title: Hidden errors of aneroid sphygmomanometers.
abstract: BACKGROUND
  Measurement of blood pressure remains the most commonly performed screening test in medical practice. With the likely removal of mercury sphygmomanometers from the workplace alternative devices are required. Of these the aneroid sphygmomanometer is popular both in the community and hospital setting. We investigated the accuracy of all the aneroid and mercury sphygmomanometers during dynamic calibration within a tertiary referral maternity hospital.
  
  
  METHODS
  We compared the accuracy of 39 aneroid and 36 mercury sphygmomanometers to a recently calibrated and serviced mercury sphygmomanometer (the accepted gold standard). All devices were in current clinical use. Using three blinded, trained observers, 30 different pressures were checked throughout the pressure range following British Hypertension Society protocol guidelines.
  
  
  RESULTS
  Only 31 (86%) of the mercury devices and 36 (92%) of the aneroid devices were in adequate working condition and suitable for analysis. Significantly more aneroid devices had systematic errors of > 5 mmHg (19 versus 3%, < 0.05). Fifty percent of aneroid devices had at least one reading > 10 mmHg out compared to only 10% of mercury devices (chi square programme).
  
  
  CONCLUSIONS
  Aneroid sphygmomanometers in apparent good working order are inaccurate compared to mercury devices. Some of these faults can only be detected during dynamic testing. To minimize the risk of erroneous blood pressure recording, aneroid devices should be regularly checked for accuracy using dynamic calibration methods as recommended in validation protocols.
authors.affiliation: Department of Obstetrics and Gynaecology, Leicester-Warwick Medical School, Leicester Royal Infirmary, Leicester, UK.
authors.forename: Jason J S
authors.initials: JJ
authors.lastname: Waugh
authors.forename: Manesh
authors.initials: M
authors.lastname: Gupta
authors.forename: Julie
authors.initials: J
authors.lastname: Rushbrook
authors.forename: Aidan
authors.initials: A
authors.lastname: Halligan
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Shennan
mesh_terms: D000328:Adult; D001795:Blood Pressure Determination / Q000295:instrumentation; D002138:Calibration; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D015588:Observer Variation; D011225:Pre-Eclampsia / Q000175:diagnosis; D011247:Pregnancy; D019722:Sphygmomanometers / Q000592:standards*