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How may I meassure blood pressure with I hear my own heartbeats? Watch

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    How may I meassure patient's blood pressure with I hear my own heartbeats?
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    Got a iPhone?

    I recommend this app:

    http://www.instantbloodpressure.com/
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    (Original post by NathanNego)
    How may I meassure patient's blood pressure with I hear my own heartbeats?
    I don't know what you mean OP. But to manually measure blood pressure (BP), you need to use a stethoscope to listen to the first blood flow sound (korotkoff)/ systole and the last sound/diastole on the brachial/radial artery, with an inflated blood pressure cuff.
    To manually measure the pulse, use a stethoscope and count the pulse rate per minute (bpm) using a fob watch as guidance.
    NB: Some people do this without the aid of a stethoscope.
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    Yes I know how to measure,The problem is that I hear my own heartbeats when I use the stethoscope and I'm afraid of mistaking with the patient's blood flow sounds.
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    (Original post by NathanNego)
    Yes I know how to measure,The problem is that I hear my own heartbeats when I use the stethoscope and I'm afraid of mistaking with the patient's blood flow sounds.
    There aren't many settings within healthcare that require you to measure blood pressure manually. It's typically done with an automated cuff.

    That said, you come to be able to tune out exogenous noise with experience when using a stethoscope.
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    The automated machines aren't always available, and even when they are, they are less accurate and provide less information than a correctly taken manual blood pressure. They are of course a lot more convenient and usually provide a great approximation.

    There is no substitute for taking the blood pressure manually. It is not a hard skill to learn, and it gets better with practice. There is no excuse, you need to find someone to practice with, if you are going to be a medical profession this is a skill you will need.

    If you are having trouble distinguishing the sound of your patient's heart beat remember you also have the dial to watch, it will start to move with the patients heart rate while the pressure is between the systolic and diastolic blood pressures. You can't use that directly for your measurements but it's a good clue that will help you pick up the sound as you learn.
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    (Original post by Nefarious)
    The automated machines aren't always available, and even when they are, they are less accurate and provide less information than a correctly taken manual blood pressure. They are of course a lot more convenient and usually provide a great approximation.

    There is no substitute for taking the blood pressure manually. It is not a hard skill to learn, and it gets better with practice. There is no excuse, you need to find someone to practice with, if you are going to be a medical profession this is a skill you will need.

    If you are having trouble distinguishing the sound of your patient's heart beat remember you also have the dial to watch, it will start to move with the patients heart rate while the pressure is between the systolic and diastolic blood pressures. You can't use that directly for your measurements but it's a good clue that will help you pick up the sound as you learn.
    Unless you're in the third world, automated machines are universally available in a healthcare setting. The exception being some pernickety GP rooms. These days they're as accurate as you need them to be.

    I suppose the only example would be if the patient is in extremis and an automated cuff cannot record the blood pressure. In which case, it doesn't really matter if the systolic is 40 or if it's 50. You're still going to resuscitate them.

    I can't recall the last time I ever took a manual blood pressure except during a clinical exam towards the start of medical school.

    (Unless you're a doctor from the 1600s who measures pulsus paradoxus in an asthma attack)
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    (Original post by Etomidate)
    Unless you're in the third world, automated machines are universally available in a healthcare setting. The exception being some pernickety GP rooms. These days they're as accurate as you need them to be.

    I suppose the only example would be if the patient is in extremis and an automated cuff cannot record the blood pressure. In which case, it doesn't really matter if the systolic is 40 or if it's 50. You're still going to resuscitate them.

    I can't recall the last time I ever took a manual blood pressure except during a clinical exam towards the start of medical school.
    Unless the patient has AF, then the machines are completely useless. Better to go for manual in that case.
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    (Original post by zed963)
    Unless the patient has AF, then the machines are completely useless. Better to go for manual in that case.
    They're fine even in fast AF.
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    (Original post by Etomidate)
    They're fine even in fast AF.
    Hmm, but

    British hypertension society states to use manual at times.

    http://bhsoc.org/resources/how-to-me...lood-pressure/
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    (Original post by zed963)
    Hmm, but

    British hypertension society states to use manual at times.

    http://bhsoc.org/resources/how-to-me...lood-pressure/
    In practice, I've never seen a significant difference.

    Most of my patients have arterial lines and will, for whatever reason, have an electronic blood pressure done every now and then. Don't think I've ever seen a significant difference, even in AF.
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    (Original post by Etomidate)
    Unless you're in the third world, automated machines are universally available in a healthcare setting. The exception being some pernickety GP rooms. These days they're as accurate as you need them to be.

    I suppose the only example would be if the patient is in extremis and an automated cuff cannot record the blood pressure. In which case, it doesn't really matter if the systolic is 40 or if it's 50. You're still going to resuscitate them.

    I can't recall the last time I ever took a manual blood pressure except during a clinical exam towards the start of medical school.

    (Unless you're a doctor from the 1600s who measures pulsus paradoxus in an asthma attack)
    My madwives still seem pretty keen on them!

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    (Original post by Helenia)
    My madwives still seem pretty keen on them!

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    Is that because of all the Korotkoff V business for diastolic pressure?

    I dare not question the logic of the madwives. Life is too short.
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    (Original post by Etomidate)
    Unless you're in the third world, automated machines are universally available in a healthcare setting. The exception being some pernickety GP rooms. These days they're as accurate as you need them to be.

    I suppose the only example would be if the patient is in extremis and an automated cuff cannot record the blood pressure. In which case, it doesn't really matter if the systolic is 40 or if it's 50. You're still going to resuscitate them.

    I can't recall the last time I ever took a manual blood pressure except during a clinical exam towards the start of medical school.

    (Unless you're a doctor from the 1600s who measures pulsus paradoxus in an asthma attack)
    There's plenty of other places where you don't have access to or shouldn't be using a machine. Patients in isolation in hospital for example will often have their own equipment so they don't have to share. It's probably not going to be electronic. The machines can be pretty vicious, patients who have had prior bad experiences with them might consent to a manual measurement where they wouldn't to a machine. etc. etc.

    Machines are much more prevalent now than they were a few years ago, and they are a lot better and cheaper than they used to be. But they're not actually everywhere and you should not be so reliant on them that you can't get basic physiological observations if your machine breaks down or runs out of battery or if you do end up in a third world country without them. (thanks brexit )
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    Art lines ftw

    Universities still get very excited about manual BP with student nurses, but I rarely see them used, especially in my own area of practice. I could probably remember how to do one, but it's been a long time since I've needed to measure one.
 
 
 
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