Intro of Blood pressure

Measuring blood pressure in an office setting about one in three American adults has hypertension. The American Heart Association estimates the total costs associated with high blood pressure to exceed 40 billion dollars annually.

Uses of Blood pressure Measurement:

  • Screening for hypertension
  •  And for monitoring the effectiveness of treatment for patients with a diagnosis of hypertension in the outpatient setting blood pressure is measured indirectly. It is important to use proper techniques so that readings are consistent and reliable.

Report of blood pressure

“ The 2014 evidence-based guideline for the management of high blood pressure in adults report from the panel members. Appointed to the eighth Joint National Committee also known as JNC eight guides current treatment of hypertension.”

According to JNC eight patient 60 and older. Who do not have diabetes or kidney disease. Need to have blood pressure under 150 over 90 for all other patients goal is less than 140 over 90.

Learn more about Laboratory equipment.

Manual Blood pressure

Taking a manual reading of indirect blood pressure requires a stethoscope and a sphygmomanometer. The stethoscope used should have tubing long enough to allow the clinician to view the manometer.

While listening to korot koff  sounds. The bell of the stethoscope should be use as it permits better auscultation of korot koff  sounds.

A sphygmomanometer consists of a cuff containing a distensible bladder. A rubber bulb with an adjustable valve and a flexible tubing. The tube connects to a manometer which measures the pressure within the cuff.

Each part of the sphygmomanometer should be examine on a regular basis to be sure that it is functioning correctly.

 The needle on an aneroid manometer should rest at zero before and after each blood pressure measurement. Aneroid manometers should have calibration performed at least every six months.

Blood pressure readings should be done, when the patient is in a resting state. The patient should be seat for five minutes prior to checking a blood pressure.

 So that the reading   is not artificially elevated due to the exertion of walking to the  room.

 The arms should be bared to the shoulder a study looking at the effect of taking blood pressure. Through clothing showed little average change but found that in patients with hypertension.

There can be individual differences of plus or minus 20 millimeters of mercury. Or more when compared with measurements on bare skin.

Position of blood pressure

Firstly

The patient must be correctly position to accurately measure blood pressure. The patient needs to have legs uncrossed and feet resting on a firm surface.

The patient’s back and legs should be support by the chair. The manometer should be at eye level of the care team member. The patient’s arms should be support at heart level a common error in taking.

This is the use of an improperly fitted cuff . The appropriate cuff size is determine by the circumference of the arm at the midpoint. Between the electron on process and the acromion process.

The cuff will have the size range listed in centimeters. Once the correct cuff is selecting proper fit is verified using the index line. That runs perpendicular to the length of the cuff. And arranged line that runs parallel to the length of the cuff.

Secondly

When a cuff fits appropriately the inflatable bladder should cover about 80% of the circumference of the patient’s arm. Using a cuff that is too short and narrow results in erroneously high blood pressure measurement.

 When a cuff is too large blood pressure measurements will be erroneously low. The cuff should be applie to centimeters above the crease of the elbow. It should fit snugly but still allow two finger widths under the cuff. When the cuff is in place on the upper arm the index line should fall within the range line.

Thirdly

 Next and the brachial artery which is palpable about four centimeters. From the medial epicondyle on the Anterior surface of the elbow.

Place the stethoscope lightly against the skin over the brachial artery being sure. That the pressure is appropriate for good sound transmission.

 Make sure that cuff and clothing do not touch the stethoscope inflating. The cuff to an arbitrary level will often lead to over inflation.

Which can be uncomfortable for the patient determining the pulse obliteration pressure will avoid over inflation. Rapidly inflate the cuff to 80 millimeters of mercury while palpating the radial artery pulse. Continue to inflate in 10 millimeter of mercury increments until the pulse disappears.

Then deflate the cuff at a rate of two millimeters of mercury per second noting the pulse obliteration pressure where the pulse reappears.

Measure the patient’s

You are now ready to measure the patient’s blood pressure. Inflate the cuff to twenty to thirty millimeters of mercury above the pulse obliteration pressure. Then deflate the cuff at a rate of approximately two millimeters of mercury per second. While listening with the stethoscope for Croat cough sounds. As the pressure in the cuff is decrease blood flow in the brachial artery increases. Which creates turbulence and generates korot koff  sounds.

Phase one

 Phase one cough sounds are clear tapping sounds that coincide with reappearance of a palpable radial or brachial pulse. Systolic blood pressure is determine by the onset of phase one sounds.

Phase two and three

sounds are of no clinical significance and are describe as softer and longer than crisper and louder.

Part four

Sounds become muffled and softer as the pressure measurement approaches the diastolic pressure usually within ten millimeters of mercury of true diastolic pressure.

Part five

  Sound is not a sound but rather is the level at which sounds disappear. The diastolic blood pressure is measured at the start of phase 5 to ensure that diastole has been reached.

The cuff pressure should to be continuing slowly deflated. For an additional 10 millimeters of mercury beyond the fifth korot koff  sound. That should be measure at least twice waiting one minute between readings.

Then recording the average of the two measurements in the following example. Please listen for the various phases of the korot koff  sounds. While you observe the reading on the manometer. And a skull Tottori gap is defining as the intermittent disappearance of the initial korot koff  sounds after their first appearance.

 This phenomenon can lead to underestimation of systolic blood pressure. Obtaining the pulse obliteration pressure can be helpful in avoiding and correct measurement. Certain conditions such as cardiac arrhythmias may complicate this measurement. Or interpretation in these circumstances decreasing the rate of deflation and averaging several readings may improve accuracy. Observer bias is the most common error that occurs in this measurements.

 It occurs because practitioners often show digit preference or round off the terminal digit. When two people use the same correct technique for measuring blood pressure. There should be little variation in the reading they obtain.

Conclusion

 By following the process demonstrated in this content. You will be able to correctly measure the blood pressure of your patients. Getting accurate measurements is crucial for your care team.

Your patient because this data is useing to classify patients to stratify their Cardiovascular risk. And to monitor the effects of treatment you.

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