Measurement of blood pressure: an algorithm of action. Algorithm for measuring blood pressure in children

Increased blood pressure today is one of the main causes of disability and mortality of the adult population. Annually, the number of cardiovascular disasters that occur as a result of increased blood pressure is progressively increasing. In many respects, the reason for this situation is the lack of proper diagnosis and therapy. And if rational pharmacotherapy of this disease can be attributed to medical activities, the measurement and control of blood pressure entirely lies with the responsibility of the patient himself. Let's analyze the algorithm for measuring blood pressure in peripheral arteries.

Physiological basis of measurement of blood pressure

For a long time people could not measure pressure by indirect methods, as it was popular and a direct measurement of blood pressure was conducted . The algorithm of action in this case was as follows: a special cannula was introduced into the vessel, which was communicated with a manometer. The pulsation of blood and pressure directly through the tubes were transferred to the device. Of course, this method allows accurate and reliable measurement of blood pressure, but it is associated with a significant disadvantage - the need for a puncture of the vessel and the introduction of a foreign body into it. Therefore, indirect methods have become very popular, and technological progress has made it possible to create tonometers (apparatus for measuring blood pressure), which are not inferior exactly to direct methods. With their help, the daily measurement of blood pressure is being successfully carried out. The algorithm of action, as well as the necessary equipment, will be considered below.

The theoretical principle of indirect methods of measuring blood pressure is the following principle. When a blood pressure monitor is injected into the cuff (assuming that the pressure in the cuff is higher than the systolic blood pressure in the vessel), the pressure of the latter is squeezed. As a result of a higher pressure in the cuff, blood does not pass through the blood vessels. If you gradually start to release air from the cuff, when the pressure in the cuff is quite a bit lower than in the artery, the blood will begin to flow into the limb. This principle is the basis for the following methods of measuring blood pressure.

Basic methods of measuring blood pressure

Official science knows two main methods that are used to measure blood pressure: the Korotkov method and the Riva-Rocchi method. Another appropriate name for these methods is auscultatory and palpatory. Let's look at the features of each method.

The Riva-Rocchi method (palpation)

How does it help to measure blood pressure? The algorithm is as follows. A cuff for measuring blood pressure is attached to the shoulder, which is connected to the tonometer.

Further, air is pumped into the cuff, and after the pulsation of the radial artery stops on the wrist, the air pressure gradually decreases. In this case, one hand continues to control pulsation of the radial artery, and the other controls the rate of pressure reduction in the cuff (which should be about 3-4 mm / sec). As soon as the pressure in the cuff becomes lower than the systolic pressure in the artery, the blood will begin to flow into the limb, which will be felt as the passage of a pulse wave. When there is a tactile sensation of pulse oscillations, the data are compared with the scale of the manometer and the value of systolic blood pressure is obtained. The drawbacks of this method include the absolute impossibility of obtaining the value of diastolic blood pressure without the help of a stethoscope, but among the advantages it is necessary to note the possibility of using emergency situations and emergencies in emergency conditions. In this case, obtaining the value of diastolic pressure plays a much smaller diagnostic role than systolic pressure .

Korotkov's method (auscultative)

With the help of a stethoscope, this method allows you to measure blood pressure. The algorithm for implementing actions using this method is as follows. The cuff is superimposed on the middle third of the forearm in such a way that 1-2 fingers can be placed under it. After this, the cuff is injected with air until the pulsation of the radial artery on the wrist stops.

A special feature of the method is the use of a stethoscope or phonendoscope for listening to auscultatory phenomena in the ulnar fossa. To do this, the head of the device is placed in the ulnar fossa and the air pressure in the cuff is gradually reduced. When auscultative phenomena occur in the stethoscope, the value on the scale of the tonometer that corresponds to the value of systolic blood pressure is noted, and when this phenomenon disappears, the value of diastolic pressure is noted.

The method has an undeniable advantage - obtaining information about systolic and diastolic pressure, but among its shortcomings, it should be noted the need for a stethoscope, as well as the presence of silence in the room where blood pressure is measured.

The main classes of tonometers used to measure blood pressure

To date, the market is quite saturated with devices that measure blood pressure. The algorithm of actions of their electronics and mechanics can be divided into three main types: mechanical, semi-automatic and automatic. At the same time, if properly used, the instruments have comparable measurement accuracy. The difference is only in the usability and, of course, in the cost.

Assessment of blood pressure with an automatic blood pressure monitor

The use of an automatic blood pressure monitor is most convenient and limits intervention in the results of the human factor. When using this type of instruments from the patient, you only need to place the cuff on your shoulder and press the button on the device. All other actions the device will perform independently: pumps the air into the cuff to a certain value, conducts a smooth and even pressure decrease and gives the final result, i.e., in an automatic mode conducts a measurement of blood pressure.

The algorithm of action of the device in this case is registered in its non-volatile memory and has been tested in many international services and associations. Among the advantages of this type of device, it is necessary to note the high information value of the results obtained, since the devices are able not only to measure the pressure, but also to calculate the heart rate and evaluate the heart rate. And in the case of arrhythmia will give a warning signal.

Evaluation of blood pressure using a semi-automatic type tonometer

With the help of a tonometer of this type, it is also possible to measure blood pressure with equal accuracy. The algorithm is briefly as follows. Measurement of blood pressure using devices of this type is largely similar to automatic, with the only difference that semi-automatic tonometers do not have a compressor and are not able to pump and release air from the cuff.

In other respects, the applied electronic components are not inferior exactly to the components of automatic tonometers. Moreover, it is believed that semi-automatic tonometers are reliable, since they do not contain rubbing and mechanical parts in their construction. In addition, the battery of these devices has a long service life. Next, we will consider the measurement of blood pressure in children. The algorithm of actions, as will be said, will remain the same, but there will be some nuances. They will need to be taken into account without fail.

Algorithm for measuring blood pressure in children

In principle, in children, blood pressure measurement (algorithm) is practically the same as for an adult. Children should use the appropriate cuff size, which depends entirely on the child's age and shoulder diameter. Compliance with this simple rule (when the cuff used corresponds to the age of the child) is the key to obtaining the correct results of blood pressure values.

Conclusion

If the algorithm for measuring blood pressure with a mechanical tonometer is rather difficult to learn, it's worthwhile to dwell on the acquisition of an automatic or semi-automatic tonometer.

They will always act as devices capable at a high level to ensure the measurement of blood pressure. The algorithm of actions in their application is very simple, and the results obtained are highly reliable and informative.