Reported by Rowena P Ligon .

Blood

pressure measurement is a simple and painless exercise. Setting aside the time to pay a trip to your doctor or local clinic or alternatively investing in a home blood pressure monitor may very well end up saving your life in the long run. When high blood pressure is caught early, it is far easier to treat than when it has reached higher levels.

When the BP is taken, the cuff should be inflated to a pressure approximately 30 mmHg greater than systolic, as estimated from the disappearance of the pulse in the brachial artery by palpation. Initial estimation of the systolic pressure by palpation avoids potential problems with an auscultatory gap. Korotkoff sounds transiently disappear as the cuff is deflated. Once the cuff is adequately inflated, the following steps should be followed : The stethoscope should be placed lightly over the brachial artery, since the use of excessive pressure can increase turbulence and delay the disappearance of sound. The net effect is that the diastolic pressure reading may be artifactually reduced by upto 10 to 15 mmHg.

The BP should always be taken with patient's arm supported at the level of the heart. Allowing the arm to hang down when the patient is sitting or standing, will result in the brachial artery being 15 cm below the heart. As a result, the measured BP will be elevated by 10-15 mmHg due to the added hydrostatic pressure induced by gravity . The cuff should deflated slowly at the rate of 2 to 3 mmHg per heartbeat. The systolic pressure is equal to the pressure at which the brachial pulse can first be palpated as blood flow is restored through the previously compressed vessel; the systolic pressure is also equal to the pressure at which the pulse is first heard by auscultation (Korotkoff phase 1).

As the cuff is deflated below the systolic pressure, the pulse continues to be heard until there is abrupt muffling (phase 4) and, approximately, 8 to 10 mmHg later, disappearance of sound (phase 5), although the point of muffling sound should be used in those patients in whom there is more than 10 mmHg difference between phase 4 and 5. The BP should be measured initially in both arms. If there is a disparity due to a unilateral arterial lesion, the arm with higher pressure should be used. The BP should be taken at least twice to be sure of the accurate readings.

 Proper

measurement and interpretation of the blood pressure (BP) is essential in the diagnosis and management of hypertension. However, observational studies suggest that most of the doctors do not follow the correct technique of BP measurement, leading to potential errors in diagnosis and management of hypertension . It was seen that among medical students who had completed a course on how to properly measure the BP, only 5% adhered to course guidelines one year later .

BP should be recorded in a quiet, warm setting. Sitting pressures Patient conditions : the patient should sit quietly with the back supported for five minutes and the arm supported at the level of heart. The patient should not take any caffeine or exogenous Adrenergic stimulants during the hour preceding the reading and no smoking during the preceding 30 minutes. If possible, the BP should be measured 30-60 minutes before antihypertensive drugs are taken, to estimate through or nadir effect.

 Mercury

sphygmomanometers provide the most accurate measurement of BP. Use of proper-sized cuff is essential, the bladder should encircle and cover two third of the length of the arm; if not, place the bladder over the brachial artery to prevent high readings bladder that is too small.

 If

your doctor has told you that you need to start taking your blood pressure at home or if you have decided yourself that it is something you would like to keep an eye on then there is basically two different blood pressure monitors you can use 1) Aneroid monitors 2) Digital Monitors. Here we will explain how to take your own blood pressure using either kind of monitor and what to do to prepare beforehand.

1) At least 30 minutes before taking a reading avoid using any kinds of foods or drinks that alter your blood pressure such as stimulants like tea and coffee and energy drinks like red bull. Alcohol and cigarettes should also be avoided. 2) Empty your bladder before taking a reading. 3) Rest for 5 minutes before measuring your blood pressure and avoid talking also. 4) Sit comfortably with your back supported and with your ankles uncrossed. 5) You will need to rest your left arm on a desk or table that keeps your arm level with your heart. 6) Attach the cuff of the blood pressure monitor you are using to your bare upper left arm at approximately 1 inch above the crease of your elbow. The cuff should be snug but leaving enough room for you to fit one finger underneath.

1) Put the ear pieces of the stethoscope in your ears.

2) The disc of the stethoscope should be place on your upper arm on the inside just above the elbow crease. 3) The cuff will need to be inflated quickly with no delay. A delay can cause a false reading. Keep inflating the cuff until the reading exceeds your previous reading by 30 40 points. 4) At this point let out some air at a rate of about 2 -3 mm per sec. Dont deflate the cuff any faster than this as it will create an inaccurate reading. 5) As the cuff deflates, listen carefully for the first sound of your heart beat. When you hear it, write down the reading on the dial, this is your systolic pressure. 6) Continue to deflate the cuff at 2 -3 mm per sec until you hear your heart beat completely stop. Right down the reading at this point, this is your diastolic pressure.

1) Place the cuff around your bare upper arm, just above the elbow crease.
2) Press the start button.

3) Fully automatic digital monitors will inflate by themselves and semiautomatic digital monitors will need to be inflated manually with a rubber bulb.
4) All digital monitors will begin to deflate automatically to give your complete blood pressure reading. Some digital monitors will store the reading, for others you will need to write down the reading. 5) You can now press the exhaust button to release all of the air.

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Mercury Filled Glass Tube In Easy-To-Read Metal Scale, Calibrated From 0mm. Hg To 300mm. Hg. Minimum Maintenance ACUMAX Is a Calibrated Cuff With Two Tube Latex Bladder. Cuff Has Size, Index and Range Markings, Artery Indicator Label And Gauge Holder. Compact, Accurate Mercurial In Self- Contained Aluminum Case With Push-button Lock. Silver Gray Textured Color. The Scale Is Aluminum, Black, Anodized Background With Large White Numbers. Aluminum-Alloy, Lightweight, Strong, Portable Caring Case. Delivers Scientific Precise Accuracy. Weight - 2 1/4 Pounds.

Mini Arm Blood Pressure Monitor (01/24/2005) Mini Arm type Blood pressure monitor Size same as wrist type East carry for travel One hand operation Large LCD Display Smart sense oscillometric Pressure +/- 2mmhg Pluse +/- 2% Automatic inflation 60 set non-volatile memory Year-month-day display Arm size 135195mm Synchronize heart beat buzzer Battery life over 250 times Accurate.

1. Please key-in the file name before storing measured curves. 2. It shows measuring curves of pulse on real time. 3. It shows measuring curves of cuff pressure on real time. 4. Adjusting curves of pulse in upper and lower displacement. 5. Adjusting curve of blood pressure in left and right sides. 6. Adjusting curve of blood pressure in upper and lower. 7. Storing the measured curves. 8. Closing the application program.

digital

 BP

is currently measured in the arm because it is convenient. However, this may not always accurately reflect what the pressure is in the larger arteries close to the heart. The new technology uses a sensor on the wrist to record the pulse wave and then, using computerised modelling of the pulse wave, scientists are able to accurately read the pressure close to the heart.