I put my professional-grade anesthesia machine blood pressure cuff which, by the way, costs around $5,000 (that's for the cuff and the blood pressure machine, booboo; what, you thought the cuff alone was 5K? Hey, I know hospital charges are inflated, but that's a bit too rich).

As soon as the anesthesia machine value came up on my monitor screen, I pushed the little button on my Panasonic and then recorded both readings on a flow chart I'd created.

My conclusion after doing this informal study on six or seven patients was that the Panasonic is accurate, reliable and in fact better than the medical-grade equipment I use in two areas:

1) It's much easier to use: goes on in a couple seconds, as opposed to screwing around trying to get the blood pressure cuff and Velcro seal positioned just so, and then having to move the long rubber connecting tube to the anesthesia machine out of the way.

2) It's much faster: a reading from the Panasonic takes about 30 seconds from button push to obtaining a value; the anesthesia version takes 1-2 minutes, sometimes even longer.

I keep my little Panasonic in my fanny pack when I'm in the OR, 'cause you just never know when your monitor's gonna crash.

Panasonic's also recently come out with a more tricked-out version (below),

Ew3032s

model number EW3032, with colored lights and all, for $80; same basic design.

I see where Oregon Scientific's gotten in the game as well with the device below ($80).

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I can't speak to its quality or reliability.

However, I note that it measures 4" x 3.5" x 2", about twice the size of the Panasonic in every dimension.

That's a lot more bulk.

Especially if you use the device as I do at home, for playing around with biofeedback and seeing if by relaxing, I can lower lower my heart rate and blood pressure.

I sometimes lie comfortably in my best reading spot (below - indentation in red cushion is where my head goes)

Bestreadingspot_2

with the Panasonic on my wrist and every now and then push the button to amuse myself.

Hey - everyone's got their own idea of fun, OK?

Live and let live, I say.

February 2, 2005 at 03:01 PM | Permalink


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Comments

Gee, I expected the dent in the pillow to be bigger.

Posted by: ScienceChic | Feb 4, 2005 7:35:03 PM

As an ER doc, I hate those things. We get a good number of people who come in because their el cheapo home BP machine reads high. They never have any symptoms other than "My machine read high." To top it off, usually their pressure is fine when they get to the ER.

Posted by: Jeremy | Feb 3, 2005 11:02:50 PM

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