OBJECTIVE:To identify possible causes of inaccuracy in the use of the Hawksley random-zero sphygmomanometer and methods that could reduce this.

METHODS:Four Hawksley random-zero sphygmomanometers were compared with a standard sphygmomanometer under static conditions. Two methods (standard and rapid) were used to release pressure from the inflated cuff with pressures recorded by independent blinded observers. The rate at which the hand valve released pressure was analysed. The effects of varying filling times and pressures on the size of the final zero correction were investigated.

RESULTS:The Hawksley devices all under-recorded pressure compared with that measured by using a standard machine. A rapid means of pressure release approximately halved this error in each case. Pressure release through the hand valve was shown to have a characteristic and prolonged exponential decay. Using low filling times and pressures reduced the observed range of zeros seen, with the production of a correlation between the size of the zero and the inflation pressure used.

CONCLUSION:These findings suggest that overestimation of the final zero correction is a common and major source of error in the use of the Hawksley sphygmomanometer. A simple change in the design of the final pressure release would improve the machine's reliability in clinical usage. The machine's zero mechanism is susceptible to unintentional misuse. Such misuse could occur when the machine is used in accordance with current sphygmomanometry guidelines.

译文

目标:确定使用Hawksley随机零血压计的可能原因以及可以减少这种误差的方法。

方法:四个Hawksley随机在静态条件下,将零血压计与标准血压计进行了比较。两种方法(标准方法和快速方法)用于释放充气袖带中的压力,并由独立的盲人观察员记录压力。分析手动阀释放压力的速率。研究了不同的填充时间和压力对最终零校正量的影响。

结果:与采用标准方法测得的压力相比,Hawksley设备的压力均低于记录值机器。在每种情况下,快速的压力释放方式几乎都会使这一误差减半。已显示通过手动阀释放压力具有特征性和长时间的指数衰减。使用较低的填充时间和压力会减小观察到的零位范围,并在零位大小和所用充气压力之间产生相关性。

结论:这些发现表明最终零校正的高估是使用Hawksley血压计的常见且主要的误差来源。最终压力释放设计的简单更改将提高机器在临床使用中的可靠性。机器的调零机构容易被误用。按照当前的血压计指南使用机器时,可能会发生这种误用。

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