Saturday, October 31, 2009

Could someone walk through what to listen for when taking your blood pressure?


Answer:
The preferred area to check blood pressure is the forearm -the front side of theelbow. The artery normally produces no any sound. When you apply the cuff above the forearm and applies pressure, the blood supply is stopped and when the pressure is released, the pulse becomes audible with the resumption of the blood flow. The first distinct sound heard indicates the systolic blood pressure while the last sound heard will be the diastolic blood pressure.
There should be numbers that tell you ure diastolic and systolic pressure...
You may take your blood pressure on either arm, although most people choose the left. The arm should be bare. If you roll up a sleeve, be certain that it is not so tight that it cuts off circulation to the arm. Slide the cuff onto your arm to a position just above the elbow.
Now rotate the cuff so that the chest piece of the stethoscope is about one inch above the elbow and under the biceps muscle. This is where the brachial artery runs. By putting your finger along this spot, you may be able to feel the pulse. Make sure the stethoscope chest piece is over the pulse spot. Tighten the cuff by pulling the tail of the cuff through the D-ring and wrapping it back over the fastener. Make sure the chest piece is placed correctly or you won't be able to measure your blood pressure accurately.
Sit at a table with your forearm resting comfortably at about heart level. The room should be quiet.
Place the ear tips of the stethoscope in your ears, remembering to turn ear tubes slightly forward for better fit.
Hold the pressure gauge in the other hand of the arm without the cuff.
With the trigger in the "out" or "pump" position, rapidly squeeze the bulb until the pointer in the gauge is about 30 mmHg above your systolic (top number) pressure. If you do not know your systolic pressure, try 180. The cuff should feel tight and your arm may feel cramped.
Once the cuff is inflated, stop pumping and position your index finger over the trigger air release valve. Watch the gauge dial face and slowly deflate the cuff by depressing lightly on the trigger until tension is felt. During the measurement phase attempt to keep the deflation rate slow and steady, at 2 to 4 mmHg per second. This requires only light pressure on the trigger. (Note: Inflate the cuff rapidly, and quickly begin pressure deflation to avoid hazards that occur due to prolonged overinflation of the cuff).
As you start to deflate the cuff you should hear nothing. If you hear sound immediately you will have to pump higher before you begin. As the cuff pressure decreases and the pointer falls, the first sound you will hear is a thumping - the first of several similar beats. The point at which these sounds begin is your systolic pressure. Note the position of the pointer.
Continue listening for the thumping sounds. When the sound stops, you have reached your diastolic pressure. Note the position of the pointer. Once you have measured your systolic and diastolic pressures, depress the trigger to the "dump" position and release the remaining air out of the cuff.
Immediately record your systolic and diastolic pressure.
If you are not certain about either the systolic or diastolic pressures, do not immediately reinflate the cuff. Wait a few minutes for normal circulation to return to your arm and begin again.
If you have not been able to hear the sounds clearly:
You may not have the cuff positioned correctly. Make sure the stethoscope is over the brachial artery.
You may be in a noisy place and not able to hear clearly. Relax and take your pressure in a quiet place.
You may not have the cuff tight enough when you begin to pump it. In general, two fingers should fit snugly under the uninflated cuff.
The sounds are louder if the cuff is inflated as rapidly as possible. Make sure you're pumping quickly.
The stethoscope ear tips should fit comfortably in your ears, forming an "air seal" to block outside noise. This may take several adjustments of the stethoscope ear tubes.
People whose arms are extremely large may require a larger than standard sized cuff for accurate measurement. Check with your doctor if your upper arm is larger than 16 in. around.
For a variety of medical reasons, your blood pressure may be particularly hard to measure. Check your technique with someone experienced in blood pressure measurements if you continue to have difficulty.
You listen for the first "hard" beat sound, then continue to listen until you hear the faintest beat and then nothing. Mark the numbers when you hear these two beats and you have systolic (the top number) and diastolic (the bottom number).
You don't have to listen to any thumps if you are taking your own blood pressure. Follow the procedure suggested by Indiana Frenchman but forget the stethoscope. As you release the air from the cuff you will feel your own pulse in the arm. Mark the systolic pressure when the pulse appears and the diastolic where it disappears. It works only if you are recording the BP on yourself. Try it.
If recording BP on another person, you need the stethoscope; which basically makes the same pulse audible to you.

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