Thursday, June 4, 2020

BLOOD PRESSURE

Hi friends!!!

Blood Pressure Measurement is a day to day activity in healthcare settings. So it is important for every healthcare professional to know in detail about Blood pressure Measurement.

Let’s get into the topic.

WHAT IS BLOOD PRESSURE?

Blood Pressure is the force exerted by the blood on the walls of the arteries. There are two types of blood pressure.

SYSTOLIC BLOOD PRESSURE

Force exerted by the blood on the artery walls when the heart contracts to pump the blood to the peripheral organs and tissues.

DIASTOLIC BLOOD PRESSURE

Pressure exerted on the arteries as the heart relaxes between beats to refill the blood.

NOTE: The average normal blood pressure is 120/80 mmHg.

120mmHg for Systolic Pressure and 80mmHg for Diastolic Pressure.

WHICH DEVICE IS USED TO MEASURE BLOOD PRESSURE?

SPHYGMOMANOMETER is a device used for blood pressure measurement. It consists of a inflatable cuff which is wrapped around the arm. The cuff is connected to the mercury column with a measurement scale to measure the cuff pressure. A bulb inflates the cuff and a valve releases the pressure. A stethoscope is used to hear arterial blood flow sounds.


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NOTE: Mercury Sphygmomanometers are phased out because of the usage of mercury. As the spillage of mercury is hazardous to environment & nearby persons.

WHAT IS THE TECHNIQUE USED?

OSCILLOMETRIC TECHNIQUE is used for blood pressure measurement which means the cuff pressure is well inflated 30 - 40mmHg above arterial systolic pressure (above 120mmHg). Now there is no blood flow in the arm. The valve is opened slowly to deflate the cuff pressure at the rate of 2 – 3mmHg. When the cuff pressure equals the arterial systolic pressure, blood flow starts in the arm and produces audible sounds called korotkoff sound. These sounds are heard using stethoscope and pressure reading is noted. It indicates the Systolic Blood Pressure.

The cuff is further deflated and  the cuff pressure drops below are arterial diastolic pressure (below 80mmHg). The pressure when the blood flow sound stops indicate the arterial diastolic pressure.

WHAT ARE THE STEPS TO FOLLOW DURING BP MEASUREMENT?

1. Allow atleast 5 minutes of relaxation time for patients before taking measurement.

2. Use the appropriate cuff size. Cuffs are available in market are Adult Cuffs, Large Adult Cuffs, Paediatric Cuffs & Thigh cuffs.

3. Locate the brachial artery and place the cuff so that the artery marker in the cuff  points on the brachial artery.

4. Wrap the cuff around the arm with one finger gap.

5. Make the patients to sit straight without legs being crossed.

6. Take the measurement for at least two times because blood pressure measurement is affected by various environmental factors.

7. Leave a time gap of above 5 minutes between measurements.

WHAT IS WHITE COAT HYPERTENSION?

As you know, for a patient blood pressure measurement taken at home will show lesser value when compared to the measurement taken at the hospital. This is because of various factors like nervousness due to doctors and hospital settings. This kind of increase in blood pressure is called white coat hypertension.

WHAT ARE THE TYPES OF BP MONITORS AVAILABLE?

1. Spot Check BP Monitor – It is used to measure BP immediately on the spot. There are two grades available, Home grade and Clinical grade. Home graded is used for home based BP measurement and Clinical grade is used in typical hospital settings which is clinical testing for its high accuracy.

2. Ambulatory BP Monitor - It is used to measure blood pressure continuously for 24 hours to know BP readings at different stages of the day. It stores the readings time wise for interpretation by doctors.

3. Stress BP Monitor - It is used in hospital settings along with a Treadmill to know the BP readings of patients during physical activities like running, walking, exercise etc.

4. Vet BP Monitor: As the name suggests, it is used to find BP readings of animals and pets.

BASIC TROUBLESHOOTING IN BP MONITORS:

1. Reading Aborted – Check air hose connection and make sure air tubing is not crimped.

2. Artifact/Weak/No oscillometric signal – Check the position of the cuff, remain still during BP reading & tighten the cuff.

3. Power supply out of range – Replace the batteries.

4. Exceeded Measurement Time – Check air hose connections & make sure the cuff is tight.

Now I hope you have acquired some knowledge about Blood Pressure Measurement.  We will discuss more about Medical Devices in future blogs..


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