The risk of cross-transmission from blood pressure cuffs

Blood pressure cuffs come into frequent contact with the skin of patients (obviously) and are rarely disinfected. A number of studies have evaluated whether and to what extent blood pressure cuffs become contaminated with pathogens that may cause HCAI. This post reviews a few of these articles, illustrating the risk of cross-transmission from contaminated blood pressure cuffs.

• Due to the risk of blood pressure / sphygmomanometer cuff contamination, many hospitals have gone down the disposable route. A study from Australia tested whether disinfection of blood pressure cuffs using disinfectant wipes was an effective (and cost saving) option. A sample of 54 non-disposable sphygmomanometer cuffs were collected from a rural emergency department and tested for bacterial contamination before and after decontamination using Universal wipes. Levels of contamination were significantly lower following decontamination with the wipes; 29% of the cuffs had no growth before decontamination compared with 98% after decontamination. The authors concluded that using wipes to decontaminate non-disposable cuffs would be clinically effective, environmentally friendly, and cost-saving compared with using disposable cuffs.
• A Japanese study from a few years ago sampled pressure cuffs in wards and outpatient clinics at an acute-care hospital in Japan. The cuffs were sampled on the inside (skin-contact side) using gauzes. Of the 30 cuffs sampled, remarkably, 11 (31.4%) were contaminated with MRSA. The team also evaluated two different methods of disinfection: an outsourced washing process and wiping with 80% ethanol. No cuffs were found to be contaminated following either disinfection process. Only a small number of cuffs were included in the disinfection study, and they weren’t sampled before and after treatment, but these findings reinforce that blood pressure cuff disinfection is an option.
• A study from the north of England sampled 24 cuffs from an acute care hospital, finding potential pathogens on 14 (58%) of cuffs. Clostridium difficile was cultured from 8 (33%) of cuffs, and MRSA from 2 (8%) of cuffs. The findings of these pathogens on such a high proportion of the cuffs argues for disinfection between patients or the use of disposable cuffs.

Taken together, these studies show that blood pressure and sphygmomanometer cuffs can become contaminated with pathogens that can cause HCAI during routine patient care. Whilst using disposable cuffs is an option, disinfection using disinfectant wipes is clinically effective, environmentally friendly, and cost-saving compared with using disposable cuffs.