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Assignment I Measurement of Blood Pressure: Instruments

This document describes how to measure blood pressure using a sphygmomanometer and stethoscope. Blood pressure is measured indirectly by compressing the brachial artery in the arm and listening for sounds with the stethoscope as the cuff pressure is lowered. The systolic pressure is read when sounds are first heard, and the diastolic pressure is read at the point where sounds disappear. Proper cuff placement and positioning of the patient are important for accurate measurement. Repeating measurements and recording the lowest values is recommended.

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3K views

Assignment I Measurement of Blood Pressure: Instruments

This document describes how to measure blood pressure using a sphygmomanometer and stethoscope. Blood pressure is measured indirectly by compressing the brachial artery in the arm and listening for sounds with the stethoscope as the cuff pressure is lowered. The systolic pressure is read when sounds are first heard, and the diastolic pressure is read at the point where sounds disappear. Proper cuff placement and positioning of the patient are important for accurate measurement. Repeating measurements and recording the lowest values is recommended.

Uploaded by

pasha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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ASSIGNMENT I

Measurement of Blood Pressure

Blood pressure is the lateral pressure exerted by the blood on the artery wall at the level
of the heart. In experimental animals this can be measured by connecting a manometer
directly to the artery. The blood pressure of man is measured by an indirect method; a
measurable pressure is applied over the artery; the pressure required to compress the
artery is equal to the pressure. Measuring blood pressure is an accurate and simple
method of assessing the state of the circulatory system.

Instruments:
Sphygmomanometer and stethoscope

Method:
Make sure that the subject (or patient) is comfortably seated or in bed and in a relaxed
condition. Remove cloths from the arm and apply the
cuff.

Application of the cuff:


Blood pressure is generally recorded in the arm with
the patient in sitting or recumbent position. The artery
over which the pressure is to be measured should be
at the level of the heart. The deflated compression cuff
is applied evenly and snugly but without constriction
around the arm. The lower edge of the cuff should be
about 2.5 cm above the elbow joint. Make sure that the
middle of the rubber bag is over the brachial artery, in
the medial aspect of the arm.

Palpatory method of measurement:


This method is based on the fact that the pulse wave is
not conducted through when the brachial artery is
occluded. This happens when the external pressure (in the cuff) is more than the
maximum pressure in the artery.
First, locate and palpate the redial or brachial pulse. While feeling the pulse by one
hand, inflate the cuff by the other hand. Continue to increase the pressure for about
further 30 mm Hg after the disappearance of the pulsation. Deflate the cuff slowly
(about 2 or 3 mm Hg per second) until the pulse is felt again. The pressure at this
moment is equal to the systolic blood pressure.

Auscultatory method of measurement:


This method is based on sounds produced at the lower end of the partially compressed
artery due to turbulence. If the pressure in the cuff exceeds systolic pressure the artery
is closed and there will be no sound. If the pressure in the cuff is below the diastolic
pressure also there will be no sound because the artery is fully opened and there is
laminar flow. When the cuff pressure is between systolic and diastolic pressures, the
artery closes when the pressure in the artery goes below the cuff pressure and the
blood flows through when the pressure in the artery goes above the cuff pressure. The
intermittent flow produces turbulence at the end of the cuff, which produces a sound
(Korotkoff sound).

Locate the brachial artery in the cubital fossa by feeling for the pulse. Inflate the cuff to a
pressure above the systolic pressure, measured by palpatory method. Place the
stethoscope gently on the brachial artery and reduce the pressure slowly. The pressure
at which the Korotkoff sound appears is the systolic pressure. Go on reducing the
pressure while listening. Suddenly at one point the sound becomes muffled and when
the pressure is lower lowered further the sound disappears.

There is a controversy as to the measurement of diastolic pressure. Some doctors


consider the muffing point as the diastolic pressure while others consider the point of
disappearance as the diastolic pressure. In this lab, the point of disappearance will be
considered as the diastolic pressure. Repeat the measurements three times and record
the lowest value. If you could not get the reading within two or three minutes, release
the cuff pressure and start all over again after few minutes.

PHASES OF THE KOROTKOFF SOUNDS


Phase 1 beginning of a sharp ―Thud‖ --- Systolic pressure (Tapping Sound)
Phase 2 Muffle Sound (Not Loud Sound)
Phase 3 Loud and Clear (Softer than Phase 1)
Phase 4 a soft blowing sound [muffling] - - First diastolic pressure
Phase 5 silences -------------- Second diastolic pressure

Observations

● Pulse pressure for the subject: Pulse Pressure = Systolic BP – Diastolic BP

● Mean Arterial Pressure = Systolic BP + 2(Diasystolic Bp)/3

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