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15 Monitoring Noninvasive Blood Pressure (NIBP)
15.1 NIBP Introduction
• Blood pressure measurements determined with this device are equivalent to those obtained by a
trained observer using the cuff/stethoscope auscultatory method or an intra-arterial blood pressure
measurement device, within the limits prescribed by the American National Standard: manual,
electronic, or automated sphygmomanometers.
• NIBP measurement can be performed during electro-surgery and discharge of defibrillator.
15.2 NIBP Safety Information
• Be sure to select the correct patient category setting for your patient before NIBP measurement. Do
not apply the higher adult settings for pediatric or neonatal patients. Otherwise, it may present a
safety hazard.
• Do not perform NIBP measurements on patients with sickle-cell disease.
• To avoid further injury, do not apply the NIBP cuff on the limb with a wound.
• Use clinical judgment to determine whether to perform frequent unattended blood pressure
measurements on patients with severe blood clotting disorders because of the risk of hematoma in
the limb fitted with the cuff.
• To avoid the risk of patient injury, do not apply the NIBP cuff on a limb that has an intravenous
infusion or catheter in place. Apply the cuff on another limb if possible.
• Do not apply cuff on the arm on the side of a mastectomy or lymph node clearance.
• Continuous cuff pressure due to connection tubing kinking may cause blood flow interference, and
resulting in harmful injury to the patient.
• NIBP reading can be affected by the measurement site, the position of the patient, exercise, or the
patient's physiologic condition. If you doubt the NIBP measurements, determine the patient’s vital
signs by alternative means, and then verify that the monitor is working correctly.
• Taking NIBP measurements exert pressure on the patient's tissue. This can cause skin purpura,
ischemia, and neuropathy. Periodically check the cuff site and the limb distal to the cuff for normal
color, warmth and sensitivity. If there is a sign of skin change or poor distal circulation, move the cuff
to another limb or stop NIBP measurements. Check more frequently when using the STAT mode or
using the auto mode at short intervals. Auto NIBP measurements with one and two minute intervals
are not recommended for extended periods of time.
• NIBP diagnostic significance must be decided by the physician.
• Using IABP may cause NIBP, including PR, measurements inaccurate or failed.
• Accuracy of NIBP measurement depends on using a cuff of proper size. It is essential to measure limb
circumference and choose a cuff with proper size.
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