Measuring Blood Pressure

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Measuring blood pressure

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BLOOD PRESSURE

• The non-invasive ausculatory method is one of the most common ways of monitoring a patient's blood pressure

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BLOOD PRESSURE

• The subject sits down and rests their arm on a table so the brachial artery is level with the heart.

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• A sphygmomanometer cuff is wrapped around the subject's upper arm, just above the elbow and a stethoscope is placed on the hollow of the elbow, over the brachial artery as shown below.

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Equipment

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Cuffs • The cuff at the top is

a thigh cuff.

• The cuff in the middle is an adult cuff.

• The cuff at the bottom is designed to fit a child.

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Most cuffs are marked with an O or an arrow. This should be placed near the artery

CARDIOVASCULAR BLOCK PHASE TWO • Occupy 2/3 of arm length

• Alow 2 finger to pass between the cuff and arm

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• Note how the ear pieces slant slightly in one direction.

• Make sure the ear pieces on the stethoscope are point away from you when you put them on.

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A Grasp the bulb so that your thumb can easily access the valve.

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Turn the valve to the right to tighten it and pump up the cuff, turn it to the left to loosen

to and deflate the cuff.

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• Pump up the cuff until the sphygmomanometer reads 180 to 200.

• Loosen the valve to let a little of the air out.

• Listen for the first heartbeat, that is the top number.

• Continue to listen until there are no more heartbeats. The last beat you hear is the bottom number.

• Let the air all the way out and remove the cuff.

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The Korotkoff sounds• The Korotkoff sounds are the sounds

heard through the stethoscope as the pressure cuff deflates.

• The sounds are first heard when the cuff pressure equals the systolic pressure, and cease to be heard once the cuff has deflated past the diastolic pressure.

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Phase 1

•The artery is completely occluded and no blood can flow through it.

•No sounds are heard above the systolic pressure.

•At the point where cuff pressure equals the systolic pressure, a sharp tapping sound is heard.

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• The blood pressure oscillates between systolic and diastolic pressure.

• At systolic, blood to spurt through. • diastolic the artery walls bang shut• The closing shut of the artery walls that

results in the tapping sound.

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Phase 2

• This phase is characterised by a swishing sound, caused by the swirling currents in the blood as the flow through the artery increases

• If the cuff is deflated too slowly, the sounds vanish temporarily.

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• This happens when the blood vessels beneath the cuff become congested, and is often a sign of hypertension

• The congestion eventually clears, and sounds resume.

• The intervening period is called the auscultatory gap.

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Phase 3

• In this phase, there is a resumption of crisp tapping sounds, similar to those heard in phase 1.

• At this stage, the increased flow of blood is pounding against the artery walls.

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Phase 4

• An abrupt muffling of sound.

• The blood flow is becoming less turbulent.

• Some medical practitioners choose to record this point as the diastolic pressure.

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Phase 5

• Sounds cease to be heard all together.

• The blood flow has returned to normal and is now laminar.

• The pressure cuff is deflated entirely and removed.

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QUESTIONS?