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Nurse failures mean arrhythmias being missed

Patients with arrhythmias may be going undetected because nurses are failing to measure patients' pulse rates when taking blood pressure, say researchers.

In a survey of 105 nurses, 67% used an electronic sphygmomanometer to measure patients' blood pressures.

But almost a quarter of these did not take their pulse. Only 26% of nurses palpated the pulse in the last five blood pressure consultations.

Dr Jane Upton, research project manager at Education for Health, said their results were ‘serious'. Pulse palpation was the only screening tool for detecting atrial fibrillation, apart from ECG, she said.

‘A lot of nurses do not palpate the pulse and this might mean that atrial fibrillation might be missed,' she said.

Dr Stewart Findlay, a GP in Richmond and member of the Primary Care Cardiovascular Society board, said he was concerned as blood pressure readings were inaccurate if patients had atrial fibrillation.

He said it was ‘essential' nurses took the pulse at the same time as taking the blood pressure, so their diagnosis could be confirmed by ECG and patients put on appropriate drug treatment.

‘This problem is increasing as people get older, so there are quite a lot of people going around with asymptomatic atrial fibrillation and they are therefore at risk of having stroke,' said Dr Findlay.

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