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Blood pressure measurement by mercury sphygmomanometer - background information EHES Training Material.

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Presentation on theme: "Blood pressure measurement by mercury sphygmomanometer - background information EHES Training Material."— Presentation transcript:

1 Blood pressure measurement by mercury sphygmomanometer - background information EHES Training Material

2 Hypertension as a cardiovascular risk factor

3 What is blood pressure? Systolic blood pressure (higher value), represents the pressure while the heart contracts to pump blood to the body First appearance of a clear repetitive sounds (Phase I) Diastolic blood pressure (lower value), represents the pressure when the heart relaxes between beats Disappearance of the repetitive sounds (Phase V)

4 Risk factors of elevated blood pressure Salt intake Obesity Alcohol use Sedentary lifestyle Smoking Fat contents of the food

5 Factors affecting blood pressure levels Measurement environment Noise, temperature Factors related to the participant Factors related to the measurer Measurement device Cuff size

6 Factors related to the participant Emotions – white coat hypertension Exercise Eating before measurement Smoking Use of caffeine containing drinks Alcohol use Full bladder Pain Daily variation Medication

7 Average magnitude of the effects (1/3) EffectSystolic bp (mmHg)Diastolic bp (mmHg) Full bladder mmHg, even up to 50 mmHg if bladder uncomfortably distended 10 mmHg, even up to 40 mmHg if bladder uncomfortably distended Not resting 3 to 5 minutes before measurement mmHg 14 mmHg Back / feet unsupported 5-15 mmHg 6 mmHg Supine posture instead of sitting posture 3-10 mmHg 1-5 mmHg

8 Average magnitude of the effects (2/3) EffectSystolic bp (mmHg)Diastolic bp (mmHg) Legs crossed 5-8 mmHg 3-5 mmHg Participant talks during the measurement mmHg 6-10 mmHg Arm below heart level 10 mmHg Physical exercise before measurement 22 mmHg 7-8 mmHg Left arm instead of right arm 1-3 mmHg 1 mmHg Arm unsupported during the measurement 1-7 mmHg 5-11 mmHg

9 Average magnitude of the effects (3/3) EffectSystolic bp (mmHg)Diastolic bp (mmHg) Diaphragm of the stethoscope instead of bell 2 mmHg 0-2 mmHg Cuff too small 3-12 mmHg 2-8 mmHg Cuff too large mmHg Cuff over clothing up to 5 mmHg

10 Three categories of observer error 1.Systematic error that leads to both intra- observer and inter-observer error 2.Terminal digit preference, which results in the observer rounding of the pressure reading to a digit of his or her choosing, most often to zero 3.Observer prejudice or bias, whereby the observer adjust the pressure to meet his or her preconceived notion of what the pressure should be Rose G et al. Lancet 1965; 1: 673-4

11 Acknowledgements Slides Hanna Tolonen


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