Tue, 20 May 2008|
Mike McEvoy has some tips on taking a patient's blood pressure in noisy conditions and more.
It. Hi I'm Mike Matt -- that you must coordinator -- -- -- in New York. And the fiery -- technical editor for fire engineering -- Wanna talk today about measuring blood pressure in patients the first -- -- you a couple of key points to make your blood pressure measurement as accurate as possible. Size of the -- is the first thing that's an important. Characteristic of making accurate measurements. If we took this cough and placed -- -- -- patient. We should end up with the size that covers two thirds of the distance. Between the elbow. And -- shoulder. And our patient here. From the elbow to the shoulder -- is actually covering two thirds in the distance proper size. If the -- was too small and -- less then there's this and we get all high blood pressure. If the couple's two large uncovered more than two thirds in the distance -- you know falsely low pressure and the second thing that's important. -- measured blood pressure is where the extremity is located in relationship to the heart. In all cases where you're trying to measure blood pressure accurately. You want to -- of the -- heart level. So our patients sitting upright the -- should be right at the side of the patient if we were to measure pressure with the arm up in the inner. Or we were to measure pressure with the extremity much lower than hello Hart as -- the patient relying on the side. We would end up with inaccurate numbers. Arm up in the -- if you falsely low blood pressure. Below the level -- the patient was laying aside -- -- -- -- falsely high blood pressure. The other characteristic of the blood pressure -- just takes you where the Blatter of the cup is located. The inflatable part of the -- Is where the -- connect and half of that actually inflate. That part of the cup. You would like to be on the inside of the economy against the artery we're actually measuring pressure. In many of the commercial -- That we have putting the Blatter on the inside the extremity. Causes this phenomenon honor to be clipped inside the patients on. And often times necessary patches that can actually seen measurements. I want to talk a little bit about. Measuring blood pressures and high noise environments where you may not be able to actually here are hostile take blood pressure using a stethoscope. In many cases were able to place this -- the scope and listen to pressure. As we're taking. If we were in an environment such as an education or perhaps in the back of -- moving ambulance. You may not actually be able to hear the blood pressure with a stethoscope. And in those situations are opportunities. That would help you to measure pressure the first you're probably familiar way. And that's but -- patient. If we were to inflate the -- While feeling the -- the polls and in this case will feel the patients radial pulse. Once we feel the polls -- inflate the cuff until the polls this appears. We wanna do with the patient here is pump the cup up while I'm watching this phenomenon governor of which was in -- -- It took took. -- -- When I feel the polls -- -- I slowly deflate the -- Until -- feel the -- return. That happens that a 120 millimeters of Mercury so we reporter pressure in this patient 125. Outpatient or 120 full repeat. Another method of measuring pressure in cases where it may be difficult you can help me. And peripheral polls would be used the -- like senator. And what we do with a -- -- that matter is there was -- a clip of the patient's finger. Or to a -- -- you're measuring pressure in the leg. And actually get an oxygen saturation. And a wave forms. On -- unit of the patient. We'll set the -- are so that it continuously measures. -- -- oxygen saturation. And then once we have -- operating so -- continuously measures. Will inflate the blood pressure stuff until the waveform disappears from the outset there. The waveform disappears. And now slowly deflate the blood pressure -- -- -- -- -- At a 120 millimeters of Mercury and that would be the patients systolic blood pressure and. Mike Mack -- -- thanks for watching.