title: Prehospital blood pressures: inaccuracies caused by ambulance noise?
abstract: Blood pressure measurements in a moving ambulance can be difficult to obtain. Sirens, engine noise, and road noise can all interfere with the accurate detection of a patient's blood pressure. This study was undertaken to determine the influence of ambulance noise and vibration on auscultated blood pressures. A model was developed that used dynamic pressures to simulate systolic Korotkoff sounds. Forty-nine emergency personnel were asked to obtain blood pressures using the model in both a quiet environment and in a moving ambulance. A total of 485 blood pressure measurements were obtained. Systolic pressures were randomized to two settings: 76 mm Hg and 138 mm Hg. Stationary readings were compared with moving readings using analysis of variance for repeated measures. Systolic blood pressure measurements obtained in the quiet environment averaged 133 +/- 5 mm Hg at the high setting, and 45 +/- 6 mm Hg at the low setting. Systolic blood pressure measurements obtained in a moving ambulance averaged 86 +/- 7 mm Hg at the high setting, and 41 +/- 7 mm Hg at the low setting. The average differences between quiet and moving measurements were 47 mm Hg at the "high" setting (P < .01) and 4 mm Hg at the "low" setting (P > .01). At physiological levels, blood pressures obtained in moving ambulances differ significantly from those obtained in a quiet environment, which may be caused by road noise and ambulance motion.
authors.affiliation: Division of Emergency Medical Services, East Carolina University School of Medicine, Greenville, NC 27858.
authors.forename: N H
authors.initials: NH
authors.lastname: Prasad
authors.forename: L H
authors.initials: LH
authors.lastname: Brown
authors.forename: S C
authors.initials: SC
authors.lastname: Ausband
authors.forename: O
authors.initials: O
authors.lastname: Cooper-Spruill
authors.forename: R G
authors.initials: RG
authors.lastname: Carroll
authors.forename: T W
authors.initials: TW
authors.lastname: Whitley
mesh_terms: D000552:Ambulances; D001314:Auscultation; D015982:Bias; D001795:Blood Pressure Determination / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D005069:Evaluation Studies as Topic; D006347:Heart Sounds; D006801:Humans; D008955:Models, Cardiovascular; D009624:Noise, Transportation; D015203:Reproducibility of Results; D013599:Systole; D014732:Vibration