(1) The process of taking a patient's blood pressure (beginning at the time
you start inflating the bladder and ending at the time you completely release the
pressure) should take less than two minutes. Do not leave an inflated bladder wrapped
around the patient's limb for more than two minutes.
(2) If you are having problems that will result in going over the two minute
mark, deflate the bladder, remove the bladder from around the patient's limb, and wait
at least one minute before trying to take his blood pressure again.
q. Listen for Pulse. The point at which you hear the pulse beat return is the
patient's systolic pressure. Note the reading on the gauge when you hear the first
distinct sound of a pulse beat.
(1) The markings on the gauge will mark off readings (130, 132, 134, etc.).
When you record blood pressure readings, record the reading to the nearest even
number (for example, 128 instead of 127).
(2) Normally, you will remember the patient's systolic reading and not write it
down until you have the determined his diastolic reading also. Writing the number down
distracts you from listening to the pulse and watching the gauge as the air continues to
escape.
r. Continue to Release Pressure. After you identify the patient's systolic
pressure, continue to listen to the pulse and watch the gauge as the air continues to
escape from the valve. The air should be escaping at a rate that does not require you
to adjust the airflow (turn the screw).
s. Listen for Last Distinct Sound. As long as the air pressure in the bladder is
greater than the diastolic pressure, the artery will collapse after each pulse beat. This
makes the pulse have distinct sound. Once the air pressure in the bladder is less than
the diastolic pressure of the blood, the artery will remain open at all times. This means
that you will be hearing the sound of continuous blood flow in addition to the blood
surge caused by the pulse. The pulse will sound muffled and not distinct. The point at
which the distinct pulse sound changes to a muffled sound marks the diastolic pressure.
(1)
Often the pulse will sound louder just before the diastolic pressure is
reached.
(2)
A change in rhythm may also occur at the diastolic level.
(3) Sometimes the diastolic is difficult to determine. You may wish to close
the valve (turn screw clockwise), inflate the bladder to a point where the pressure is
above the diastolic, and release the air at a slower rate than before in order to check
yourself.
MD0531
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