Thursday, June 2, 2011

Blood Pressure - Things to Know

Do you ever wonder what is the size of the cuffs used in clinics and wards?
Have you ever wondered whether you used the right cuff for the right age ?

Well, here it is.

It is basically sold in four sizes.
The ones that we usually get in clinics for adults are 20 inches long, not wide.

We must aware that wrong size of cuff could lead to misinterpretation of the blood pressure values.

Hence, the right cuff must be used according to suitable age.

    General Practice, Multicuff, Blood Pressure Cuff Kit - Latex Free
  • Cuff Size: Adult 10.28 to 16.1 inches 
  • Cuff Size: Child 7.48 to 10.71 inches 
  • Cuff Size: Large Adult 13.5 to 20.04 inches

         Pediatric, Multicuff, Blood Pressure Cuff Kit
  • Cuff Size: Newborn 3.94 to 5.59 inches 
  • Cuff Size: Infant 5.31 to 7.68 inches 
  • Cuff Size: Child 7.48 to 10.71 inches 

Next, the measurement of blood pressure.

How to secure the cuff
  • Make sure that the cuff is covering 2/3rd of the upper arm.
  • Make sure that the cuff is tight allowing only one finger to pass through under cuff.
  • Make sure that the cuff is at the level of the heart.

Important steps during clinical examination:
  • Secure the cuff at 2/3rd of upper arm
  • Palpate the pulse with your left hand, raise the pressure above systolic level to make pulse disappear. Take note of the pressure where the pulse disappear
  • Palpate the brachial artery pulse which is medial to biceps tendon
  • Put the diaphragm of stethoscope under the medial aspect of the cuff 
  • Raise the pressure above  noted systolic level 
  • Release the pressure slowly 
  • Listen to the first Korotkoff sound that appears which indicating the systolic pressure of the patient
  • As the sound muffled and disappear , note that this muffling sound is the diastolic pressure level
5 Phases of Korotkoff's sound
  • Phase 1: First appearance of the sound marking the systolic pressure
  • Phase 2 and 3: increasingly loud sounds
  • Phase 4 : abrupt muffling of the sounds
  • Phase 5 : disappearing of the sounds
*Phase 5 provides better measure of diastolic pressure than phase 4,not only because it corresponds more closely with the directly measured diastolic pressure , but also because its identification is less subjective.
source: Hutchinson's Clinical Methods

Blood Pressure Measurement For Dummies

Download link : here.

*Note : Also important as viva questions especially in Pediatric department.


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