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U.S ARMY HEALTH CARE B/P LAB SGT Chase Johnson Army Health Care Recruiter • • • • • U.S Army Medic ( 68W) Emergency Medical Technician (NREMT) Advance Cardiac Life Support Pediatric Advance Life Support International Trauma Life Support 2 B/P Lab Overview • • • • • Blood Pressure Defined Pertinent Anatomy Baseline Knowledge Procedure Steps Practical Exercise 3 Blood Pressure Defined • Blood Pressure is the force that blood puts on the arterial walls as it goes through the body. • Readings are usually written as 2 numbers. The top number is called SYSTOLIC BP. The bottom number is called DIASTOLIC BP. • BP is measured in millimeters of mercury (mmHg). 4 Blood Pressure Defined Example: Systolic/Diastolic 120/80 mmHg 5 Blood Pressure Defined • Systolic pressure: pressure when the heart is contracting. It is specifically the maximum arterial pressure during contraction of the left ventricle, of the heart. • Diastolic pressure: the minimum arterial pressure during dilatation of the ventricles of the heart, when the ventricles fill with blood. 6 Pertinent Anatomy • The Heart • The Circulatory System • The Five Points of Palpation 7 Pertinent Anatomy 8 Pertinent Anatomy The Circulatory System: • Moves blood throughout the body. It is composed of the heart, arteries, capillaries, and veins. • Transports oxygenated blood from the lungs and heart throughout the body via the ARTERIES. • Blood that has been depleted of oxygen by the body is then returned to the lungs and heart via the VEINS. 9 Pertinent Anatomy 10 Pertinent Anatomy THE 5 POINTS OF PALPATION • Carotid: on the neck • Brachial: under the arm • Radial : on the wrist • Femoral: in the groin • Pedal: on the foot 11 Baseline Knowledge • • • • Heart Rate Oxygen Saturation Blood Pressure Instruments Orientation 12 Baseline Knowledge Heart Rate Pulse: rate at which your heart beats each minute (bpm). Rhythm: frequency and strength of the heartbeat. How to check a pulse: Palpate a major artery with your index and middle fingers with light pressure. Count how many times you feel a beat over 30 seconds and multiply by 2. 13 Baseline Knowledge Heart Rate Attain a Heart Rate: • Palpate a major artery with your index and middle fingers with light pressure. • Count how many times you feel a beat over 30 seconds and multiply by 2. Example: HR: 77 14 Baseline Knowledge Heart Rate 15 Baseline Knowledge Heart Rate 16 Baseline Knowledge Heart Rate THE 5 POINTS OF PALPATION • Carotid: on the neck • Brachial: under the arm • Radial : on the wrist • Femoral: in the groin • Pedal: on the foot 17 Baseline Knowledge Oxygen Saturation • Is a measure of how much oxygen the blood is carrying as a percentage of the maximum it could carry. • It is commonly annotated as SpO2% Example: SpO2: 98% 18 Baseline Knowledge Oxygen Saturation Pulse Oximeter 19 Baseline Knowledge Blood Pressure in Adults • Blood pressure rates can vary widely • Ask questions such as physical activity level and medications/ supplements taken. Example BP: 120/80 20 Baseline Knowledge Blood Pressure in Adults 21 Baseline Knowledge Instruments Orientation Sphygmomanometer: • blood pressure meter can be manual or automatic • composed of an inflatable cuff to restrict blood flow, and a mercury or mechanical manometer to measure the pressure 22 Baseline Knowledge Instruments Orientation 23 Baseline Knowledge Instruments Orientation Stethoscope: • is an acoustic device for auscultation • usually consists of two-sided chest piece (bell for low frequencies and diaphragm for higher frequencies) and a hollow tube used to transmit sound. 24 Procedure Steps: Instruments 25 Procedure Steps Position the Patient • There are three positions for taking BP: supine, seated, standing. • In seated position, the patient's arm should be flexed. • The flexed elbow should be at the level of the heart. 26 Procedure Steps Position the Patient: Seated 27 Procedure Steps • To begin, use a properly sized blood pressure cuff. The length of the cuff's bladder should be at least equal to 80% of the circumference of the upper arm. • Wrap the cuff around the upper arm with the cuff's lower edge one inch above the antecubital fossa. 28 Procedure Steps • Lightly press the stethoscope's bell over the brachial artery just below the cuff's edge. • Rapidly inflate the cuff to 180mmHg. Release air from the cuff at a moderate rate (3mm/sec). • Listen with the stethoscope and simultaneously observe the sphygmomanometer. 29 Procedure Steps • The first knocking sound (Korotkoff) is the patient's SYSTOLIC pressure. • When the knocking sound disappears, that is the DIASTOLIC pressure. • Document your findings!!! 30 Practical Exercise • Pulse/ Heart Rate (HR) • Respirations (RR) • Blood Pressure (BP) 31 For More information on a career in Army Medicine please contact: • SGT Chase Johnson • (210)279-0429 • [email protected] • www.goarmy.com/amedd 32