Non-invasive blood pressure cuff

Measurement of blood pressure is often used in medical practice as an important diagnostic procedure that reflects the patient's condition. In fact, this indicator reflects the pressure of blood on the vascular wall with its continuous constant flow. Moreover, it is directly related to arterial vessels. They began to measure pressure relatively recently, although the device for the procedure is quite simple and is based on the practical laws of biophysics.

Measurement procedure technique

The great Russian scientist Korotkov formulated the basic rules for measuring blood pressure using a manual non-invasive sphygmomanometer with a cuff applied.

The Korotkov method provides for the presence of a measuring device consisting of a cuff with a fabric clasp, a pressure gauge and a silicone bulb.

Significant requirements are placed on the condition and position of the patient:

1. 15 minutes before the direct measurement, the patient should not experience physical exertion, be exposed to excitement and emotional experiences.
2. The patient must be seated on a chair with a hard back. The forearm should be on a hard surface.
3. Due to the inability of the patient to sit, his lying position is allowed.
4. In any position, you can not cross the limbs. The patient should not smoke before the procedure, take drugs that can change blood pressure, including alcohol.

Accurate adherence to the methodology of actions when measuring blood pressure according to the Korotkov method will allow you to reflect the indicator as it really is, which will become the basis of a correct diagnosis. It will also facilitate the work of the doctor in choosing the optimal therapeutic program.

Sequencing

During the measurement, the following sequence should be traced:

• For the patient, a comfortable position is chosen lying or sitting. The doctor or nurse should also have convenient access to the patient, in particular to one of his hands.
• The cuff of the tonometer is superimposed exclusively on the forearm. The middle of the cuff should coincide with the level of the fourth intercostal space in the patient. If a person is lying, the analogy is drawn to the accepted midaxillary line. It is very important to apply the cuff at the required level, since its underestimation will increase the pressure, and its overestimation, on the contrary, will lower it. In general, the bottom edge of the cuff should be at least two fingers above the crease of the elbow, which is approximately two and a half centimeters.
• Tighten the cuff fabric should also not be too tight: before starting the procedure, one finger should safely pass between the skin and the cuff. The shoulder must be freed from clothing, since the imposition of textiles on the cuff overestimates the measured values.
• The cuff is applied strictly individually, but in such a way that it covers almost the entire circumference of the upper arm and at least half the length of the shoulder. The width of this element of the tonometer also affects the accuracy of measurements: a wide cuff lowers the pressure, a narrow one overestimates. Blood pressure monitors are produced according to the standard scheme for the average person, but children's hospitals are equipped with devices of a smaller caliber, and departments of geriatrics and endocrine pathology often have blood pressure monitors where the cuff has a large area.
• The air in the cuff should be inflated quickly enough, without a clear tracking of the growth of the tonometer needle per second. But it is necessary to release air no more than 2 mm in one second. So, Korotkov's tones are perfectly heard from their first appearance.
• For a correct non-invasive arterial measurement, the stethoscope must also be used correctly. Before the actual procedure, it is necessary to feel the pulsation of the brachial artery in the cubital fossa. The stethoscope is applied to the established place without effort and pressure.

• Systolic pressure is determined at the time of the first of two consecutive Korotkoff sounds. In this case, it is necessary to note the numerical reading of the tonometer. When the tones subside, it is important to note the last tone, which reflects the diastolic pressure.
• The first visit of a patient with a clinical picture of blood pressure jumps should be accompanied by a measurement of this indicator on both hands. The highest value is taken as the desired value, and the subsequent measurement is carried out on the hand that showed the highest result.
• Recent trends in pressure measurement indicate the need for repeated procedures to accurately establish vascular tone. So, the measuring procedure is carried out three times with an interval of 3 minutes, which allows you to capture minute fluctuations in pressure. The desired value is the average among it, measurements thereof on one hand.

These conditions will allow you to measure the pressure as accurately as possible to assess the patient's condition. Inaccuracies in the procedure form an erroneous impression, which contributes to misdiagnosis or incorrect treatment.

Interpretation of results

Pressure surges in any direction are unfavorable for the body. For any gender and all ages, the optimal pressure is at the turn of 120/80 mm Hg. Deviation from this norm forms a characteristic symptomatology, and is also captured by a tonometer in its absence. For a long time, the body can compensate for high blood pressure figures with compensatory mechanisms, so that the patient learns about his problem during annual production examinations, in case of accidental treatment for another disease or from a hypertensive crisis that has occurred.

Pressure over 140/80 mm Hg. interpreted in the diagnosis of arterial hypertension. Certain values ​​correlate pressure indicators to a certain degree of the disease. So, arterial hypertension of the first degree is set from 141 to 159 mm Hg, for the systolic index they are stopped by basic antihypertensive drugs and lifestyle changes. Hypertension in the second and third stages requires complex therapy and an individual approach to each patient.

Diastolic pressure reflects vascular tone at the time of myocardial relaxation, and this indicator is naturally lower than systolic. But it can also be high or low. When diastolic pressure exceeds the limit of 90 mm Hg, this also indicates the presence of hypertension.

Reduced vascular tone has a less intense clinical picture, but its symptoms are also unpleasant. They are usually noticeable even without a confirmatory measurement of blood pressure, since such patients are lethargic, apathetic, and feel sleepy. The brain is susceptible to reduced pressure, which is reflected in headaches, cognitive decline, and the inability to concentrate. But even to such a state a person adapts with developed and healthy compensatory systems. Such people are called hypotonic, and if generally accepted normative pressure indicators are detected during the measurement, for them this is regarded as an increased tone. There are many hypotensive patients among the younger generation, but recent studies show that in the future, reduced tone develops into hypertension. Atypical tone still wears out the vessels, which provokes pathological processes in them in the future.

There is also an isolated form of hypertension, when systolic pressure rises, while diastolic pressure remains at the same level or falls. In the treatment of such a pathology, an individual approach to treatment is required, which necessarily includes the correction of background somatic diseases.

High blood pressure is often the result of emotional stress that patients experience in various situations. Thus, a separate form of hypertension has been identified as a “white coat” disease. From one type of medical worker, the pressure rises in patients, the metabolism increases, and symptoms of stress appear. The measuring procedure in this case reflects overestimated indicators of arterial tone. To clarify the diagnosis of such persons, non-invasive portable tonometers are used, which measure pressure independently and periodically during the day.

Devices for measuring pressure are constantly being modified and improved, and now you will not surprise anyone with an electronic tonometer. Manufacturers are working to improve the accuracy of devices and reduce their weight for easy carrying. Small parameters are combined with a comfortable screen and sufficient cuff area.