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Manufacturer
Model
What This Guide Helps With
Inaccurate or unstable blood pressure readings during patient movement, exercise stress testing, or motion-related conditions.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- Do not rely on inaccurate readings for clinical decisions.
- Move the patient to a stable monitoring method if needed.
Expected: Patient monitoring continues safely
Why it matters: Motion artifact can lead to incorrect BP readings and unsafe clinical decisions
Verify the Reported Issue
- Run a BP measurement while observing the patient’s activity level.
- Is the patient walking, running, or moving arms?
- Does the reading fluctuate or fail only during motion?
Expected: Inaccuracy correlates with movement
Why it matters: Confirms motion artifact vs true device malfunction
Check Cuff Placement and Fit
- Inspect the BP cuff:
- Proper size for patient arm
- Snug fit (not loose or slipping)
- Positioned correctly on upper arm (artery aligned)
- Reapply cuff if needed.
Expected: Properly fitted cuff improves stability
Why it matters: Poor cuff fit is the most common cause of inaccurate readings under motion
Inspect Cuff Tubing and Connections
- Check:
- Tubing fully connected to monitor
- No kinks, cracks, or leaks
- Secure connection at cuff and device
Expected: No air leaks or restrictions
Why it matters: Air loss or restriction worsens measurement accuracy, especially during motion
Confirm Use of Motion-Tolerant Mode (If Applicable)
- Verify the Tango+ is set for stress/exercise mode.
- Ensure proper mode for treadmill or ergometer use
- Confirm correct measurement method (oscillometric vs gated, if configured)
Expected: Device configured for motion conditions
Why it matters: Tango+ is designed for motion, but incorrect mode reduces accuracy
Check ECG Signal Integration (If Used)
- If the system uses ECG gating:
- Confirm ECG leads are properly attached
- Check for clean ECG signal
- Ensure proper synchronization with BP measurement
Expected: Stable ECG signal present
Why it matters: Poor ECG signal affects timing and accuracy of BP readings during motion
Minimize External Motion Interference
- Evaluate environment and technique:
- Ensure patient arm is supported and relatively still
- Avoid excessive arm swinging during measurement
- Ensure staff is not holding or moving the arm
Expected: Reduced motion artifact
Why it matters: Even motion-capable systems require some stabilization for accuracy
Test with Known Good Cuff and Setup
- Swap:
- BP cuff
- Tubing
- Repeat measurement under similar conditions.
Expected: Improved readings with known good accessories
Why it matters: Isolates accessory-related issues
Perform Static BP Test
- Take a reading with the patient completely still.
Expected: Accurate reading at rest
Why it matters: Confirms device functions correctly outside motion conditions
If the Problem Persists
If all external factors (cuff, tubing, setup, ECG signal, and configuration) have been verified, the issue is likely internal (pressure sensing or motion compensation failure).
Remove the device from service, label it Out of Service, and send for repair or bench evaluation.
Knowing when to stop is proper troubleshooting.
Clinical Use Tip
Do not troubleshoot during an active stress test. Always pause testing and stabilize the patient before evaluating inaccurate BP readings.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"NIBP readings inaccurate during treadmill stress testing."
Cause
What was observed during troubleshooting.
Example:
"Improper cuff fit and arm movement during measurement."
Resolution
What action was taken.
Example:
"Replaced cuff, adjusted placement, and instructed proper arm positioning; verified accurate readings."
Helpful Details to Include (If Known)
- Cuff size and placement verified
- Tubing condition checked
- ECG signal quality (if used)
- Motion conditions during failure
- Static vs motion test results
- Accessories swapped
- Final device status
Final Thought
Motion-related NIBP issues are usually external and setup-driven. Focus on cuff fit, patient stabilization, and proper configuration before suspecting device failure. Escalate only after these are ruled out.
That is successful troubleshooting.