Measurement of Blood Pressure(Part 2):

Continued from part 1.

Protocol use

The standard method is to measure the cuff with stethoscope (counterpulsation). She is a patient in a reclining position, arms along the body, after five to ten minutes rest. The arm must be maintained at the heart: if the arm is too low, the pressure will be overestimated. The size of the cuff should be appropriate to the size of the arm if the cuff is too small, the pressure will be overestimated. Initially, we measure the pressure in both arms. Sometimes the pressure is slightly higher in one arm than another: we take the highest pressure as the reference value.

It is currently recommended during a consultation, measure blood pressure at the beginning and the end of the consultation: the syndrome of the white coat (the patient anxiety generated by the presence of medical staff) very often leads falsely high values early in the review.


Estimation without unit

In an emergency, lower systolic blood pressure can be estimated by simply taking the pulse, the latter resulting in the disappearance of a distal pulse; in an adult:

  • if the radial pulse is received, the systolic pressure exceeds 80 mmHg (T ? 8 mm Hg);
  • if the radial pulse is not seen but the carotid or femoral pulse is the systolic pressure is between 50 mmHg and 80 mmHg (8 cmHg ? T ? 5 mm Hg);
  • if the carotid and femoral pulse disappeared, the voltage is below 50 mmHg (T ? 5 mm Hg).


According to people, distal pulses (radial and pedal) may be more or less well received, and on the other hand, the disappearance of a pulse may also be due to external compression (effect withers) or internal (eg arteriosclerosis). We must therefore seek both radial pulse. On the other hand, if the voltage is below 80 mmHg, we did not feel the radial pulse, but conversely, if we do not feel the radial pulse, this does not necessarily mean that the voltage is low.

We can also estimate the systolic pressure with the "capillary refill" it exerts pressure on a nail, it fades, and watch how fast it recolors:

  • capillary refill normal (less than two seconds): systolic pressure exceeds 100 mmHg (T ? 10 mm Hg);
  • delayed capillary refill (greater than two seconds): systolic pressure is between 85 and 100 mmHg (10 cmHg ? T ? 8.5 mm Hg);
  • no capillary refill: the systolic pressure is less than 85 mmHg (T ? 8.5 mm Hg).

Pathologies

  • If it is always too high, it is a high blood pressure.
  • If it is too low, it speaks of hypotension.
  • If it is collapsed, it speaks of cardiovascular collapse, which can cause shock.
  • If it is increased in the presence of a physician, one speaks of the effect of "white coat"

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