• Maryanne Crowther, Jennifer Ricker, Lisa Frank, Naomi James, Evangeline Kupyak, Christiam Fajardo, Lindsey Foran, and Clive Persaud.
• Maryanne Crowther is a critical care advanced practice nurse, St Joseph's University Medical Center, Paterson, New Jersey.
• Am. J. Crit. Care. 2022 May 1; 31 (3): 250-254.

BackgroundMany critically ill patients have invasive arterial catheters inserted for blood pressure monitoring. Whether catheter leveling method and alternative transducer location affect the accuracy of blood pressure measurements is unknown.ObjectiveTo determine whether the use of alternative transducer locations and visual alignment versus laser device leveling significantly affect the accuracy of blood pressure measurements.MethodsA convenience sample of 36 participants were randomly assigned to 1 of 3 experimental groups with different transducer locations: taped to the upper arm, next to the upper arm taped to a rolled cloth, or at the wrist. Participants served as their own controls; the control condition was having the transducer on the intravenous pole. Four blood pressure measurements were recorded for each patient (2 from each of the experimental and control conditions) using visual alignment and then laser device leveling.ResultsOnly diastolic blood pressure (DBP) differed significantly between leveling methods (P = .01); no pressures differed significantly by transducer location. Covariate analysis indicated expected relationships between (1) age and DBP (P = .001), (2) Simplified Acute Physiology Score II and both DBP (P = .003) and mean arterial pressure (P = .03), and (3) duration of mechanical ventilation and DBP (P = .05).ConclusionThe findings indicate that any of the transducer locations evaluated may be useful in clinical prac-tice. Also, visual alignment rather than laser device leveling may be acceptable, except for DBP in the control location. More research is needed to strengthen these findings.©2022 American Association of Critical-Care Nurses.

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