in Blood pressure is the measurement of the force of circulating blood on the walls of the arteries. Blood pressure is measured in millimeters of mercury (mmHg) and is taken using two measurements: one is systolic pressure (the pressure when your heart pushes blood out) and the other is diastolic pressure (the pressure when your heart rests between beats). Let us learn how to take these measurements to check blood pressure.
How to check blood pressure manually?
The following two basic diagnostic instruments are used to check blood pressure.
Let’s discuss them one by one.
“Stethoscope is a simple device made up of a chest piece, a hollow plastic tube, and two earpieces”.
The chest piece picks up the sounds and is usually double sided made up of a diaphragm and a bell. The diaphragm picks up high-frequency sounds while the bell picks up low-frequency sounds well.
The sounds from the chest pieces are transmitted by the hollow tubing to the headpieces. The end of the headpieces contains two soft ear tips which you can easily remove for cleaning or replacement.
Sphygmomanometer or Blood pressure cuff
A sphygmomanometer” is more often referred to as a blood pressure cuff. Because in order to check blood pressure, a cuff is wrapped around your upper arm. Then to measure your systolic and diastolic blood pressure, the pressure in the cuff is first increased and then gradually released.
Types of sphygmomanometers
There are two main types of sphygmomanometers that are extensively used.
- Old-style Mercury Sphygmomanometers
- The aneroid Sphygmomanometers
A Mercury sphygmomanometer consists of a vertical column of mercury which is a manometer (a device used to measure the air pressure in mmHg), connected with a tube to the cuff. The cuff contains an inflatable bladder that is further connected with two tubes. One tube sends the pressure to the manometer and the other is connected to the pump. To pump up the cuff, you need to close the valve. Due to its toxic contents mercury, it is banned in some countries to check blood pressure.
An aneroid sphygmomanometer consists of a dial instead of a mercury column with the rest of the components similar to the mercury types of sphygmomanometers.
Cuff size is important:
Cuffs are available in several sizes, however, the following three sizes are the most common.
- Standard-sized cuffs for average adults
- Large-sized cuff for big arms
- Smaller ones for children and used.
You need to check that you are using the right-sized cuff to check the blood pressure of the victim. Otherwise, the blood pressure measurement will be inaccurate. Using a small-sized cuff for a victim’s arm results in falsely high ratings. The ideal cuff bladder length is ≥ 80 percent of the patient’s arm circumference.
Tips to remember before checking blood pressure:
- Before checking blood pressure, choose a quiet place so you can hear the heartbeat while checking your blood pressure.
- Ensure that the patient arm is free of clothing.
- The patient arm is comfortably resting supine on the desk.
- Sit in an upright position with support on the back and the feet flat on the floor.
- Ideally, arms should be at the same level as their heart.
- Keep the palm of the victim’s hand facing up.
Position the cuff
To check the blood pressure, position the cuff at about two and half centimetres above the bend of your elbow. Tuck the cuff end through the metal loop and slide it onto your upper arm. Make sure it is evenly tight around your arm. Check the tightness of the cuff by wedging two fingertips underneath, make sure it’s neither too loose nor too tight.
Locate the pulse of the patient
Press lightly over the centre of the inner elbow using your index and middle fingers to feel the pulse of your patient. Or you can make use of the head of the stethoscope to hear the victim’s heartbeat.
How to use a stethoscope to check blood pressure?
- Place the headpieces over the ears ensuring that ear tips are facing slightly forward.
- Hold the chest piece in your hand for a few minutes to help warm up the metal components before touching the patient’s skin.
- Slide the wider side of the stethoscope head under the cuff and position over the pulse of the brachial artery. Ensure that you have turned the chest piece so that the open hole is connected to the wider side that you are applying on the patient’s inner elbow.
- Apply the stethoscope with gentle pressure, but sufficient enough to form a seal with the patient’s skin.
To check the blood pressure, position the manometer and the pump.
- Place the mercury or gauge manometer where you can easily see the reading.
- Hold the pump on your right side and turn the screw on the pump bulb clockwise to close the airflow valve.
How to check the blood pressure of a patient?
- Pump up the cuff until you no longer hear the sound of the patient’s pulse through the stethoscope.
- Open the airflow valve by twisting the screw counterclockwise. Let the cuff deflates gradually. The gauge should fall two lines on the manometer, per second.
- Note the measurement on your manometer when you hear the victim’s pulse again. This measurement is his systolic reading.
- Note the measurement on your manometer at the moment when the sound of a heartbeat disappears. This measurement is his diastolic reading.
- Completely deflate the cuff. After several minutes, follow the same steps to check blood pressure again.
Interpretation of results
For an adult, the normal systolic blood pressure should be less than 120 mmHg and the diastolic blood pressure should be less than 80 mmHg.
- Stage 1 Hypertension: Systolic: between 130-139 or Diastolic: between 80-89
- Stage 2 Hypertension: Systolic: 140 or higher and Diastolic: 90 or higher
- Hypertensive crisis: Systolic: Above 180 and/or Diastolic: Above 120
Hypertension is nothing but high blood pressure and is a serious condition because it makes the heart work harder to pump blood into the body and if not controlled, can result in an increased risk of heart attacks, strokes, and kidney failures.
Similarly, Hypotension is low blood pressure. In this condition, the blood pressure typically falls below a Systolic value of 90 and a Diastolic value of 60.
Within prescribed limits, a lower blood pressure reading is generally good. However, sometimes this condition can result in dizziness and tiredness. But if there are no adverse symptoms as such then there is nothing to worry about.
Consult a physician if you suspect you have any stage of hypertension or hypotension. Your doctor will retest your blood pressure to make sure your readings are accurate. If you do have hypertension or prehypertension, your doctor will make recommendations for lowering your blood pressure. This will include lifestyle changes in addition to medication.
If you are already on medication for your blood pressure, your doctor may suggest therapy or consider testing for additional health problems that prevent the medication from working properly.
The content of this blog post is not aimed at substituting for professional medical advice or treatment. It’s always appreciated to contact your healthcare provider before starting, shifting, or halting any health treatment.