How To Measure Blood Pressure With Sphygmomanometer

How To Take Blood Pressure Readings

Taking readings requires some thought and preparation, though it will soon become second nature. There are several things to remember:

• Relax. Steer clear of caffeine and exercise for thirty minutes beforehand, and rest for a few minutes. Sit comfortably upright with your feet flat on the floor and with your back supported.
• Position your arm correctly. Rest it on a flat surface, with your upper arm level with your heart.
• Position the cuff correctly, with the bottom edge just above your elbow.

The instruction manual of your device will also provide you with clear instructions.

What Is Ambulatory Blood Pressure Monitoring

If a doctor recommends ambulatory blood pressure monitoring, you will need to wear a blood pressure cuff for 24 hours. It’s connected to a small, portable measuring device that automatically measures your blood pressure at set times and records the readings.

Ambulatory blood pressure monitoring is used, for example, to see whether blood pressure levels vary greatly over the course of the day and night or whether they are constantly elevated. During those 24 hours, you can do all of the usual things you would otherwise do over the course of the day. If you are especially active at certain times, you can make a note in a diary. Then the doctor has a better idea of how to interpret the recorded values when evaluating them.

What Happens During A Blood Pressure Test

A blood pressure test includes the following steps:

• You will sit in a chair with your feet flat on the floor.
• You will rest your arm on a table or other surface, so your arm is level with your heart. You may be asked to roll up your sleeve.
• Your provider will wrap a blood pressure cuff around your arm. A blood pressure cuff is a strap-like device. It should fit snugly around your upper arm, with the bottom edge placed just above your elbow.
• Your provider will inflate the blood pressure cuff using a small hand pump or by pressing a button on an automated device.
• Your provider will measure the pressure manually or with an automated device.
• If manually, he or she will place a stethoscope over the major artery in your upper arm to listen to the blood flow and pulse as the cuff inflates and deflates.
• If using an automated device, the blood pressure cuff automatically inflates, deflates, and measures pressure.

As the blood pressure cuff inflates, you’ll feel it tighten around your arm.

Your provider will then open a valve on the cuff to slowly release air from it. As the cuff deflates, blood pressure will fall.

As the pressure falls, a measurement is taken when the sound of blood pulsing is first heard. This is the systolic pressure.

As the air continues to be let out, the blood pulsing sound will start to go away. When it completely stops, another measurement is taken. This is the diastolic pressure.

This test only takes about one minute to complete.

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How Do I Measure My Blood Pressure

Before you check your blood pressure, you should:

• Wait 30 minutes after eating or using caffeine, alcohol, or tobacco products.
• Go to the bathroom and empty your bladder.
• Rest for 3 to 5 minutes and do not talk.
• Sit in a comfortable position, with your legs and ankles uncrossed and your back supported.
• Elevate your left arm to the level of your heart. Place it on a table or desk and sit still.
• Wrap the cuff around the upper part of your bare arm. The cuff should be smooth and snug. There should be enough room for you to slip one fingertip under the cuff.
• Check the placement of the cuff. The bottom edge of it should be 1 inch above the crease of your elbow.

Below are the steps to take to use an aneroid monitor.

Below are the steps to take to use a digital monitor.

• Turn the power on to start the unit.
• On the automatic models, the cuff will inflate by itself with a push of a button. On the manual models, you have to inflate the cuff. You do this by squeezing the rubber bulb at a rapid rate.
• After the cuff inflates, the automatic device will slowly let air out.
• Look at the display screen to get your blood pressure reading. It will show your systolic and diastolic pressures. Write down the measurement in your record. The systolic pressure goes in front of the diastolic pressure. For example, 120/80.
• Press the exhaust button to release all of the air from the cuff.
• If you need to repeat the measurement, wait 2 to 3 minutes before starting.

Can I Check Blood Pressure Without Equipment

What If I Dont Have Equipment? You dont need a blood pressure cuff to take your resting heart rate, which is another measurement that helps indicate heart health. Digital monitors usually display both blood pressure and heart rate, but you can determine the latter on your own by checking your pulse by hand.

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Second Step: Measure Blood Pressure

Now, you can start to measure blood pressure. Place the bell of the cleansed stethoscope over the brachial artery using a light touch and complete seal. Inflate the cuff to the maximum pressure inflation number . Open the valve slightly. Deflate the cuff slowly and evenly at about 2 mm Hg per second. See Film Clip 5.3 which focuses on the speed of the needle when deflating the blood pressure cuff.

Note the points at which you hear the first appearance of Korotkoff sounds and the point at which the Korotkoff sounds go silent . These sounds are called Korotkoff sounds and vary in quality from tapping, swooshing, muffled sounds, and silence. The pressure at which the first Korotkoff sound is noted signifies the systolic pressure, while the pressure at which the Korotkoff sounds are no longer heard marks the diastolic pressure. See Audio Clip 5.1 to listen to Korotkoff sounds and noting systolic and diastolic blood pressure. Alternatively, if viewing textbook as a pdf, use this link: https://www.youtube.com/embed/lPlYNt8cVnI?rel=0

Film clip 5.3: Deflation rate of sphygmomanometer

Alternatively, if viewing textbook as a pdf, use this link: https://www.youtube.com/embed/QbGPzUluT5c?rel=0

Manual Blood Pressure Monitors

Manual models are like the ones that might be used in your doctorâs office. They usually include an arm cuff, a squeeze bulb to inflate the cuff, a stethoscope or microphone, and a gauge to measure the blood pressure.

To take your blood pressure, you inflate the cuff around your upper arm. This stops the flow of blood in the artery for a short time. You place the stethoscope on the skin over the artery. As you release air from the cuff, you listen for the sound of the blood as it starts to flow through the artery again.

The reading on the gauge when blood flow is first heard is the systolic pressure. The reading when blood flow can no longer be heard is the diastolic pressure.

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Questions To Ask Your Doctor

• Why do I need to monitor my blood pressure at home?
• How often do I need to measure my blood pressure?
• What type of monitor should I use?
• What do my blood pressure readings mean?
• What is considered a normal blood pressure for me?
• What should I do if my readings are abnormal?
• Are there any lifestyle changes I can make to help manage my blood pressure?
• Do I need to take medicine to manage my blood pressure?
• What other things can affect a blood pressure reading?

Learn And Practice Taking Blood Pressure

Learn how to take blood pressure with our illustrated lessons and interactive patient simulations. In this section we provide a review of taking blood pressure techniques assessment guides for adults and children practice drills for the assessment of hypertension in children and a series of case studies on hypertension and hypotension blood pressure.

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How Can I Check My Blood Pressure At Home Using

But you dont need to go to your doctor just to get a blood pressure reading. The easiest way to monitor your own blood pressure at home is to get a machine that has a blood pressure calculator and digital display.

Purchase a blood pressure monitor cuff that wraps around the upper arm. The cuff should fit well, and not be too loose or too tight when not in use. Wrist and finger monitors are not recommended because the readings arent as reliable. When choosing a blood pressure monitor, take it to your doctors office. They may be able to show you how to use it properly and check whether the machine provides accurate readings.

Here are some tips to follow while measuring your blood pressure at home:

• Before measuring your blood pressure, sit quietly for 5 minutes with your arm relaxed on a supporting surface at the level of your heart.
• Your back should be supported and both feet should be flat on the floor.
• The cuff should be positioned on your upper arm as instructed on the guide that came with the monitor. It is easier to use your non-dominant arm .
• Avoid caffeine, smoking, or exercise at least 30 minutes before measuring your blood pressure. Do not take a reading if stressed or angry.

Blood pressure categories defined by the American Heart Association are as follows:

• Normal: Below 120/80 mm Hg
• Prehypertension: 120-139/80-90 mm Hg

What Is Systolic And What Is Diastolic Pressure

Every time you hear your heart beating, it expels a quantity of blood to your arteries. This amount of blood increases the pressure inside the arteries. Between two beats the heart rests and fills with blood. Thus blood pressure is expressed by two numbers. The first number, e.g. 14 or more correctly 140 is the pressure exerted by the blood on the wall of the arteries as it leaves the heart and is called systolic or high pressure, while the second number, e.g. 7 or more properly 70 is the pressure exerted by the blood on the walls of the arteries when the heart is now resting and is called diastolic pressure or low.

The units of pressure measurement are the millimeters of mercury .

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How A Sphygmomanometer Works To Take Readings

As your heart beats, blood is forced through your arteries. This rise in pressure as the blood is pumped out of the heart is called systolic pressure.

As the heart contracts and the ventricles prepare for another beat, there is a reduction in pressure. This low-pressure period is called diastolic pressure.

Essentially, it is the difference between these two pressures that the Sphygmomanometer is reading.

The process begins with the cuff. When this is attached to the patients arm and the air is pumped into it, the cuff becomes inflated to above the expected systolic pressure.

The user then opens the valve so that cuff pressure slowly decreases to a level where it is equal to the arterial systolic pressure.

At this point, blood begins to flow past the cuff creating sounds that can be detected with a stethoscope.

The sounds are heard and the cuffs pressure is recorded, while air is slowly released using the valve.

When the cuffs pressure falls below the arterial diastolic pressure the blood flow sounds will stop. This point indicates the diastolic pressure and is recorded accordingly.

Systolic and diastolic pressures are recorded as systolic over diastolic, .

Is There Anything Else I Need To Know About A Blood Pressure Measurement

If you were diagnosed with high blood pressure, your provider may recommend one or more of the following lifestyle changes.

• Exercise regularly. Staying active can help lower your blood pressure and also help manage your weight. Most adults should aim for 150 minutes of physical activity per week. Check with your provider before beginning an exercise program.
• Keep a healthy weight. If you are overweight, losing as little as 5 pounds can lower your blood pressure.
• Eat a healthy diet that includes fruits, vegetable, and whole grains. Limit foods high in saturated fat and total fat.
• Reduce salt in your diet. Most adults should have less than 1500 mg of salt per day.
• Limit alcohol use. If you choose to drink, limit yourself to one drink a day if you are a woman two drinks a day if you’re a man.
• Don’t smoke.

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Your Readings Exhibit Prejudice

Prejudice for normal readings significantly contributes to inaccuracies in blood pressure measurement. No doubt, youd be suspicious if a fellow EMT reported blood pressures of 120/80 on three patients in a row. As creatures of habit, human beings expect to hear sounds at certain times and when extraneous interference makes a blood pressure difficult to obtain, there is considerable tendency to hear a normal blood pressure.

Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or more, or diastolic blood pressure decrease of 10 mm Hg or more measured after three minutes of standing quietly.

There are circumstances when BP measurement is simply not possible. For many years, trauma resuscitation guidelines taught that rough estimates of systolic BP could be made by assessing pulses. Presence of a radial pulse was thought to correlate with an SBP of at least 80 mm Hg, a femoral pulse with an SBP of at least 70, and a palpable carotid pulse with an SBP over 60. In recent years, vascular surgery and trauma studies have shown this method to be poorly predictive of actual blood pressure .

Noise is a factor that can also interfere with BP measurement. Many ALS units carry doppler units that measure blood flow with ultrasound waves. Doppler units amplify sound and are useful in high noise environments.

Blood Pressure Results And Documentation

BP is recorded as a fraction, with the top number representing the systole and the bottom number representing the diastole. If first and second diastolic are recorded, the first diastolic is written over the second i.e. 120/90/80.

Documentation post the assessment is essential and should include the location the BP was taken and any factors that may have impacted the result. Further, it is important that health professionals note that drastic changes in BP can be a sign of clinical deterioration.

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What Is Blood Pressure

Blood pressure is the force of blood against the walls of the arteries. Blood pressure is recorded as two numbers, the systolic pressure over the diastolic pressure .

We record this with the systolic pressure first and the diastolic pressure second . For example, if the systolic pressure is 120 mmHg and the diastolic pressure is 80 mmHg, we would describe the blood pressure as 120 over 80, written 120/80.

All patients must be assessed for fitness before they undergo surgery. As part of this assessment, it important to measure and record the patient’s blood pressure. There are two reasons for this:

It provides an initial recording . If the blood pressure falls suddenly below this baseline after surgery, we are alerted to the fact that the patient may be experiencing complications.

It allows us to confirm that the patient is fit enough to undergo surgery. A high blood pressure reading, or indeed a very low blood pressure reading, could suggest that the patient has other medical problems, e.g. an undiagnosed heart condition. He or she may need further medical tests and possibly medication to stabilise the blood pressure before undergoing surgery.

When measuring a patient’s blood pressure, the nurse should be aware of factors that can affect the reading and possibly give a false reading, which could lead to unnecessary medical investigations. These factors include:

S Of A Sphygmomanometer

• Bladder: It is an inflatable bag that, when filled, squeezes the arms to block the artery.

• Cuff: The cuff has an inflatable rubber bladder that is cloaked around the upper arm. A pressure meter indicates the cuff’s pressure.

• Valve: The deflation valve allows for controlled deflation of the cuff and its critical for accurate measurement. An end check valve prevents air from escaping.

• Bulb: A small, handheld air pump inflates the blood pressure inside the cuff.

• Manometer: It is the portion of the sphygmomanometer that measures the blood pressure in mmHg. This aneroid gauge contains a watch-like movement that measures the air pressure applied to the cuff. Within the gauge, there is a series of diaphragms that expands when air is filled and contains gears that transform the linear motion of diaphragms, turning the needle on a dial calibrated in mmHg.

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Blood Pressure Monitoring At Home

Many people monitor their blood pressure at home. They often do this to manage or treat a certain health condition. If you monitor your blood pressure at home, keep a record, or log, of the measurements. The record shows your doctor how your blood pressure changes throughout the day. If you take medicines to control your blood pressure, it will help document if they are working. Measuring your blood pressure at home is a good way to take part in managing your health.

What Is Blood Pressure And How Is It Measured

The heart supplies the organs and tissues of the body with blood. With every beat, it pumps blood into the large blood vessels of the circulatory system. As the blood moves around the body, it puts pressure on the walls of the vessels. Blood pressure readings are made up of two values:

• Systolic blood pressure is the pressure when the heart beats while the heart muscle is contracting and pumping oxygen-rich blood into the blood vessels.
• Diastolic blood pressure is the pressure on the blood vessels when the heart muscle relaxes. The diastolic pressure is always lower than the systolic pressure.

Blood pressure is measured in units of millimeters of mercury . The readings are always given in pairs, with the upper value first, followed by the lower value.

So someone who has a reading of 132/88 mmHg has a

• systolic blood pressure of 132 mmHg, and a
• diastolic blood pressure of 88 mmHg.

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