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REVIEW: Terumo Elemano Digital Blood Pressure Monitor from QuickMedical

December 7, 2010

It was my first clinical placement. Somehow, a classmate and I wound up being assigned to a Family Doctor who had recently converted his practice to mainly cosmetic dermatology. Eager to teach us some clinical skills – and perhaps a little embarrassed at not be a ‘true’ GP  – he found a friendly, elderly, moley patient to let us experiment on. We were to start our learning by taking this fellow’s blood pressure. As my classmate remarked in his Valedictorian speech, we have really grown since those days, when it *snicker* it took two of us to figure out how to even put the cuff on, never mind perform the whole ‘operation’ of sphygmomanometry (Blood Pressure measurement).

Yes, that’s a real word. As “Mr. Always Prepared for Everything Guy” knows, you’ve gotta have a sphygmomanometer:

I actually didn’t own one until this year although I’ve found myself wishing I had one in a few places (Northern India, rural BC, house visits in my current town); I was sent one for review and have actually found occasion to use it. The company that provided it, QuickMedical, is a medical equipment and supplies source for healthcare providers; they’ve got everything from parallel bars (for physiotherapy), to exam gloves of every description, to super-cute pediatric reflex hammers.

NB: the sphygmomanometer was provided to me by QuickMedical for free for the purposes of this review

Product: Terumo ESH5503 Elemano Digital Blood Pressure Monitor
Manufacturer: Terumo Medical
Cost: 187.50$ USD            Availability:
Function: measures blood pressure and pulse in Automatic, Slow, and Auscultation modes
Best for: Family Doctors, anyone doing mobile medicine/home visits, doctors who don’t trust most digital monitors but want the benefits of one

In the office, I use a traditional mercury (or equivalent) manual sphygmomanometer. I am like many older doctors in that I rarely trust a digital reading. I’m often called to assess a patient with “no blood pressure” in the hospital, and when I find out it was the digital monitor that got this value, I proceed directly to manual reading, which usually solves the problem! I often get patients to bring in their BP monitor to compare with my manual one, if it seems they have some spurious readings.  While the manuals are pretty accurate if calibrated, it can be difficult to control the rate at which the cuff releases. Though it should be at 2-3mmHg/s, many of us rush this, probably rendering our measured BP values somewhat inaccurate.

Likes:

What I absolutely love about this device is that I can get the benefits of accurate measurement of a digital readout, careful decompression of the cuff, and the reassurance of auscultation mode. It’s really a hybrid of the manual and automatic digital realms, with three modes that provide a lot of flexibility in function. If I’m being lazy, the Automatic Mode seems to be accurate when compared to the manual auscultation mode. There was, although likely funded by the manufacturer and not very carefully designed, a study about the ESH5503’s accuracy.

There’s even a Slow Mode for patients you know are hypertensive. The Auscultation Mode also visually displays the pulse. This. which in a way mimics the flicker of a mercury sphygmomanometer’s needle, might be handy in patients with faint pulses or if you’ve got bad ears!

The device itself has a good feel to it; having the readout at the pump is more helpful than I thought it would be. With one ‘A’ battery and plastic casing, it’s much lighter than the average dial-mounted-on-pump manual machine. There are no tangled cords and no looking away from what you are doing to turn awkwardly in order to view the gauge on the wall. The cuff inflates as you pump it, meaning that it doesn’t automatically go to 200 mmHg right off the bat; this is important for patient comfort. It will beep and the screen will display “LOW” if you haven’t pumped it high enough to get the Systolic BP. When it gets the diastolic reading, it deflates quickly or you can hold the EXH button to deflate quickly. This too is ideal for comfort.

If you are getting fancy and trying to look for pulsus paradoxus this cuff will work. I didn’t have any patients with a Korotkoff gap to test the Elemano on, but I imagine that the functionality would be appropriate.

Support is more than expected; the device comes with clear instructions and trouble-shooting advice. They even have a tech hotline, but I didn’t try it out since nothing has seemed to go wrong yet!

Dislikes:

This is a pretty well-designed machine, so it’s hard to critique. I will say that the price puts it out of the range of the average hypertensive patient, but I don’t think they are the target market. Cost might seem a bit much for health care professionals, but you do get what you pay for. I don’t think the average consumer would require a device like this, because the cuff is not designed to be self-applied (though it could be, and it’s not that hard), and the Auscultation Mode would be superfluous. The cuffs are also proprietary, so I don’t think it would be easy to find cheap replacement or disposable cuffs, if you wanted them. Not having owned it long enough, I can’t comment on the cuff or tube durability. I also don’t know how long it will be accurate and whether any kind of recalibration is necessary, though it appears that no regular maintenance is required.

If you are a fool like me, and forget the pressure you’ve just measured, you can power it back on for the latest reading. Beyond that, however, there’s no additional memory bank; a few readings would be useful for doing orthostatic vitals but I suppose any memory function beats a manual with no recall!

This may seem like a weird comment, but this is the first device where I could distinctly feel my pulsations under the cuff; I don’t know if it’s the double bladder design that’s just occluding things well or why this phenomena is so prominent. In a way it makes me trust the accuracy more but it also feels pretty strange!

Overall:

This is a great product with more functionality than the average sphygmomanometer. If you have any questions about function, I’d be happy to try it out further. I’m hoping it will stay in my toolkit for many years, and it’ll sure make me look fancy compared to the other suckers (doctors) with their clunky manual machines!

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5 Comments leave one →
  1. December 8, 2010 12:28 am

    I’ll take two!!!

    You had me at “careful decompression of the cuff”

    • December 8, 2010 1:55 am

      Haha Shan! in my meekest voice: Too quick decompression is a serious issue; lots of docs go too fast and it gives erroneous results. Not sure if it’s a problem with home cuffs – I expect they go too slowly if anything. I know this post probably isn’t too exciting for friends, then again, a few have hypertension and many more are residents. Glad you could find some humor in an otherwise kinda dry post! How’s your writing going? More inspired I hope!!

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  1. REVIEW: Terumo Elemano Digital Blood Pressure Monitor from QuickMedical « health care commentaries from around the world
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