UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
Page 1 of 15
Valid for:
2 years from
approval
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
Valid for:
2 years from
approval
1. Scope
This Standard Operating Procedure (SOP) applies to the staff and students using the
OneCHECK Automatic Sphygmomanometer in the Pharmacy Practice Resource Unit
(PPRU) at the Pharmacy Department, University of Malta.
2. Objective
To describe the procedure for set-up, operation, recording and recalling of results and
troubleshooting of the OneCHECK Automatic Sphygmomanometer.
3. Definitions
3.1.
Blood Pressure (BP): Pressure exerted on the artery tube while blood flows
through the arteries.
3.2.
Cuff: Band wrapped around the arm to restrict blood flow during BP
measurement. The cuff is suitable for use if the arrow falls within the solid
colour line. If the arrow falls outside the solid colour line, a cuff with another
circumference is needed. The colour strip indication should be positioned
closer to the elbow with the tube pointing in the direction of the arm.
3.3.
Diastolic BP: Minimum pressure in the arteries when the heart is at rest.
3.4.
Main artery: The aorta; it originates from the left ventricle and extends
downwards to the abdomen where it branches into smaller arteries transporting
oxygenated blood to all the body. It is located by pressing two fingers
approximately 2cm above the bend of the elbow on the inside of the left arm;
where the pulse is felt to be the strongest, the main artery is present.
3.5.
ON/OFF/START key: Once pressed, all digits will light up, checking the
display functions. The checking procedure will be completed in a few seconds.
The last measurement values will be shown and after all the symbols appear on
the display, a beep will alert the user to take the measurement.
3.6.
Pulse Rate: Number of pulsations noted in a peripheral artery per unit of time.
3.7.
Systolic BP: Maximum pressure being exerted when the heart is contracting.
Page 2 of 15
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
Valid for:
2 years from
approval
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
3.8.
WHO BP Classification
Low BP
Systolic
Diastolic
<100
<60
Normal BP
(Green)
100-139
60-89
Types of High BP
Mild
Medium
Serious
(Yellow)
(Orange)
(Red)
140-159
160-179
≥180
90-99
100-109
≥110
4. Responsibility
4.1.
The members of the Department of Pharmacy (staff and students) are
responsible for following this SOP.
4.2.
The designated Laboratory Officer or Laboratory Assistant is responsible for
ensuring that this SOP is followed.
5. Procedure
5.1.
Diagram of OneCHECK Automatic Sphygmomanometer
a: Cuff
b: Pulse rate
c: Pulse indicator
d: ON/OFF/START Key
e: Diastolic BP
f: Systolic BP
Page 3 of 15
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
5.2.
Set-up
5.2.1.
5.2.2.
5.2.3.
5.2.4.
5.3.
Press down and lift the battery cover to open the battery compartment.
Install or replace 4 “AA” sized batteries in the battery compartment.
Click in the bottom hooks first to replace the battery cover.
Push in the top end of the battery cover.
Applying the Cuff
5.3.1.
5.3.2.
5.3.3.
5.3.4.
5.3.5.
5.3.6.
5.3.7.
5.3.8.
5.3.9.
5.4.
Valid for:
2 years from
approval
Plug the cuff connecting tube into the unit.
Wrap the cuff around the arm.
Put left arm through the cuff loop.
Turn left palm upwards and place the edge of the arm cuff at
approximately 1.5 to 2.5cm above the inner side of the elbow joint
(SOP/PD/236_01/A1a).
Tighten the cuff by pulling the end of the cuff (SOP/PD/236_01/A1b).
Centre the tube over the middle of the arm.
Press the hook and loop material together securely allowing room for 2
fingers to fit between the cuff and the arm; Position the artery mark
over the main artery on the inside of the arm.
Centre the tube over middle of the arm.
Lay arm on a table, palm upwards, so that the cuff is at the same level
as the heart (SOP/PD/236_01/A2) ensuring that the tube is not kinked.
Measurement procedures
5.4.1.
5.4.2.
5.4.3.
5.4.4.
Press the ON/OFF/START key.
Allow cuff to inflate when the monitor is “Ready to measure” and a
flashing “0” appears on the LCD screen.
Allow the arm band to deflate after another beep is heard which
indicates that the measurement has finished.
Record the systolic pressure, diastolic pressure and pulse rate which
would be shown simultaneously on the LCD screen.
Page 4 of 15
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
5.5.
Valid for:
2 years from
approval
Troubleshooting
Symptoms
No display when the
ON/OFF/START key is
pressed
Control
Have the batteries run
down?
Are
the
batteries
positioned the wrong
way round?
EE mark shown on Is the cuff placed
display or the blood correctly?
pressure
value
is
displayed
excessively Did patient talk or
low (high)
move?
Was the cuff shaken
when measuring?
Refer to SOP/PD/236_01/A3.
Page 5 of 15
Correction
Replace them with new
alkaline batteries.
Re-insert the batteries in
the correct positions.
Wrap the cuff properly
so that it is positioned
correctly.
Measure again, staying
still. Keep the wrist
steady
during
measurement.
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
5.6.
Flow Charts
5.6.1.
Set-up
Start
Press down and lift the battery cover to open
the battery compartment
Install or replace 4 “AA” sized batteries in the
battery compartment
Click in the bottom hooks first to replace
battery cover
Push in the top end of the battery cover
End
Page 6 of 15
Valid for:
2 years from
approval
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
5.6.2.
Applying the cuff
Start
Plug the cuff connecting tube into the device
Wrap cuff around the arm
Put left arm through the cuff loop
Turn left palm upwards and place the edge of the arm cuff at
approximately 1.5-2.5cm above the inner side of the elbow joint
(SOP/PD/236_01/A1a)
Tighten the cuff by pulling the end of the cuff
(SOP/PD/236_01/A1b)
Centre the tube over the middle of the arm
Press the hook and loop material together securely allowing
room for 2 fingers to fit between the cuff and the arm; Position
the artery mark over the main artery on the inside of the arm
Centre the tube over the middle of the arm
Lay arm on a table (palm upwards) so the cuff is at the same
level as the heart (SOP/PD/236_01/A2)
End
Page 7 of 15
Valid for:
2 years from
approval
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
5.6.3.
Measurement procedures
Start
Press the ON/OFF/START key
Allow cuff to inflate when the monitor is
“Ready to measure” and a flashing “0” appears
on the LCD screen
Allow the arm band to deflate after another
beep is heard which indicates that the
measurement has finished
Record the systolic pressure, diastolic pressure
and pulse rate which would be shown
simultaneously on the LCD screen
End
Page 8 of 15
Valid for:
2 years from
approval
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
Valid for:
2 years from
approval
6. Precautions
6.1.
6.2.
6.3.
6.4.
6.5.
6.6.
6.7.
6.8.
6.9.
Replace the batteries when the low battery icon appears on the display
(SOP/PD/236_01/A3) or when the ‘ON/OFF/START’ key is pressed and
nothing appears on display.
Do not use rechargeable batteries.
Remove the batteries from the device if it is not being used for a long time.
The memory is not cancelled when the batteries are removed.
Ensure that the tube is not kinked when the cuff is being applied.
Ensure that the measurement is taken in a silent room, while not talking or
moving and at least an hour after consuming a large meal.
Do not use the device on patients under 12 years of age.
Do not use thinner, alcohol or petrol to clean the monitor and cuff; Use only a
slightly damp, soft cloth.
Do not drop or shake the unit.
Avoid exposure of the unit to extreme temperatures, humidity, direct sunlight
and dust since the unit contains high-precision components which may be
affected.
7. Reference
OneCHECK® Automatic Arm Blood Pressure Monitor Instruction Manual. Italy:
Artsana Group Pic Solution; 2010.
Page 9 of 15
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
Valid for:
2 years from
approval
8. Appendices
SOP/PD/236_01/A1a – Diagram of application of the cuff on the arm (1)
SOP/PD/236_01/A1b – Diagram of application of the cuff on the arm (2)
SOP/PD/236_01/A2 – Diagram of the cuff at the same height as the heart
SOP/PD/236_01/A3 – Table with icons and their cause/action
9. Revision History
Version Number
01
Amendments/ Reasons for change
Initial Release
Page 10 of 15
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
Valid for:
2 years from
approval
SOP/PD/236_01/A1a – Diagram of application of the cuff on the arm (1)
Page 11 of 15
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
Valid for:
2 years from
approval
SOP/PD/236_01/A1b – Diagram of the application of the cuff on the arm (2)
Page 12 of 15
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
Valid for:
2 years from
approval
SOP/PD/236_01/A2 – Diagram of the cuff at the same height as the heart
Page 13 of 15
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
Valid for:
2 years from
approval
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
SOP/PD/236_01/A3 – Icons and their cause/action
Icons
Cause/Action
Low battery indicator: appears when
batteries should be replaced
Management error: Ensure the plug is
securely connected to the air socket and
measured again calmly. Wrap the cuff
correctly and keep arm steady during
measurement. If error keeps occurring, return
the device to the local agent.
Air circuit anomaly: Ensure the plug is
securely connected to the air socket and
measure again calmly. If error keeps
occurring, return the device to the local
agent.
Pressure exceeding 300mmHg: Switch the
unit off and measure again quietly. If error
keeps occurring, return the device to the local
agent.
Data Error: Remove the batteries, wait for
60 seconds, and reload. If error keeps
occurring, return the device to the local
agent.
Page 14 of 15
UNIVERSITY OF MALTA
FACULTY OF MEDICINE & SURGERY
PHARMACY DEPARTMENT
Ref. No.
SOP/PD/236_01
STANDARD OPERATING PROCEDURE
ONECHECK AUTOMATIC
SPHYGMOMANOMETER
Valid for:
2 years from
approval
Exceeding Measurement Range: Measure
again calmly. If error keeps occurring, return
the device to the local agent.
Calibration Indicator: Appears when the
monitor
requires
re-calibration.
Recalibration recommended.
Page 15 of 15