Blood pressure checks in thai hospitals = waste of time

[Changwatchap]

I'm really confused. Thai hospitals are great, I get far better care vs UK hospitals. And the nurses are good too.

So why: every single time I go, are they SO BAD at taking blood pressure?

Ttoday:

Immediately after I sit down to wait for the doctor, a nurse wants to take my blood pressure. Never mind I just walked 15 minutes from the BTS and didnt have a 'resting' pulse rate.

So we take the test, and no suprise my SYS high. And my DIA... was 140! So I'm either having a stroke, am already dead, or they seriously ffed up the BP reading. On top of not waiting for my pulse to normalize.

The nurse looks at these insane readings - higher than heart attack levels - 'oh little bit high sir', and sends me back. She should be rushing me to ER, does she not understand or does she know the test results are garbage?

So the test was a complete failure in every possible way. And it's the same every time: bangkok hospital, phayathai 2, paolo memorial. Sometimes if the reading is high, they immediately do the test again, giving an even more useless reading.

I dont know, why do they do this test to every patient every time you visit, for any reason? It's a total waste on every level. It's a strange weakness.

[laolover88]

Agree!!

[tonray]

It's worth it to get your own monitor...I have an Omron...very good for self maintenance. I get high readings at the dentist, the clinic, etc etc. I get terrified until they take a 2nd reading after 10 minutes and it is near normal. At home I can check and it makes me sane.

[tirekicker]

I've had similar experiences at both the hospital and even the dentist when my blood pressure was on the high side due to either just walking up the stairs (I never take the lift) or just after arriving by bike having just ridden though busy traffic.

Within 5 minutes when retaken my blood pressure is normal.

Edited May 3, 2016 by tirekicker

[lopburi3]

Indeed this is often the case when crowded and normally not done by nurse but by clerical staff. Those paying for service do not want to wait - and blood pressure should be checked and recorded for doctor to view. Am sure they will allow you to wait five minutes if you ask.

I note in major government hospital here in Bangkok it is a self service exercise so you have plenty of time to wait awhile before taking yourself as you will not be called for that data until nurse gets to your processing paperwork.

[mcfish]

I've had similar experiences at both the hospital and even the dentist when my blood pressure was on the high side due to either just walking up the stairs (I never take the lift) or just after arriving by bike having just ridden though busy traffic.

Within 5 minutes when retaken my blood pressure is normal.

people are generally anxious at the dentist. Can see a lot of false reading due to that

[gerryBScot]

Yeah if you are concerned about your BP then, as already has been suggested, monitor it yourself by buying your own monitor. There are, however, issues with every kind of monitoring. For BP I would suggest that if you get your own monitor you do the following:

• take three measures one after the other soon after you get up and then average them; you can do this easily using a spread sheet;
• record each average on a daily basis and then you can average for the week and the month if you wish; it is these averages which will help establish if you have high BP; once more you can do this using a spreadsheet;
• having these records can also be useful to review lability, the variation in your BP; for instance it can be useful to identify high and low systolic and diastolic readings on a monthly basis and calculate the difference between these extremes by simple subtraction; you can monitor lability on a monthly and weekly basis using your spreadsheet;
• this will provide you with strong data to help you and your doctor reach decisions about your care.

Be wary of doctors in general, not just in Thailand but everywhere, who are often quick to prescribe anti-hypertensive medication, especially in border line cases. Don't get me wrong, uncontrolled BP kills people so if your BP is high then you may need to go on meds. But please do remember that lifestyle changes can effect significant changes in your BP.

But first and foremost get the data so you can make an informed judgement about your BP.

[losworld]

Don't be too confident about any of the medical here due to incompetence and corruption. Not all but its a business here and a big business in the private hospitals.

[gt162]

I use those 1 baht blood pressure machine all over the city.

[Hedghog]

Don't be too confident about any of the medical here due to incompetence and corruption. Not all but its a business here and a big business in the private hospitals.

You must of had some bad experiences,or just following a trend?

[Bullie]

They can only apply a nurse-fee if she does something, like taking your pulse. Never mind you don't need it, only coming to see the doctor to discuss some results .

Last time I was there I explained I had just had a full fysical in my home country by my own GP, and refused the test.

The girl was genuinly upset, and went to the doctor to complain. Go figure.

[Sheryl]

This is not correct, but it is a common misunderstanding. The "nursing fee" is a charge for use of the hospital facility (waiting room, exam rooms, reception staff, utilities etc etc) and will be charged regardless of whether your blood pressure is measured.

Taking vital signs on all patients is a standard practice and has utility. Doing it carelessly/inaccurately is of course another matter.

[Greenhill]

As with most things in Thailand, you have to be pro-active, rather than just go along with stuff that you know is nonsense.

If you have just walked some distance in the stifling heat, or walked up several flights of stairs, tell the eager nurse the reason why you want to wait for 5/10 mins before taking the bp test!! She'll understand if said in a polite manner.

[Familyonthemove]

The blood pressure check serves no purpose other than to bump up the cost of whatever it was you came for. Even a simple vaccination is preceeded by a blood pressure test. It's like having ypur windscreen cleaned when you buy fuel.

[Denim]

Knowing in advance how it's going to be I always make them wait as long as possible before checking my blood pressure. When I explain why they always see the sense in waiting until I have been waiting a good 30 minutes or so.

[NancyL]

I've been with several people who have had extremely high BP with these initial screenings and the hospital staff does scramble to get care to them immediately. So they do seem to serve some purpose.

[Happy Grumpy]

So the test was a complete failure in every possible way.

You were billed for it.

It was a success.

[NancyL]

What's sad is that in many Thai hospitals they can't accomodate patients with oversize upper arms. Instead the "nurse" wraps the blood pressure cuff around the lower arm or, if they're using one of those machine where you stick your entire arm into the machine -- it's the same. But reading the BP just below the elbow isn't appropriate.

[Freakin Musashi]

Yep, in my beloved stateside hospital, they call me in for an appointment, then make me wait. That stewed my beans (and probably drove my BP up) until I realized they wanted me to rest.

BTW, most store-bought home BP cuffs are not calibrated and can't be calibrated. They can be VERY inaccurate.

[Sheryl]

Again - this had no effect on the cost and you are not billed for it. The "nursing charge" is a hospital charge. This is the way the Thai term is sometimes translated since the word for nurse and hospital are the same (actually the proper full term for hospital is place/center of nurses/nursing but the first part is often dropped). The charge has nothing to do with whether your BP is measured.

[Oxx]

On particular hospital always insists on taking blood before taking my blood pressure. The mere sight of an hypodermic syringe is enough to send my blood pressure soaring.

I also don't understand why they use electronic machines to measure blood pressure when the old fashioned way with a stethoscope and mercury manometer is much more accurate and reliable.

[lopburi3]

But there is no visual proof to patient - and in many cases this procedure is not being done by a medical trained nurse. Doctor will be more than willing to double check in my experience - and often will do anyhow. This also check for emergency conditions, basic Triage procedure.

But agree probably not a good idea to do after blood draw - I always look the other way rather than watch the vial fill.

Edited May 4, 2016 by lopburi3

[Speedo1968]

If you can find a pre-waiting area and sit for 15 minutes before checking in.

Don't talk and don't let the nurse talk to you whilst your BP is being checked.

Where I live ( out of town ) ( in town has a hospital and many other clinics ) there is a local clinic run by ex-nursing staff volunteers, they do everything from BP testing, blood sugar testing, baby checks, cuts and bruises, urine checks, osteopathy, evening aerobics / dance / movements, speakers on various relevant health issues - all for free or a small donation. A wonderful group of people.

[chowny77]

I remember one time I was having my BP done and another nurse started talking to the one pumping up my arm collar. She was so engrossed in the conversation she just kept pumping away until I had to tell her to stop. I thought I was going to lose my arm from lack of circulation.

[Bosse137]

I once asked about the nursing fee in a RAM hospital.I was told,it was for the nurses being nice and friendly,giving me their smiles.... I was contemplating to tell them to stop smiling,but my pen ray,sweet little ladies as they are..

[gerryBScot]

This thread highlights why you need to be careful about the reliability of one single measure of BP for any purpose. That's why I suggest a process of self-monitoring over a period of a month or so, especially if you're BP is only being measured on occasional visits to doctors/hospitals/clinic. I have been massively over-prescribed BP medication ( and guess what, some of the most expensive anti-hypertension medicine available in Thailand!) , as a result of which I have suffered serious side effects. I am now in the process of reducing this with a long term goal of being clear of it altogether. I have halved the dosage and my own readings show everything is normal. I'm jogging most days, weight is coming down nicely and I am feeling 100% better in myself.

[guru]

So I went to Sukhumvit hospital for something minor and had the mandatory bp taken in one of those machines where you put your whole arm through a hole and it starts to squeeze on your arm. Bp was way high as was the second attempt which was way up in the red danger zone. Later the Dr reads it and is quite concerned and starts talking about prescribing hypertension meds. Asks my symptoms but with nothing indicating hypertension she double checks with an ancient manual pump bp device but unhappy with reading. Finally wheels in a digital wrap around the upper arm Bp monitor and bp is normal. Verdict was that the size of my upper arm and the tightness of the armband caused false high readings in the earlier attempts.

[ripstanley]

My initial blood pressure test is always very high because I have just driven 14 kms to the hospital. When I finally see the doctor it is back to normal.

[harrry]

I once asked about the nursing fee in a RAM hospital.I was told,it was for the nurses being nice and friendly,giving me their smiles.... I was contemplating to tell them to stop smiling,but my pen ray,sweet little ladies as they are..

They were so pretty at one hospital a friend offerred to pay two lots of 100 baht nursing fee if they both took it:)

[arjunadawn]

Clearly those figures are a 'hypertensive crisis' and require immediate problem solving. But not before a few things (as you know):

It should be tried on the other arm. It should be tried with a manual device, or another cuff. Consistently checking BP for small people they might have to change to the larger cuff for you. Also, they should ask the questions: "smoke, just drink, run from BTS," "is this normal for you?" "Do you have history of ^BP?" I think they have little concept of its value, only that it needs to be done.

Injured while visiting the UK recently, I can confirm that there is a marked difference in the quality of care from Thailand. In the UK I had a systolic of over 150 and they did not even note it unusual. Certainly a diastolic is a greater concern. In the future, you should talk them politely through the steps they should next follow. Its your life.