U.S ARMY HEALTH CARE B/P LAB

2 SGT Chase Johnson Army Health Care Recruiter U.S Army Medic ( 68W) Emergency Medical Technician (NREMT) Advance Cardiac Life Support Pediatric Advance Life Support International Trauma Life Support

3 B/P Lab Overview Blood Pressure Defined Pertinent Anatomy Baseline Knowledge Procedure Steps Practical Exercise

4 Blood Pressure Defined Blood Pressure is the force that blood puts on the arterial walls as it goes through the body. Readings are usually written as 2 numbers. The top number is called SYSTOLIC BP. The bottom number is called DIASTOLIC BP. BP is measured in millimeters of mercury (mmHg).

5 Blood Pressure Defined Example: Systolic/Diastolic 120/80 mmHg

6 Blood Pressure Defined Systolic pressure: pressure when the heart is contracting. It is specifically the maximum arterial pressure during contraction of the left ventricle, of the heart. Diastolic pressure: the minimum arterial pressure during dilatation of the ventricles of the heart, when the ventricles fill with blood.

7 Pertinent Anatomy The Heart The Circulatory System The Five Points of Palpation

8 Pertinent Anatomy

9 Pertinent Anatomy The Circulatory System : Moves blood throughout the body. It is composed of the heart, arteries, capillaries, and veins. Transports oxygenated blood from the lungs and heart throughout the body via the ARTERIES. Blood that has been depleted of oxygen by the body is then returned to the lungs and heart via the VEINS.

10 Pertinent Anatomy

11 Pertinent Anatomy THE 5 POINTS OF PALPATION Carotid: on the neck Brachial: under the arm Radial : on the wrist Femoral: in the groin Pedal: on the foot

12 Baseline Knowledge Heart Rate Oxygen Saturation Blood Pressure Instruments Orientation

13 Baseline Knowledge Heart Rate Pulse: rate at which your heart beats each minute (bpm). Rhythm: frequency and strength of the heartbeat. How to check a pulse: Palpate a major artery with your index and middle fingers with light pressure. Count how many times you feel a beat over 30 seconds and multiply by 2.

14 Baseline Knowledge Heart Rate Attain a Heart Rate: Palpate a major artery with your index and middle fingers with light pressure. Count how many times you feel a beat over 30 seconds and multiply by 2. Example: HR: 77

15 Baseline Knowledge Heart Rate

16 Baseline Knowledge Heart Rate

17 Baseline Knowledge Heart Rate THE 5 POINTS OF PALPATION Carotid: on the neck Brachial: under the arm Radial : on the wrist Femoral: in the groin Pedal: on the foot

18 Baseline Knowledge Oxygen Saturation Is a measure of how much oxygen the blood is carrying as a percentage of the maximum it could carry. It is commonly annotated as SpO2% Example: SpO2: 98%

19 Baseline Knowledge Oxygen Saturation Pulse Oximeter

20 Baseline Knowledge Blood Pressure in Adults Blood pressure rates can vary widely Ask questions such as physical activity level and medications/ supplements taken. Example BP: 120/80

21 Baseline Knowledge Blood Pressure in Adults

22 Baseline Knowledge Instruments Orientation Sphygmomanometer: blood pressure meter can be manual or automatic composed of an inflatable cuff to restrict blood flow, and a mercury or mechanical manometer to measure the pressure

23 Baseline Knowledge Instruments Orientation

24 Baseline Knowledge Instruments Orientation Stethoscope: is an acoustic device for auscultation usually consists of two-sided chest piece (bell for low frequencies and diaphragm for higher frequencies) and a hollow tube used to transmit sound.

25 Procedure Steps: Instruments

26 Procedure Steps Position the Patient There are three positions for taking BP: supine, seated, standing. In seated position, the patient's arm should be flexed. The flexed elbow should be at the level of the heart.

27 Procedure Steps Position the Patient: Seated

28 Procedure Steps To begin, use a properly sized blood pressure cuff. The length of the cuff's bladder should be at least equal to 80% of the circumference of the upper arm. Wrap the cuff around the upper arm with the cuff's lower edge one inch above the antecubital fossa.

29 Procedure Steps Lightly press the stethoscope's bell over the brachial artery just below the cuff's edge. Rapidly inflate the cuff to 180mmHg. Release air from the cuff at a moderate rate (3mm/sec). Listen with the stethoscope and simultaneously observe the sphygmomanometer.

30 Procedure Steps The first knocking sound (Korotkoff) is the patient's SYSTOLIC pressure. When the knocking sound disappears, that is the DIASTOLIC pressure. Document your findings!!!

31 Practical Exercise Pulse/ Heart Rate (HR) Respirations (RR) Blood Pressure (BP)

32 For More information on a career in Army Medicine please contact: SGT Chase Johnson (210)