Presentation on theme: "Blood Pressure And BMI. How To Measure Blood Pressure (as given by Oxford Clinical Guide) WIPERS Take name & DOB Ask arm preferences, make sure no tight."— Presentation transcript:
How To Measure Blood Pressure (as given by Oxford Clinical Guide) WIPERS Take name & DOB Ask arm preferences, make sure no tight clothing. Check for no caffeine in last hour, no smoking last 15 mins. Use correct cuff size (see questions). Centre bladder over brachial artery, apply snugly. Support arm in horizontal position at mid-sternal level. Inflate the cuff while palpating the brachial artery, until the pulse disappears. Note the pressure at which it disappears and deflate the cuff.
Inflate the cuff until 20-30mmHg above the previous pressure, then place stethoscope over the brachial artery. (Shouldn’t hear any sounds at this point) Deflate slowly at 2mmHg per second. Appearance of sustained repetitive tapping sounds is systolic pressure. Disappearance of sounds would indicate the diastolic pressure.
Video This video is useful, they skip the step of inflating with palpating the pulse but as a rough guide it can help. http://www.youtube.com/watch?v=S648xZDK 7b0 http://www.youtube.com/watch?v=S648xZDK 7b0
Korotkoff Sounds These are the arterial sounds you hear when taking blood pressure. They are caused by turbulence in the blood flow caused by compression of the artery.
Body Mass Index A measure for human body shape based on height and weight. Formula: Don’t use the imperial one…
How to perform: Explain to patient the procedure and what you will do. Wash hands etc. Ask patient to remove shoes. Weigh on scales, should be in room. Make sure you get close to the scales to show you are getting an accurate reading. Height is measured using the wall tapes. Get patient to stand with heels to wall and back of head against wall. Read off the measurement.
If you are getting a reading that comes miles off what you expect then don’t panic. Make sure you used metres rather than cm and that you read kg off the scales.
Possible Questions What other possible measures of size/obesity etc. are there? – Waist/hip ratio. Fat callipers. What is considered the normal range for BMI? – 18.5-24.9. We’ve had different answers given to us for this so it may be worth saying some sources also say 20-24.9 but the first is the one in the Oxford Clinical Medicine handbook.
What are the sounds you are listening for in blood pressure tests? – Korotkoff sounds. The first sound is systolic. Korotkoff 4/5 is diastolic. That is the move between the last noises and silence. How do you choose the size for a sphygmomanometer? – Two thirds of the cuff should be the circumference of the arm. What blood pressure is regarded as hypertension? – Above 140/90mmHg
Above what BMI is an individual considered obese? – Greater than 30.0 – Obesity I; Greater than 35.0 – Obesity II; Greater than 40.0 – Morbidly obese. What do systolic and diastolic blood pressure mean? – Systolic (maximum pressure in artery following ventricular systole), Diastolic (lowest pressure in the artery during ventricular diastole)
Why is getting the correct cuff size on a sphygmomanometer important? – If its too big, the bp will be artificially low, if its too small it will be artificially high Why is BMI not a perfect measure to use? – It doesn’t take into account an individuals build and can be different in different ethnicities. What causes Korotkoff sounds? – Turbulence in blood flow in artery caused by cuff compressing artery.
What are some possible complications of hypertension? – Ischaemic Heart Disease, Stroke, Heart failure, Kidney failure What are some possible factors that could influence blood pressure? – Age, circadian variation, food, drink, posture, pain and anxiety (“white coat” hypertension)