Download 9 - KUET

Biomeasurement
Measurement ofi)
ii)
iii)
Body Temperature
Blood Pressure
Heart Rate
Biomeasurements are used to evaluate health
problems
Provide information about patient’s overall
condition
Taken at each visit and compared to baseline
Use Standard Precautions
Body Temperature is the most important vital sign to
evaluate health problems or patient’s overall condition
Classification of Body Temperature:
Condition
Temp. in Deg. Celsius
Temp. in Deg. Fahrenheit
Hypothermia
<35.0
<95.0
Normal
36.5-37.5
97.7-99.5
Fever
>37.5 or 38.3
>99.5 or 100.9
Hyperthermia
>38.3 or 40.0
>100.9 or 104.0
Hyperpyrexia
>40.0 or 41.5
>104.0 or 106.7
Measurement of
Body Temperature (Contd…)
Methods of measurement:
Routes
Normal Range ºF / ºC
Sites
Oral
Tympanic
Rectal
Axillary
Temporal
98.6 ºF / 37.0 ºC
Mouth
99.6 ºF / 37.6 ºC
Ear
99.6 ºF / 37.6 ºC
Rectum/Anus
97.6 ºF / 36.6 ºC
Axilla (under arm)
99.2 ºF / 37.3 ºC
Forehead skin
Measurement of
Body Temperature (Contd…)
Oral Temperature:



Wait at least 15 minutes after
eating, drinking, or smoking
Place under tongue in either
pocket just off-center in lower jaw.
Oral not appropriate for children
under 5 years old
Measurement using electronic thermometer is more
accurate, fast, easy to read, comfortable for the patient
as well as Measure to nearest tenth of a degree
Measurement of
Body Temperature (Contd…)
Tympanic Temperature:




Proper technique essential
Adult – pull ear up and back
Child – pull ear down and back
Fast, easy to use, and preferred in
pediatric offices
Measurement using electronic
thermometer is more accurate,
fast, easy to read, comfortable for
the patient as well as Measure to
nearest tenth of a degree
Measurement of
Body Temperature (Contd…)
Rectal Temperature:
Standard precaution – gloves
 Patient is positioned on side (left
side preferred) or stomach
 Lubricate tip of thermometer
 Slowly and gently insert tip into
anus
 ½ inch for infants
 1 inch for adults
 Hold thermometer in place while
temperature is taken

Measurement of
Body Temperature (Contd…)
Axillary Temperature:
Place patient in seated or lying position
 Place tip of thermometer in middle of axilla with shaft
facing forward
 Probe must touch skin on all sides

Measurement of
Body Temperature (Contd…)
Temporal Temperature:



Temporal scanner
Noninvasive, quick
Stroke scanner across forehead,
crossing over the temporal
artery
Measurement of Blood Pressure
Blood pressure (BP), sometimes referred to as arterial
blood pressure, is the pressure exerted by circulating blood
upon the walls of blood vessels, and is one of the principal
vital signs.
A person’s blood pressure is usually expressed in terms
of the systolic pressure over diastolic pressure and is
measured in millimeters of mercury (mm Hg).
Normal resting blood pressure for an adult is
approximately 120/80 mm Hg.
Measurement of Blood Pressure (Contd…)
120/80
Systolic Pressure
Diastolic Pressure
 Contraction of left
ventricle
 Top or first number
 Heart at rest
 Bottom or second
number
Measurement of Blood Pressure (Contd…)





Low blood pressure-Hypotension
Normal for some people
Severely low blood pressure readings
occur with:
◦ Shock
◦ Heart failure
◦ Severe burns
◦ Excessive bleeding
Hypertension
High blood pressure readings-Hypertension
Major contributor to heart attacks and strokes
Hypotension
Measurement of Blood Pressure (Contd…)
Measuring Equipments◦ Sphygmomanometer : A sphygmomanometer, blood
pressure meter, or blood pressure gage (also referred to
as a sphygmometer) is a device used to measure blood
pressure, composed of an inflatable cuff to restrict
blood flow, and a mercury or mechanical manometer to
measure the pressure.
Types:
Aneroid
Electronic
Mercury
Measurement of Blood Pressure (Contd…)
Aneroid sphygmomanometers:
◦ Circular gauge for registering pressure
◦ Each line 2 mmHg
◦ Very accurate
◦ Must be checked,
serviced, and
calibrated every
3 to 6 months
Measurement of Blood Pressure (Contd…)
Electronic sphygmomanometers:
◦ Provides a digital readout of the
blood pressure
◦ No stethoscope is needed
◦ Easy to use
◦ Maintain equipment according
to manufacturer’s instructions
Measurement of Blood Pressure (Contd…)
Mercury sphygmomanometers:
◦ A column of mercury rises
with an increased pressure as
the cuff is inflated
◦ No longer
purchase
available
for
◦ If in use, must be checked,
serviced, and calibrated every
6 to 12 months
Measurement of Blood Pressure (Contd…)
Stethoscope:
Earpieces
Binaurals
Rubber or plastic tubing
Bel
lChestpiec
eDiaphragm
The stethoscope is an acoustic
medical device for auscultation,
or listening to the internal
sounds of an animal or human
body.
 It is often used to listen to lung
and heart sounds.
 It is also used to listen to
intestines and blood flow in
arteries and veins.
 In
combination
with
a
sphygmomanometer,
it
is
commonly
used
for
measurements of blood pressure

Measurement of Blood Pressure (Contd…)
BP Measuring Procedure:
◦ Place cuff on the upper arm above the brachial pulse site
◦ Inflate cuff about 30 mmHg above palpatory result or
approximately 180 mmHg to 200 mmHg
◦ Release the air in cuff and listen for the first heartbeat
(systolic pressure) and the last heartbeat (diastolic
pressure)
◦ Record results with systolic as the top number and
diastolic as the bottom number (i.e., 120/76)
Measurement of Heart Rate
Heart rate, or heart pulse, is the speed of the heartbeat
measured by the number of heartbeats per unit of time,
typically beats per minute (bpm).
The heart rate can vary according to the body's physical
needs, including the need to absorb oxygen and excrete
carbon dioxide.
Activities that can provoke change include physical
exercise, sleep, anxiety, stress, illness, ingesting, and drugs.
The normal resting adult human heart rate ranges from
60–100 bpm.
Measurement of Heart Rate (Contd…)
Bradycardia is a slow heart rate, defined as below
60 bpm.
Tachycardia is a fast heart rate, defined as above
100 bpm at rest.
When the heart is not beating in a regular pattern,
this is referred to as an arrhythmia.
These abnormalities of heart rate sometimes
indicate disease.
Measurement of Heart Rate (Contd…)
Measurement:
Manual MeasurementHeart rate is measured by finding the pulse of the heart.
This pulse rate can be found at any point on the body
where the artery's pulsation is transmitted to the surface
by pressuring it with the index and middle fingers. (A
good area is on the neck, under the corner of the jaw.)
The radial artery is the easiest to use to check the heart
rate.
However, in emergency situations the most reliable
arteries to measure heart rate are carotid arteries.
Measurement of Heart Rate (Contd…)
Measurement:
Manual MeasurementPossible points for measuring the heart rate are:
1. The ventral aspect of the wrist on the side of the thumb (radial
artery).
2. The ulnar artery.
3. The neck (carotid artery).
4. The inside of the elbow, or under the biceps muscle (brachial
artery).
5. The groin (femoral artery).
6. Behind the medial malleolus on the feet (posterior tibial artery).
7. Middle of dorsum of the foot (dorsalis pedis).
Measurement of Heart Rate (Contd…)
Measurement:
Manual MeasurementPossible points for measuring the heart rate are:
8. Behind the knee (popliteal artery).
9. Over the abdomen (abdominal aorta).
10. The chest (apex of the heart), which can be felt with one's hand or
fingers. It is also possible to auscultate the heart using a stethoscope.
11. The temple (superficial temporal artery).
12. The lateral edge of the mandible (facial artery).
13. The side of the head near the ear (posterior auricular artery).
Measurement of Heart Rate (Contd…)
Measurement:
Manual Measurement
Locate pulse by pressing lightly
with index and middle finger
pads at the pulse site

Count the number of beats felt
in 1 minute

If regular – may count beats for
30 seconds and multiply by 2
Measurement of Heart Rate (Contd…)
Measurement:
Manual Measurement-
Regular Pulse Rhythm
Count for 30 seconds,
then multiply by 2
(a rate of 35 beats in 30
seconds equals a pulse
rate of 70 beats/minute)
Irregular Pulse Rhythm
Count for one full minute
May use stethoscope to
listen for apical pulse and
count for a full minute
Measurement of Heart Rate (Contd…)
Measurement:
Electronic Measurement
Using Electronic devices:
◦ Blood Pressure Machines
◦ Seismocardiography
◦ Pulse Oximetry
 Infrared light measures
pulse and oxygen levels
Using ECG
Measurement of Heart Rate (Contd…)
Measurement:
Electronic Measurement
Using ECG:

A more precise method of determining
heart rate involves the use of an
electrocardiograph, or ECG.
On the ECG, instantaneous heart rate
is calculated using the R wave-to-R
wave
(RR)
interval
and
multiplying/dividing in order to derive
heart rate in heartbeats/min.

Multiple methods exist:
1. HR = 300/number of "large" squares between successive R waves.
2. HR = 1,500/(RR interval in millimeters)
3. HR = 60/(RR interval in seconds)