1. How to Measure Blood Pressure Ramy Shaaban

2. Goals and Objectives Goal: Students will learn how to measure blood pressure.

3. Objectives: Define what is blood pressure. Differentiate between systole and diastole. Outline the risk factors of the high blood pressure. Label the tools used in measuring blood pressure. Identify the importance of measuring blood pressure. Outline the symptoms associated with the increase of the blood pressure. Outline the steps of measuring blood pressure. Use the basic knowledge gained to measure blood pressure virtually. Use gained knowledge and virtual practice to measure blood pressure using real Sphygmomanometer. What? Why? How? Goals and Objectives

4. What is Blood Pressure Blood pressure is the force that blood exerts against blood vessel walls. The pumping action of the heart generates the flow Pressure occurs when the flow is met by resistance from blood vessel walls RBCs WBCs Pressure on the blood vessel’s wall Blood Flow

5. What is Blood Pressure Contract Relax Contract Relax Systole Diastole Systole Diastole

6. In order to measure blood pressure, we must measure: Systolic Blood Pressure (Pressure inside the heart during systole) Diastolic Blood Pressure (pressure inside the heart during diastole) So, the blood pressure measurement will be in the form of: Systolic Blood Pressure 140 ___________________ e.g. _______ Diastolic Blood Pressure 110 What is Blood Pressure

7. Normal Blood Pressure 120 ___ 80

8. How would I know if I have it? Very few people experience symptoms. This is a silent disease. Damage is done before symptoms develop. Some symptoms may be: Headaches Dizzy spells More nosebleeds than normal This is why we screen for HBP!

9. Special populations who may benefit from Home Blood Pressure Monitoring Elderly: BP variability tends to be high, and white coat hypertension is common. Diabetics: Tight BP control is important and home monitoring may help achieve this. Pregnancy: The early detection of pre-eclampsia might be facilitated by HBPM. Chronic Kidney Disease: BP may fluctuate a lot and home monitors help with management. Children: White coat hypertension occurs in children, and there are some data on normal home BP levels at different ages.

10. How? Sphygmomanometer

11. Cuff Manometer Pump Valve Stethoscope

12. Mechanism of Measurement of Blood Pressure A cuff is inflated to constrict an artery so that no blood flows. As the cuff pressure is slowly released, but the artery is still partially constricted, blood flow begins again. Sounds can be heard because the blood flows violently causing audible sounds. When the artery is fully open, the blood flows freely and the sounds disappear.

13. Correct Technique Sit calmly with back support, feet flat on floor for 5 minutes before taking a reading. Upper arm should be bare. When taking a reading the arm with cuff should be supported on a firm surface at heart level. Caffeine, smoking, and exercise should be avoided for at least 30 minutes before the reading is taken. The cuff should fit snugly.

14. Systole Vs. Diastole The first sounds that are heard indicate systolic pressure (top number). The top number in blood pressure readings Measures the pressure in arteries when heart is beating When the sounds stop, diastolic pressure has been reached (bottom number). The bottom number in blood pressure readings Measures pressure when heart is at rest

15. Steps of measuring blood pressure

16. Step 1 Place the cuff around the arm Just above the elbow.

17. Step 2 Place the stethoscope under the cuff just above the elbow.

18. Step 3 Close the valve to begin inflating the cuff.

19. Step 4 Use the pump to inflate the cuff.

20. Step 5 When the cuff inflated to high pressure, open the valve to deflate.

21. Step 6 Listen carefully, when the sound of beats appears, this is the systolic reading (the upper reading) When the sound stops, this is the diastolic reading (the lower reading)

22. Step 7 Repeat twice for accurate reading.

23. Simulation Session

24. Actual Practice Session

25. Thank You!