What is blood pressure? Its value depends mainly on the strength of the heart rhythm, the amount of blood released and the elasticity and resistance of blood vessels. Therefore, it is obvious that its significance will depend on the state and activity of the organism. With intense work, blood pressure will be much higher than during sleep.
How pressure is measured
Now many people have an electronic blood pressure monitor (a modern device for measuring pressure). How it works is known to all. The doctor rests the phonendoscope on the back of the elbow and listens to "something there." An electronic device can work without listening. However, electronic devices are less accurate.
What happens inside your hand during the measurement? And what does the doctor really listen to? To understand the principle of measuring pressure, it is necessary to refresh the knowledge of physics. We need to recall the story of the laminar and turbulent flow, here is a natural example.
Imagine a calm river flow. Water flows lazily, and the river is almost silent. But as soon as it flows along the spillway or rapids, a rapid surge will occur.
When measuring pressure, this is precisely the phenomenon that is used.
When the cuff of the tonometer on the arm is inflated, the pressure in the cuff is higher than in the artery, and it contracts, closes. Blood does not flow. Can not hear anything. Then the air from the cuff starts to slowly exit, and the pressure drops. As soon as the pressure in the artery and cuff has equalized, blood begins to flow (quite loudly).
Air continues to escape, and a murmur is heard until the cuff pressure ceases and the blood can flow freely. At this point, the value of diastolic pressure is determined. It is also necessary to add that systolic pressure is an indication at the time of the heart rhythm, and another - diastolic - at the time of rest.
Measuring instruments
To diagnose blood pressure at home, two types of blood pressure monitors are used:
- Analog tonometers or aneroid sphygmomanometers. These are devices of mechanical-acoustic type. They are quite simple to operate and maintain. They have a long service life, but require adjustment and calibration for long-term use. Mechanical devices record values and numbers more precisely than automatic ones.
- Electronic blood pressure monitors. They can be either automatic or semi-automatic. These devices are designed specifically for the diagnosis of blood pressure at home. They are convenient, and do not require special skills from the patient when measuring. The cost of these devices is slightly higher than that of mechanical counterparts. The only negative is a small error, after frequent use.
How to measure your pressure
To increase the accuracy of measurements, it is necessary:
- Before starting the diagnosis, sit in a calm environment for 5 minutes,
- do not smoke for 30 minutes before diagnosis,
- Blood pressure is best measured in a sitting position. In this case, the patient’s hand is in a relaxed state and is free from clothing. The skin should not have scars or cuts in the area of the brachial artery, as well as edema or fistula for hemodialysis,
- the elbow bend is placed at the level of the heart, for this they put a hand on the table just above the lumbar,
- The tonometer cuff is placed on the shoulder so that its lower border is two fingers above the level of the elbow. The cuff itself is attached quite tightly, while it should not cause pain,
- The determination of blood pressure is performed twice, with an interval of 2 minutes. In the event that the readings diverge by more than 5 mm Hg. pillar, carry out an additional measurement. According to the data obtained, its average value is derived.
The first measurement is recommended to take readings from both hands. After the initial reading, the pressure is checked on the hand where its level is higher. A more difficult task is to calculate it with a disturbed rhythm of the heart. In this case, it is better to entrust the taking of indicators to a medical officer.
In the diagnosis of hypertension, it is recommended to measure blood pressure twice a day, morning and evening (at 21 00 - 22 00). It is also fixed for any signs of deterioration in the patient's condition. The obtained indicators are recorded in a special fixation diary, for further consultation with the attending physician.
Automatic blood pressure monitor
How to measure pressure with an automatic blood pressure monitor? As practice shows, in comparison with a mechanical device, an electronic tonometer is significantly inferior in diagnostic accuracy. Electronics is more sensitive, therefore, any slight violation in determining blood pressure can affect the final result.
Using an electronic blood pressure monitor is quite simple. It is enough to put the cuff on the arm and turn on one button on the device. Next, automatic pumping of air into the cuff of the device will begin. In a semi-automatic device, air is pumped with a pear. Reading, as well as deflating the cuff in both cases, is done by the device itself.
Electronic devices
Methods of measuring pressure by an electronic device:
- Before putting on cuffs release a shoulder of a hand. It is necessary to remove the sleeve of outerwear so that it does not pinch the upper shoulder. The best option is blood pressure monitoring on both hands. For self-measurement, a cuff is placed on a non-leading arm. However, the correct readings will be on the hand on which the blood pressure level will be higher than on the other.
- The hand is laid on a flat surface, this can be done on the table or armrest of the chair. In this case, the extensor part of the forearm is on the surface, and the limb is in a relaxed state.
- Check the status of the electronic device. It must not be damaged, twisted or bent on the surface of the hose.
- Disunite the edges of the cuff. Put it on the shoulder with a circular wrapping method, a little higher (two fingers) from the elbow. In this case, the air supply hose should run exactly in the middle between the conditional line of the middle of the bend of the elbow and the middle finger of the hand.
- If the cuff of the device is marked with the installation line, position it so that it is in the middle position inside the shoulder surface.
- Start the device by pressing the button.
- Wait until the unit pumps up and bleeds air. Be relaxed and do not touch the device.
- The device displays numbers. The upper indicator is responsible for systolic pressure, the lower for diastolic. Many devices also record heart rate. This value will be displayed below others. In this case, the diastolic blood pressure will be located above the pulse, in the middle column.
- Turn off the device through the button and wait until it is completely turned off.
- Remove the cuff from the shoulder. Diagnostics is complete!
An automatic blood pressure monitor is very convenient and should be present at home for every hypertonic.
Mechanical blood pressure monitor
How to measure pressure with a mechanical tonometer? Some difficulty in an inexperienced patient is caused by the use of an analog device. Not every person from the first time understands how to correctly take readings using a mechanical tonometer.
To determine the exact blood pressure, a phonendoscope is used. This device is designed to listen to sound vibrations that occur during the operation of internal organs. The device itself consists of ear tips, conductive tubes, fixing vibrations and a “head” with a sensitive membrane.
When measuring blood pressure with an analog device, a phonendoscope helps to hear fluctuations in blood flow when the cuff is weakened or compressed. At the same time, the scale of the device helps to determine the moment of the beginning of the pulsation and attenuation of blood pressure in conjunction with the appearance of sound “shocks” in the phonendoscope.
Recommendations when determining blood pressure with a manual tonometer:
- Before the measurement procedure, you need to relax for 5 minutes. If you come from a cold, you should completely warm up. Take a seat on a chair with a back and relax your legs without crossing them together. Lying is also not recommended.
- The shoulder girdle and arms should be relaxed. Place your hand with the brush up on the surface of the table, approximately at the level of the heart. Place the cuff on the arm so that one finger enters between it and the surface of the forearm. The lower edge of the cuff should be 2.5 cm higher from the elbow.
- Set the dial of the gauge in direct line of sight so that its scale is clearly visible. Place the stethoscope on the elbow, holding it, slightly adjusting the head to the edge of the cuff. Start blowing air by manually squeezing the pear.
- Listen carefully until the first tremors appear (the first stage according to Korotkov). They will show the level of systolic pressure. Repeat pumping again until the GARDEN becomes more than 30 mm Hg. Art. Release the pear. The moment of disappearance of tones will indicate diastolic blood pressure.
Repeat the whole process in a few minutes. Print the average value between the two readings of the device.
In case of heart rhythm disturbance, it is better to entrust the pressure measurement to the medical worker.
What to do if the tonometer shows very high pressure
In this case, make two control measurements after 10 minutes!
When re-identifying high blood pressure and poor patient well-being, you must:
- Hypertensive patients - urgently take a drug. Healthy people - call an ambulance.
- In very serious condition, take the pill “under the tongue”. In this case, captopril (capoten) in a dosage of 25-50 mg. Or nifedipine (Corinfar), in a dosage of 10 mg.
- When chest pain (symptom of angina pectoris) occurs, a nitroglycerin tablet is taken “under the tongue”.
- It is especially dangerous to sharply lower blood pressure in older people. Since drugs with a sharp decrease in pressure can cause drowsiness, a broken condition or eating disorders.
At the slightest suspicion of the manifestation of the symptoms of a hypertensive crisis, an urgent call is urgently needed.
CONTRAINDICATIONS ARE AVAILABLE
CONSULTING YOUR DOCTOR NEEDED
Author of the article Svetlana Ivanova, general practitioner
