Blood pressure and its measurement

FUNDAMENTALS OF FIRST AID
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Blood pressure and its measurement

Fundamentals of First Aid (OPMP)

The pressure that the blood in an artery exerts on its wall is called blood pressure. It depends on the strength of heart contractions, blood flow into the arterial system, the magnitude of cardiac output, the elasticity of the walls of blood vessels, blood viscosity and other factors. Blood pressure decreases with distance from the heart. Distinguish between systolic and diastolic blood pressure. Systolic blood pressure (maximum) - the greatest value of pressure in the arteries during systole of the heart. Diastolic (minimum) - the lowest value of pressure in the arteries during diastole of the heart.

Blood pressure is measured in the brachial artery using a sphygmomanometer (Riva-Rocci apparatus) or a membrane tonometer, using the Korotkov sound method. In recent years, automatic pressure meters have become widespread.

Blood pressure is measured with the patient sitting or lying down. At the same time, the arm is exposed, unbent at the elbow joint and laid on the table or edge of the bed at heart level with the palm up. The device is placed at the same level with the hand, the measurement is made as follows:

a cuff is placed on the shoulder so that a finger can be placed under it, the lower edge of the cuff is placed 2-3 cm above the elbow bend, the rubber tube is placed on the side;
feel the pulse on the ulnar artery, apply a phonendoscope to this place;
gradually pumping air into the cuff, through the phonendoscope listen to the appearance and disappearance of sounds corresponding to the pulse: the disappearance of sounds indicates that the artery is completely squeezed by the cuff; after that, the column of mercury is raised by another 30-40 mm;
slightly open the screw of the balloon and slowly release the air so that the mercury level does not decrease too quickly, while listening carefully: as soon as the pressure in the cuff becomes lower than the blood pressure in the artery, and the blood passes through the squeezed section of the artery, then sounds (tones) appear.

The pressure corresponding to the appearance of the first tone will be systolic (maximum), resulting from the pressure of blood on the artery wall during systole. As soon as the pressure on the artery from the cuff stops, the sounds disappear. The pressure corresponding to the moment of the disappearance of sounds is recorded as diastolic (minimum). The pressure value is noted on a scale in millimeters of mercury (mm Hg) and recorded as a fraction: in the numerator - the value of the maximum (systolic), in the denominator - the minimum (diastolic) pressure.

In order to control the reliability, the measurement is repeated at intervals of 2-3 minutes;

in the intervals between measurements, the cuff is not removed, and the air is completely released from it.
Normal for a healthy person is conditionally considered systolic pressure of 100-140, diastolic - 70-90 mm Hg. Art. In diseases, deviations are found
arterial pressure in the direction of both its increase - hypertension, and decrease - hypotension. An increase in blood pressure is observed in hypertension, nephritis, diseases of the endocrine system, and a decrease in shock, collapse, acute infectious diseases.

Authors: Aizman R.I., Krivoshchekov S.G.

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