Determination of pulse rate
Pulse rate is nothing but indirect or direct proliferation of your heart rate.
pulse rate is one of the vital signs along with the measuring of the blood pressure and
respiratory read.
the arm should be in a pronated position. The radial artery is located almost parallel to the
thumb
with your three fingers, you are supposed to feel the pulsations of the radial artery
significance of three fingers: The index finger is to slightly block the artery, middle finger, and
ring finger are used to feel the pulsations of the radial artery
once u start feeling the pulsations, start counting the pulsations exactly for one minute
normal pulse rate is 60-100 beats per minute in a normal healthy individual
once u determine the pulse rate, note it down
if a person comes with upper limbs amputated, you can use the carotid artery and other arteries
are there too
description of the Sphygmomanometer and Stethoscope
on the scale of the sphygmomanometer, the graduations are from 0 to 300 mm of
mercury
divisions in between are 2 divisions each
the two tubes that are there on the chuff, need to be parallel to the artery.
On the cuff, the adult size is given. it is 25-35 arm circumference
The arm circumference is much smaller so that means the size of the cuff should also be
smaller
For obese patients, it should be larger
The stethoscope has a chest piece and two ear nobes
The ear lobes are supposed to be placed in the auditory canal. They should be directed
forward and medially
The valve can be rotated in either direction and it is used for locking and unlocking the
stethoscope
Recording of blood pressure by palpatory method
Blood pressure is the lateral pressure exerted by the moving column of blood on the
walls of the arteries
Systolic blood pressure is the maximum pressure exerted and diastolic blood pressure is
the minimum pressure exerted.
2 methods of measuring BP is palpatory method and the auscultatory method
Palpatory method; only you can get a rough idea of the systolic blood pressure of the
subject.
The cuff should be tied 2 cm above the elbow. It should not be too tight or too loose for
the subject. At least a little finger should cross the cuff
In the air pump, there is a valve. For recording the blood pressure, it should be rotated
in the clockwise direction.
On the sphygmomanometer, there is a valve present. The valve should be rotated so
that the mercury on the sphygmomanometer can enter the limb
The first thing u need to do is palpate the radial artery with the three fingers and feel for
the pulsations of the radial artery. The arm should be semi pronated and the wrist
should be slightly flexed
Once you feel the radial artery, make sure the valve is tightened but not too tight. You
feel the pulsations of the radial artery and then start raising the pressure by inflating the
air pump and you have to inflate the air pump until you don’t feel the pulsations of the
radial artery.
Once you feel the pulsations are disappearing, don’t stop raising the pressure. Just raise
20 mm above the pressure you stop feeling the pulsations
Then slowly start deflating it. When you slowly start deflating it, at a particular point
what happens is that the pulsations will reappear
Once you start feeling the pulsations and it has reappeared, deflate the pressure down
Demo of blood pressure by auscultatory method
The unit of blood pressure is mm of mercury
In this method, you can get both diastolic and systolic blood pressure
The first thing you need to do in this method is to locate for brachial artery
The brachial artery is almost located medially to the biceps tendon.
Once you feel the pulsations of the brachial artery, take the stethoscope
The way to place the ear lobes of the stethoscope is to place it facing inwards because
the auditory canal is placed forward and medially
Once you place it inside your ears, check whether the chest piece is switched on or off.
To check for that, just tap on the diaphragm of the chest piece and rotate the valve
Take the chest piece of the stethoscope and place it on the brachial artery.
Take the air pump, tighten the valve
When doing the auscultatory method, you have to remember that you have to increase
blood pressure here only 30 mm of mercury above the systolic pressure measured by
the palpatory method
Once you reach 30 mm of mercury above the systolic pressure, slowly start releasing the
pressure. By releasing the pressure, you will hear a tapping sound around the systolic
pressure measured earlier and this is known as systolic blood pressure. When you
release the pressure slowly, the intensity of the sound keeps on increasing, and slightly
at a particular point, it will disappear. Note the pressure at which the sound disappeared
Then deflate it completely.
We use the palpatory method to avoid the auscultatory gap and it only gives us a rough
idea of the systolic pressure
The sounds produced or made during the process are known as Korotkoff sounds
