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NIBP
1) There are several methods for measuring blood pressure non-invasively, including palpation, auscultation, oscillometry, Doppler, plethysmography, tonometry. 2) Palpation allows for detection of systolic pressure but underestimates higher pressures and cannot determine diastolic or mean pressures. 3) Auscultation uses a blood pressure cuff and stethoscope to listen for Korotkoff sounds during cuff deflation to determine systolic, diastolic, and mean pressures.
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Introduction to the principle of measuring blood pressure non-invasively.
Method involves palpating the radial pulse while inflating the cuff, may underestimate systolic BP by 25%.
Describes proper cuff size relative to limb diameter for effective auscultation.
Introduction to oscillometry as a method for determining blood pressure.
Utilizes the Doppler effect for measuring systolic pressure; sensitive for low pressures.
Monitors pulse waves at various body parts; provides delayed blood pressure data.
Further insights into the plethysmography technique.
Details on tonometric sensors which ensure stable BP readings and can assess arterial properties.
Highlights limitations of tonometry; potential inaccuracies, pain, and patient movement effects.
Closing remarks of the presentation.
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NIBP
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- 2. PALPATION I cuff rapidlyto 70 mmHg, and increase by 10 mm Hg increments while palpating the radial pulse. Note the level of pressure at which the pulse disappears and subsequently reappears during deflation; will be systolic blood pressure. limitation While being easy to perform, this technique has been shown to underestimate a systolic pressure of 120 mm Hg by 25%. Diastolic and mean pressures cannot be determined.
- 3. AUSCULTATION The cuff shouldbe 20% wider than the diameter of the part of the limb being used (or cover two-third its length).
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- 5. DOPPLER Systolic pressure canalso be determined using the Doppler principle. Blood flow towards or away from the Doppler probe, reflects sound waves causing a change in frequency that is detected using the same Doppler probe. As Doppler is so sensitive, this technique is usually reserved for the measurement of low pressures, e.g. vascular insufficiency.
- 6. PLETHYSMOGRAPHY Blood pressure cuffsor other sensors are placed at different locations on the arms, legs, fingers, and/or toes. The sensors record the pulse waves that occur with each heart beat. (This data is translated into a graphic recording for later review.) Limitation--- This does not give real time blood pressure The test usually takes less than 20 to 30 minutes.
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- 8. TONOMETRY In order toobtain a stable bp signal, the tonometric sensor must be protected against movement and other mechanical artifacts. The artery wall does not influence the transmission of arterial pressure to a sensor applied to the skin. They have also been used to determine arterial elasticity and pulse wave velocity. Under favorable conditions, the accuracy of tonometric measurements can be described by standard deviations of ∼5mmHg.
- 9. Limitation • Cannot beused for continuous (beat to beat) monitoring • Painful, nerve injuries, if used for long periods and frequently • Accuracy: Patient movement, arrythmias, extremes of blood pressure ( Oscillometric measurement overestimates BP in hypotension and underestimates BP in hypertension)
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