Measure blood pressure. 22 April 2013 (First year)

Bismillahirahmanirrahim..

How are you there? =) Hope u'll be fine :)
Don't worry.. something that doesn't kill you, will make you stronger ;) keep your spirit up k :)

Ok, basically, I'll share with you what I studied this morning.And actually, we're practising for the upcoming community visit at Orang Asli Village in Tapah. As first year medical student, yeah... we are just expose to the sphygmomanometer & stethoscope. To hold those thing this morning also kind of awkward :P First time..Okay..  Maybe, I can give this post a title that is..

" How to measure Pulse Rate and Blood Pressure"

We learn to take patient's blood pressure step by step :

First : Before starting phase

1. Introduce ourself

2.Explain the procedure and inform consent to carry it out

3. Tell him/her, that he/she might feel discomfort as the cuff inflated, and thet the blood pressure measurement have to be repeated.

#And make sure your white coat didn't cause hypertension to the patient as patient might feel anxious when they feel you want to do something harm to their body :) calm them down before you start#

Second : Procedure to record pulse rate (PR)

* For convenience, its better to take radial pulse as it is superficial artery. Easy to detect it. You might use watch that has a second's hand.

*Explain the patient what you want to do

* Calm the patient, and make him/her relax.Because distressed patient might have faster pulse. Noted also if patient took medication before they come, because it might alter pulse rate.

*place 3 fingers along radial artery at wrist. Feel the pulse with middle finger, applying gentle pressure with the other 2 fingers.

*Count the pulse for a full minute

*make sure patient is comfortable

*Document your finding on patient's observation chart

*If the pulse irregular, note it in the document

*Record any change and irregularities

Third : Procedure to record Blood Pressure (BP)

 There are two methods can be use:

1. Palpatory method (Only to recored systolic BP)

* The patient right arm, put it horizontally at the level of mid sternum

* Place the vertical column so it is eye level

* Locate the radial pulse

*Put cuff to the patient's arm, up from the elbow and below shoulder level. Make sure it fit appropriately. Put your 2 fingers under the cuff, if it still can fit in, so it consider okay.

*Inflate the cuff till the radial pulse disappear.
* Reduce the pressure in the cuff gradually at rate 2-3 mmHg till you start feeling the pulse again.Record the pressure at this point (when you feel the pulse again) because it is 'approximate systolic BP'

2. Auscultatory method (To record systolic and diastolic BP)

* First, detect the brachial artey about 2 cm above antecubital fossa
* Put in cuff with appropriate size and procedure like I told 'above'.
* Inflate the cuff 20-30 mmHg more than approximate systolic BP.
(Normal BP : 120/80 mmHg)

* Place the stethoscope over the brachial artery, make sure it does not touching the cuff k :) because the sound might be affected

* Start reduce pressure in the cuff 2-3 mmHg.
- First korotkov sound :systolic BP
- Muffling and disappearence of the Korotkov sound : diastolic BP
(systolic is when our heart pump the blood, diastolic is when our heart in relax state and blood fill into it)

* Record BP, systolic over diastolic :) 'Don't make mistake by round off this position k ;)

* If the patient have high BP at first reading e.g 140/90, you may take the reading back after asking the patient to keep calm and relax first.

*If patient have history in postural hypotension, take the reading in standing position immediately after taking the reading in siiting position.

Last : After procedure

* Ensure the patient is comfortable

* Tell the patient his/her BP and explain its significance

* Hypertension can only be confirm after some repeating measurement taken over time

* Thank the patient

Ok.. hope we can apply it better in clinical year 2 years after :)

Hope you enjoy this :)

<3 you all =D