Introduction

This report is based on the Omron 3 series upper arm blood pressure monitor. The device as the
name states plays an integral part in the daily management and monitoring of the chronic disease
hypertension, which is defined by World Health Organisation as a persistent elevated pressure in
the blood vessels. The device uses the oscillometric method where it detects the bloods
movement through the brachial artery and then converts it into a digital reading. This monitor
features an arm cuff that can fit arms up to 17 inches allowing a wide range of patients to utilise
it. The device produces an easily readable visual display with large font sizes, a background light
and labels to indicate the specific readings which is convenient for those patients who may be
visually impaired. The reading located at the top is known as the systolic blood pressure and this
is the blood pressure when the heart muscle contracts. The reading below the systolic blood
pressure is referred to as the diastolic blood pressure, and this is the blood pressure when the
heart relaxes. The device also features the pulse rate per min, which is the number of times the
heart beats in a minute. It has a large memory and it can compute up to fourteen readings at a
time which allows the patient to keep track of their results. A unique feature of this blood
pressure monitor is that it can detect irregular heartbeats, when the device detects an irregular
heartbeat occurring more than once during a blood pressure reading an irregular heartbeat
symbol appears (as seen in Figure 2) and this alerts the patient that they should seek medical
evaluation from their health care provider.

Figure 1 showing the device display screen (Taken from the Omron Manual)

Figure 2 showing the irregular heartbeat symbol (Taken from the Omron Manual)

Uses

The Omron 3 series upper arm blood pressure monitor is not only intended for patients with
hypertension but also for persons who may not yet be diagnosed with hypertension but who may
be in the pre hypertension range and are at a high risk of developing the condition. These patients
may use this device to monitor their blood pressure and employ various lifestyle modifications to
avoid developing hypertension. Persons who have already been diagnosed with hypertension can
use this blood pressure monitoring tool to gauge whether or not lifestyle modifications and the
appropriate medications have been successful. They can use the device determine whether or not
theyre on the right track towards their target goal which according to the more recent JNC 8
guidelines is a systolic blood pressure of less than 150 mm Hg and a diastolic blood pressure of
less than 90 mm Hg in patients sixty years and older and a systolic blood pressure of less than
140 mm Hg and a diastolic blood pressure of less than 90 mm Hg in patients less than sixty years
including those with diabetes and chronic kidney disease. This blood pressure monitor may also
be useful in patients experiencing hypotension which is abnormally low blood pressure levels
possibly due to illness or side effects of a medication, as well as persons who do not suffer from
any abnormal blood pressure levels but prefer to have regular check-ups to maintain their health
status.

Techniques for effective use

To obtain the most accurate results the patient must avoid certain activities that may produce
false results such as smoking (nicotine), the consumption of caffeine or alcohol, bathing or eating
thirty minutes before using the monitor. The patient should be at rest for at least 15 minutes and
any stressful situation should be avoided since stress is a known contributor to elevated blood
pressure levels. Additionally the patient should be seated quietly for a minimum of 5 minutes
with feet flat on the floor and the arm should be rested on a table so that the cuff is at heart level.

To use this monitor the patient must first ensure that the arm cuff is attached securely to the main
device. The patient should avoid any tight fitting clothing on the upper arm to prevent an
incorrect reading and place the cuff on the upper arm, ensuring that the arrow on the cuff is
placed directly at the center of the arm and that it is in line with the middle finger. Ensure that the
bottom of the cuff is approximately one to two cm above the elbow.

After ensuring that the cuff is firmly in place using the cloth fastener, sitting with feet flat on the
floor and arm at heart level, press the start button and the cuff will automatically start inflating.
The inflation then stops automatically and the measurement is recorded. When the measurement
is finished recording the cuff automatically deflates completely and both blood pressure and the
pulse rate are displayed.
Figure 3 showing the correct position to take blood pressure measurements (Taken from the
Omron Manual)

When the measurement is complete, the heartbeat symbol/hypertension indicator flashes on the
screen along with the blood pressure and pulse rate if the reading for the systolic blood pressure
is above 135 mm Hg and the diastolic blood pressure is 85 mm Hg or above.
Figure 4 showing the heartbeat symbol/hypertension indicator (Taken from the Omron Manual)

The patient should attempt to measure blood pressure at the same time each day as well as use
the same arm to maintain consistency with the results. The patient should keep a journal or diary
of all the blood pressure measurements which can be presented to their health care provider to
determine and assess whether current management is successful or not.
Figure 5 showing the interpretation of blood pressure levels (Taken from the American Heart
Association guidelines)

Pharmacist skills needed

A pharmacist can play an important role in educating a patient with hypertension and therefore
needs to meet certain requirements to assess the patients ability to use the blood pressure
monitor to ensure that the patient obtains the best and most accurate results from the device. A
pharmacist should first ensure that they are knowledgeable on the device and that the information
being given to the patient is accurate. Communication is very important in terms of patient
counselling, a pharmacist must use the appropriate vocabulary when explaining the proper
technique of using the blood pressure monitor to a patient. Complicated terms and medical
jargons may overwhelm the patient and prevent them from fully understanding how to use the
device. The pharmacist should use terms that the patient already knows or fully explain new
terms so the patient can learn them.

The pharmacist should make certain that important points on obtaining the best results are
reinforced for example as mentioned above the patient must avoid certain activities that may
produce false results such as smoking (nicotine), the consumption of caffeine or alcohol, bathing
or eating thirty minutes before using the monitor.

An effective way of explaining the technique to a patient is to demonstrate the method so that the
patient has a visual idea of how it should be done. The patients understanding should be checked
by asking open ended questions and allowing them to ask questions as well. Another effective
method is asking the patient to restate what they understood in their own words, this can allow
the pharmacist to explain points that may not have been fully grasped. The pharmacist should
also ensure that the patient feels comfortable with calling or returning to the pharmacy if any
problem arises.

And finally the pharmacist should educate the patient on lifestyle modifications such as diet,
weight loss, exercise, smoking cessation and restriction of alcohol. The pharmacist can also
explain the significance of various blood pressure levels and encourage patients to keep a journal
and record their blood pressure at the same time each day as well as emphasise medication
adherence. Therefore as the patient gains confidence in their abilities in measuring their blood
pressure levels, managing lifestyle changes and medications better therapeutic outcomes can be
expected.

REFERENCES

Omron Healthcare Blood Pressure Monitor BP710 User Guide | ManualsOnline.com

[Internet]. ManualsOnline.com. 2017 [cited 19 February 2017]. Available from:
http://personalcare.manualsonline.com/manuals/mfg/omron_healthcare/bp710.html

Understanding Blood Pressure Readings [Internet]. Heart.org. 2017 [cited 19 February

2017]. Available from:
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPres
 sure/Understanding-Blood-Pressure-
Readings_UCM_301764_Article.jsp#.WKxo1fkrK00

Armstrong C. Practice Guidelines: JNC8 Guidelines for the Management of

Hypertension in Adults - American Family Physician [Internet]. Aafp.org. 2017 [cited 19
February 2017]. Available from: http://www.aafp.org/afp/2014/1001/p503.html