Biology

1. z
Monitoring of Blood Pressure
Presented to :
Mam Maryam
Presented by:
Saba Aslam (Roll # 191)
Fouzia Yaseen (Roll #
Saira Irum (roll #133)
Sania Shafique (Roll #
Iqra Abbas (Roll # 103)

2. z Objectives of this practical class:
 To define blood pressure.
 To describe the Korotkoff sounds and their
explanations.
 To define systolic, diastolic pressure.
 To list methods of measuring blood pressure.
 To discuss the indications and the precautions of
measuring BP.

3. z
Cont.…..
 To describe the equipment for measuring BP in
 each method.
 To show the correct technique for measuring BP.
 To identify the physiological factors

4. z
Definition of Blood Pressure
 The force of circulating blood on the walls of
the arteries. Blood pressure does not remains
same at all the time. It is affected by various
factors such as body position, breathing,
emotional state, exercise and sleep. Blood
pressure is taken using two measurements:
systolic (measured when the heart beats,
when blood pressure is at its highest) and
diastolic (measured between heart beats,
when blood pressure is at its lowest).

5. z
Recording the blood pressure
Blood pressure is recorded for a number of reasons.
• To acquire a baseline.
• To monitor for fluctuation in Blood pressure.
• To aid in diagnosis of disease.
• To aid in assessment of the cardiovascular system.
• To monitor medication e.g. anti-hypertensive drugs.

6. z
Systolic Pressure and Diastolic Pressure
 Systolic pressure is the pressure of blood in
arteries when the heart pumps.
 Diastolic pressure is the pressure of blood in
arteries when the heart is filling.
 The blood pressure is usually written as the
systolic pressure over the diastolic pressure
(e.g., 120/80 mm Hg).

8. z
Unit of Measurement-----mmHg
 Unit of Measurement-----mmHg
 Normal BP
 Systolic-------120 mmHg
 Diastolic------80 mmHg

9. z
Things you must know before checking
your Blood Pressure
 Before you start.
 Do not drink coffee for at least 30 minutes before
measuring.
 Do not use tobacco products for at least 30 minutes
before measuring.
 Do not exercise or eat a large meal two hours before
measuring.
 Use the restroom. A full bladder can affect the
reading.

10. z
For accurate measurement
 Sit quietly in a chair for 5 minutes before measuring.
 Sit with your back supported and feet flat on the
ground.
 Remove clothing from your upper arm.
 Make sure your arm is supported at the level of your
heart on a table or armrest.
 Do not talk while having your blood pressure
measured

11. z
Position of Patient

12. z
Position of Arm

13. z
Equipment's
 Stethoscope
 Sphygmomanometer

14. z
Stethoscope

15. z
Mercury sphygmomanometer

16. z
Aneroid sphygmomanometer

17. z
Blood Pressure Cuff

18. z
Core steps:
1. Introduce your self to the patient and check
the identity.
2. Explain the procedure and take consent.
3. Check your equipment.
4. Make sure the apparatus is working and set to
Zero.

20. z
Steps of Measuring Blood Pressure
 Patient’s arm should be supported with his/her upper
arm at heart level, back supported, legs uncrossed
and feet on the floor.
 Your upper arm should be bear with sleeve
comfortably rolled up.
 Medical personnel should wrap the blood pressure
cuff around you upper arm. The lower edge of the cuff
should be 1 inch above the bend of your elbow.

21. z
Cont.….
 The cuff must be inflated quickly either by pumping
the squeeze bulb or pushing a button. Patient would
feel tightness around his/her arm.
 Next, the valve of the cuff should opened slightly,
allowing the pressure to slowly fall.
 As the pressure falls the reading when the sound of
blood pushing his 1st heard is recorded. This is called
Systolic Pressure.

22. z
Cont.…
• The air continuous to be let out the sounds would
disappear.
• The point at which the sound disappear is recorded
this is called Diastolic pressure.
• Inflating the cuff too slowly or not high enough may
cause a false reading. If you loosen the valve too
much, you won’t be able to determine your blood
pressure.

23. z
Korotkoff Sound
 Korotkoff sounds are pulsatile circulatory
sounds heard upon auscultation of the
brachial artery with the help of stethoscope.

25. z
Measurement of Blood Pressure

26. z
Position while sitting on a chair

27. z
Placement of Stethoscope and Cuff

28. z
Precautions
 Body Position (reading varies with position).
 Activity Level (at rest), as patient should have rest in
relaxing position for at least 5 min before the
procedure.
 Cuff should be at the level of the heart.
 Don’t keep cuff inflated for too long.

29. z
Cont.…
 Do not forget to remove the cuff from the arm and
thank the patient.
 Recheck the BP of the patient after 2 minutes, by
repeating the procedure in the other arm.
 Record the systolic and diastolic pressure to the
nearest 2 mmHg, the cuff size, arm used, time & date
of measurement.
 Tell the patient about his own blood pressure.

30. z
Blood Pressure during exercise
 BP changes with exercise.
 Conditions Blood pressure :
 Before exercise 120/80 mmHg
 After mild exercise 140/80 mmHg
 After heavy exercise 160/60 mmHg
 After mild exercise, systolic blood pressure increases
while diastolic blood pressure remains more or less
the same.
 Following heavy exercise, the systolic pressure
increases tremendously and the diastolic pressure
drops

32. z
References :
 Kasper DL, Fauci AS, Hauser SL, Longo DL,
Jameson JL, Loscalzo J. Harrison's Principles of
Internal Medicine. New York: McGraw-Hill; 2015.
 Handler J. The importance of accurate blood
pressure measurement. Perm J. 2009
Summer;13(3):51-4. [PMC free article] [PubMed].