1. Respiration & Blood Pressure Recording

2. Respiration

3. Definition
It is the act of breathing where the exchange of gases takes place between lung and blood

4. Inspiration
Whenever amount of carbon dioxide in the blood increases to a certain level the respiratory centre stimulates the diaphragm and inter costal muscle to contract. This allow the lungs to expand and breath in air. This activity is called inspiration.

6. Expiration
Oxygen from air sac passes into blood and carbon dioxide from blood passes into the air sacs. This carbon dioxide is removed by breathing out which is known as expiration

7. Abnormal respiration Dyspnoea: Difficult or painful breathing
Orthopnoea: Inability to breathe in a horizontal position. It is relieved by sitting position.
Hyperpnoea: When the rate and depth of respiration both increase.
Apnoea: This happens when breathing stops for a temporary period.
Anoxia: When there is inadequate supply of oxygen to the tissue

8. Factors effecting respiration
Age
Sex
Disease Condition
&
Drugs

9. Method checking respiration
Patient should be relaxed in a comfortable position. Since respiration can be controlled voluntarily to some extent, as far as possible, the patient's respiration may be counted without making him aware of it. So after taking the pulse, count the respiration rate keeping the fingers in the patient’s abdomen. If the patient’s arm is placed across his chest, the movement of his chest wall can be seen and felt. Count the rise and fall of chest wall for one minute by using a watch.
Also note the depth and regularity of respiration, expansion of the chest on both sides and patient’s Colour.

10. What is Blood Pressure?
The blood pressure is the pressure of the blood within the arteries. It is produced primarily by the contraction of the heart muscle
It's measurement is recorded by two numbers. The first (systolic pressure) is measured after the heart contracts and is highest
The second (diastolic pressure) is measured before the heart contracts and lowest
A blood pressure cuff is used to measure the pressure. Elevation of blood pressure is called “hypertension"

11. Measurement of BP

12. Measurement of BP Palpatory method Auscultatory method
Step 1 : Patient to rest for 5 minutes
Step 2 : Cuff is level with heart
Step 3 : Inflate cuff, palpate radial artery until
20-30mmHg above disappearance of
pulse
Step 4 : Place stethescope over brachial artery in antecubital fossa and deflate cuff at
rate of 2 to 5 mmHg/sec

13. Step 5 : listen for first sound (Korokoff
phase1) - Systolic BP
Disappearance of all sounds
(Korokoff phase 5) Diastolic blood
pressure

14. Why do need to do both palpation & Auscultation ?
Severe HT has “Auscultatory Gap” which might be missed
BP has to be measured by both methods

15. Common inaccuracies in BP recording
Patient not relaxed
Cuff not at heart level
Rapid deflection
Arm unsupported
Inadequate cuff size

16. Cuff size Standard adult - 12.5 x 22.5cm Obese adult - 17.5 x 37.5cm
Child x 18cm

17. Tips to Remember BP is the same from 18 years to 70 years
Systolic Hypertension is very important
Hypertension can occur at any age

18. Thank you