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Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Blood pressure is usually measured with a sphygmomanometer, which uses an inflatable cuff around the arm. Good automatic devices are available, but it is still important to be able to check the action of these devices with a manual sphygmomanometer. Choose a cuff of the right size. If the patient has a large arm, use a large cuff or the reading will be falsely high.Wrap the cuff around the patient's arm and place a stethoscope over the brachial artery at the elbow.Inflate the cuff until no sound is heard and then slowly deflate it.When the first sounds start to be heard, this is the systolic pressure as indicated on the sphygmomanometer.When the sounds finally disappear, this is the diastolic pressure.
Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The subject must be lying horizontally, so that the limbs to be measured are all at the same height. A sphygmomanometer cuff is inflated proximally to occlude arterial flow and released slowly to allow return of the flow. When a pulse is detected by the ultrasound probe, the systolic pressure is the same as the pressure in the cuff and can be read off by the operator (Figs 9.52a,b). The pressure in both arms should be measured, in case there is peripheral vascular disease in the upper limbs [111]. If the brachial pressures differ, the highest of these two readings should be used to calculate the ABPI [112].
Paediatric history and examination
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Blood pressure Historically, auscultatory blood pressure measurements were taken using a cuff and sphygmomanometer in children aged 3 years and older, while in younger children and babies palpatory methods were employed. This is still done in many paediatric renal clinics, but the accuracy of automated blood pressure machines has significantly improved so this is now the standard way of measuring blood pressure. The usual caveats of ensuring the correct size of cuff is used remain. In difficult cases, Doppler ultrasound blood pressure monitors can also have value.
Blood pressure patterns of hypertensive disorders of pregnancy in first and second trimester and contributing factors: a retrospective study
Published in Journal of Obstetrics and Gynaecology, 2023
Jie Ren, Zhuoran Fan, Jing Li, Yujie Wang, Junnong Zhang, Shaofang Hua
This study included the 4299 pregnancies who laboured in the Second Hospital of Tianjin Medical University from January 2019 to December 2020. In Tianjin, pregnancies usually got their prenatal cares in the local community health service centre before 28 weeks of gestation and the materials such as gestational age, weight and blood pressure values were uploaded and recorded in the website: Tianjin Maternal and Child Health Care Information System (60.29.92.68:82/Site/NewTjsfezxSite/Default.aspx), and into the third trimester, they chose their preferred hospital to continue their visits until delivery. In-hospital materials including maternal age, blood pressure values of delivery, gender, length and weight of offspring were recorded in the In-patient Management Information System. Considering that most mothers experienced the first prenatal care and created the pregnancy file during 8 + 0 weeks to 10 + 6 weeks and the last care they got in the local centre is around 28 + 0 weeks. So we chose seven average time periods (8 + 0 weeks to 10 + 6 weeks, 11 + 0 weeks to 13 + 6 weeks, 14 + 0 weeks to 16 + 6 weeks, 17 + 0 weeks to 19 + 6 weeks, 20 + 0 weeks to 22 + 6 weeks, 23 + 0 weeks to 25 + 6 weeks, 26 + 0 weeks to 28 + 6 weeks) to represent the first and second trimester. The electronic sphygmomanometer (arm or wrist) was used for measuring blood pressure. Pregnancies were in a sitting position and asked to rest for 5–10 min before measurement. Our data came from the two systems and this study had been reviewed and approved by the Ethics Committee.
Evaluation of correlation between digital vs. mercury sphygmomanometer in a middle-income country: The role of socio-economic situation
Published in Clinical and Experimental Hypertension, 2022
Alireza Khosravi, Mohaddeseh Behjati, Asieh Mansouri, Mahnaz Jozan, Noushin Mohammadifard, Marzieh Taheri, Somayeh Khodarahmi, Rezvan Ansari, Mohammad Hadi Mansouri, Pejman Mansouri, Nizal Sarrafzadegan
Medical equipment are growing rapidly. Various instruments have been used for digital and manual digital sphygmomanometers but each of them has its own advantages and disadvantages. Despite of this progress in development of digital sphygmomanometers which could be used easily and simply, these devices are supposed to have low sensitivity. Using manometer sphygmomanometers as a standard measurement tool, it has been shown that digital sphygmomanometers have inappropriately lower level of accuracy and validity for measurement of systolic and diastolic blood pressure measurement. The reported high error rate has limited their widespread application. While other investigations showed similar sensitivity and accuracy of these methods. Comparisons and differences in manometer and digital sphygmomanometer are discussed in several studies in detail (6–9).
Determinants of reverse dipping blood pressure in normotensive, non-diabetic population with an office measurement below 130/85mmHg
Published in Clinical and Experimental Hypertension, 2021
Ali Çoner, Ertan Akbay, Sinan Akıncı, Gökhan Özyıldız, Gültekin Gençtoy, Haldun Müderrisoğlu
24-hour ABPM was performed for the participants. A calibrated ABPM device was used (Del Mar Reynolds Medical, Irvine, USA). The cuff of the sphygmomanometer was connected to the nondominant arm. The device was programmed to measure the blood pressure for every 15 minutes. At the end of 24 hours device was removed and data were downloaded onto a computer and processed with the CardioNavigator software program (Cincinnati, Ohio, USA). In line with the recommendation of the current hypertension guidelines, the requirement to have a minimum of 70% usable blood pressure recordings was required for a valid ABPM measurement session (9,11). Daytime (or awake) blood pressure was averaged depending on the measurements from 7 am to 11 pm and nocturnal (or asleep) blood pressure was from 11 pm to 7 am. The ambulatory blood pressure device was reconnected in participants who could not achieve these measurement values due to various reasons such as insufficient sleep duration. Participants were asked for at least 6 hours of sleep on the night of measurement between 11 pm and 7 am.