Today in the pharmacy you can buy more than 30 various models. Some are fully automatic, while others require mechanical air injection. In addition, there are options for devices with a cuff on the shoulder and wrist. Despite the seeming simplicity of the procedure, it is important to find out in advance how to correctly measure pressure with an automatic tonometer. If some nuances are not observed, the results may be incorrect or with a large error.

On which arm should I measure the pressure with an automatic sphygmomanometer?

In this case, the maximum pressure is recorded. It's connected with anatomical structure heart and uneven distribution of blood pressure in the vessels that feed the right and left hand. Moreover, the difference between the measurements different hands is about 20-30 mm Hg. Art. If you carry out the procedure only on the left hand, it is easy to overlook the development.

How to measure pressure with an automatic sphygmomanometer?

There are 3 main types of described equipment:

• tonometer with shoulder cuff;
• tonometer with carpal cuff;
• tonometer with a stationary cuff.

1. Remove tight and tight clothing, roll up sleeves right hand Or change into a T-shirt.
2. It is convenient to sit on a chair in front of the desk, it should be quite high.
3. Straighten your back, relax, place your hand on a horizontal surface so that it has support from the wrist to the elbow.

How to measure correctly arterial pressure different automatic blood pressure monitors:

It is worth noting that tonometers with a shoulder cuff are also semi-automatic. In this case, immediately after pressing the start button, you need to inflate the cuff with a mechanical bulb to a value of 220 mm Hg. Art. Then the device will continue to work.

People suffering from fluctuations in blood pressure (BP), especially hypertensive patients, need to control their own blood pressure. This will allow you to monitor the effectiveness of the drugs taken in order to avoid hypertensive crises and other complications of the disease. Since hypertension has become much younger over the past decades, it is recommended for healthy people to measure blood pressure already after 40 years for the purpose of prevention. Consider how to correctly measure pressure with a tonometer, which tonometer to choose, how to measure blood pressure correctly, what can and cannot be done before measuring pressure.

Three types of tonometers are used to measure pressure: mechanical (manual), semi-automatic, automatic (electronic). It is convenient and easy to measure pressure with an automatic tonometer, but the device must be constantly charged from the mains or batteries must be bought for it. The electronic tonometer measures in automatic mode: it pumps air into the pear itself and displays the indicators on the screen. But, like any automation, it is too sensitive, requires especially careful handling, and breaks easily.

Measurement of blood pressure with a semi-automatic tonometer is just as easy. Its difference from the automatic one is that the air is pumped into the pear manually, and the readings are analyzed automatically, after which they are displayed on the screen. Semi-automatic is cheaper in cost, not as sensitive, but requires initial skills in measuring pressure.

There are blood pressure monitors that measure pressure in the wrist area: they are easily fixed on the arm. But they, however, are not recommended for people with atherosclerosis.

Most doctors and health workers use manual (mechanical) blood pressure monitors. They are cheaper in cost, they do not need to be constantly charged. Manual measurement allows you to most accurately determine blood pressure, if practical skills are worked out and there is knowledge of how to measure pressure manual sphygmomanometer. Moreover, if the measurements of mechanical and electronic tonometers differ from each other, then the data obtained precisely through manual measurement are taken as the basis.
The disadvantage of a mechanical device: its use requires special knowledge and good hearing in blood pressure monitors. If you have hearing problems or learning difficulties, it is better to choose automatic or semi-automatic types of devices. It is not difficult to learn how to use a manual tonometer.

Manual tonometer device

The mechanical tonometer consists of:

• cuffs with metal ring and tube;
• a pressure gauge with a dial under glass, some models have a cuff pocket at the back of the pressure gauge;
• an air-injecting pear with a wheel attached to it for releasing air;
• stethoscope with binaural tube and hearing aid, tube and stethoscope head.

For the most accurate measurement it is necessary not only to know how to correctly measure pressure with this device, but also how to prepare for this process.

How to measure pressure manually step by step:

1. In a sitting position, place yourself at the table, putting your hand on its surface so that the level of the fixed cuff is at the level of the heart.
2. Put on and fasten the cuff tightly on the Velcro fastener. The lower edge of the cuff should exceed the level of the elbow by about 2-3 centimeters.
3. Attach the head of the stethoscope in the form of a metal disk to inside elbow, to the pulsating artery , hold it.
4. Insert hearing aids from a stethoscope.
5. Before you start pumping air into the pear, you need to make sure that the wheel with which it is lowered is securely twisted.
6. Inflate the cuff with a pear until the pressure gauge needle crosses the 200 mm Hg mark. Art. In hypertensive patients, the mark can be 220 mm Hg. Art.
7. After the cuff swells to the desired level, deflate the air by slowly unscrewing the wheel specially designed for this under the pear, by about 4 mm Hg. st./sec.
8. Since the pumped air in the cuff begins to put pressure on large artery pulse can be easily heard. It is necessary to notice in time at what mark of the pressure gauge scale the first sound was heard. heart attack. To do this, you must simultaneously monitor the dial and listen to the pulse. This is why people with hearing impairments are unlikely to be able to use a hand-held BP monitor. The first beat is the value of the upper, systolic, pressure.
9. Continue measuring by gradually unscrewing the wheel.

1. The last heartbeat heard is a reading of the lower, diastolic, blood pressure.
2. Write the measurements as a fraction. For example, 120/80, where the first value is the indicator of the upper, the second digit is the indicator of the lower blood pressure.
3. If there is a need for a more accurate measurement, the manipulation is carried out several times, taking a break for five minutes. You can measure blood pressure in both arms. The result is taken as a basis on the arm on which the pressure was higher. With a three-time measurement, the arithmetic mean of all data is calculated.

Common mistakes made when measuring pressure

In order to more accurately take readings of the tonometer, it is necessary to avoid common mistakes that can affect the result:

• There is no need to worry before measuring blood pressure: pressure is measured in a relaxed state for at least five minutes after any physical activity.
• An hour before the procedure, it is not recommended to drink coffee, alcohol or stimulating energy drinks.
• You can not be distracted at this time: talk, move, dangle your legs. Breathe freely, without deep breaths or breath holding.
• Sleeve roll up. If the sleeve sits tightly on the arm, and the fabric of the clothing is thin, the cuff is fixed directly to the fabric. The raised sleeve must not be allowed to squeeze the arm, this will inevitably affect the result. If a person is going to the clinic, knowing that they will measure his pressure, it is worth wearing loose clothes or one that can be easily removed at the doctor's appointment.

• Cuff too long. When choosing a tonometer, you need to pay attention to the length and width of the cuff. When fastening, it should be about 2-3 cm above the elbow. fat people when buying, you need to pay attention to the width of the cuff of the device.
• The cuff is loose. In order for measurements to be accurate, it is necessary to achieve a snug fit of the cuff to the arm. If the patient feels that it is loose, this should be reported.
• The hand lies above the level of the heart or hangs in front of the table. The hand should be in a relaxed state, located at the level of the heart.
• Wrong body position. In a sitting position, the back leans on the back of the chair, the legs are parallel. You can not hunch your back, cross your legs or put them crosswise. You need to sit comfortably, closer to the back of the chair, and not on the edge.
• You can not quickly release air from the pear wheel. If the air descends quickly, the lower pressure will be lower than the real one.
• Frequent measurements. Measure the pressure the first two times with breaks of five minutes, and starting from the third - seven minutes. It is recommended to take readings in the morning immediately after sleep and in the evening before bedtime. Morning blood pressure results are especially important for hypotensive patients.

Other features of blood pressure measurement

In addition to these errors, it is necessary to take into account the characteristics of each organism. Some people, such as the elderly and children, have a so-called white coat syndrome, when the pressure changes from one kind of doctor. At the same time, at home, the pressure is one, and when visiting the clinic, it is completely different.

Of particular difficulty is the diagnosis of hypotension: the pressure in the hospital walls seems to be normal, but in fact it is increased in a hypotensive patient.

That is why after 40 years it is so important to keep a watch at home with a diary entry. Especially if there are any signs of ailments characteristic of cardiovascular diseases. Taking home blood pressure measurements will help your doctor more accurately determine the extent of your disease, rather than relying solely on hospital measurements for your doctor's examination.

A person who regularly maintains control over his own blood pressure, is more responsible for medical prescriptions, he is organized and disciplined in taking medicines. In addition, such self-control allows you to notice under what circumstances blood pressure rises or falls in a particular person. Perhaps certain circumstances contributed to this: medication,
strong excitement, drinking a cup of coffee, drinking alcohol or smoking tobacco. In this case, you need to exclude harmful factors. Measurements should be carried out at a comfortable room temperature, preferably at the same time of day, before eating.

Approximate indicators of normal pressure

Each age has its own characteristics of blood pressure:

1. For 16-20 years old, the norm is 100-120 / 70-80 mm Hg. Art.
2. For 20-40 years old: 120-130/70-80 mmHg Art.
3. For 40-60 years old: up to 140/up to 90 mm Hg. Art.
4. Ages 60 and older: 150/90 mmHg Art.

Complaints of headaches, especially in the off-season, have become frequent these days. Everyone feels medically educated and, qualifying their physical state, refer to vessels or hypertension. Although, it is possible to be accurate in determining the nature of the symptom only after a special medical manipulation to measure blood pressure. To do this, there is a special device - a tonometer. Its presence in the house will not surprise anyone. Automatic, semi-automatic, with memory, on batteries or accumulators, they regularly carry out their service in homes where there are elderly people or patients with cardiovascular diseases.

True, the majority is guided by their feelings, although practice shows that you can easily miss a jump in blood pressure if it is asymptomatic. Therefore, measure the pressure, if without visible reasons redness appeared on the face, pounding in the temples, dizziness arose, and the reason for this was your stress at work, unpleasant conversation or thoughts. Stress and increased pressure are a stable couple. But pressure can rise and, in response to changes in the atmosphere, high temperature, to changes in the position of the body in space, excessive physical exertion.

Periodically, under the above conditions, it is worth measuring pressure for completely healthy people. Well, for those who already suffer from diabetes, kidney disease and endocrine system, like hypertensive patients, you need to use a tonometer regularly, twice a day. The first measurement is done in the morning on an empty stomach in a calm position immediately after waking up. This is especially important for older people, as the period from 4 am to 10 am is very dangerous. sharp drops pressure. It is no coincidence that at this time the most calls for cardiovascular ailments are recorded in the ambulance.

The morning measurement indicator can be checked on two hands, thus revealing sclerotic phenomena in the vessels of the hands. It would be correct to write down this indicator in order to compare it with the evening, or even with the morning indicator. next day. Evening measurement is done after taking medication, in calm state, and, too, is fixed on paper. Arterial norm an adult is 120/80, but there are also individual norms that the patient should know well for himself. Deviations occur more often in the upper range. Worst of all, when the values ​​of the upper and lower pressure are getting closer.

If you are measuring electronic tonometer, then the following conditions must be met:

• body position should be stable and relaxed;
  
• the arm on which the cuff is put on is completely free from clothing;
  
• do not cross your legs:
  
• the hand should not be in weight, the air duct tube passes through it inner surface from the bend of the elbow to the ring finger;
  
• at the moment of switching on, the display should show 0;
  
• early reset of the result may indicate the discharge of the battery of the tonometer.
  

Doctors prefer to measure pressure with a manual tonometer, they trust him more. Therefore, both at the doctor's appointment and when calling the ambulance, your blood pressure will be measured, most likely with this proven device.

How to measure blood pressure with a manual sphygmomanometer
A manual tonometer consists of a cuff connected to a rubber bulb and a phonendoscope (a device whose ends are inserted into the ears). The procedure for measuring blood pressure with it consists of the following steps.

1. Accept comfortable position sitting, and place the hand on which the measurements will be taken on the supporting surface approximately at the level of the heart and relax.
   
2. Put the cuff up on your arm elbow joint a few centimeters and secure it with Velcro.
   
3. Paste hearing aid phonendoscope in the ears.
   
4. Attach the membrane amplifier of the phonendoscope to the inside of the elbow bend in the place where the pulsating vein passes.
   
5. Close the bleed valve located next to the bulb and begin to inflate the cuff by squeezing and releasing the brush until the pressure gauge reads higher than your normal readings.
   
6. Stop pumping and slowly open the pear valve, trying not to miss the first burst of blood - this is an indicator systolic pressure during contraction of the heart muscle. It's called top pressure.
   
7. When a clear rhythm of the pulse ceases to be heard, the value of diastolic pressure is noted - relaxation of the heart muscle. The value obtained from the pressure gauge will correspond to the lower pressure.
   
8. After taking the measurement, deflate completely and remove the cuff from your arm.
   

Children are also susceptible to an increase in blood pressure, therefore, when complaining of a headache or dizziness, the child also does not interfere with measuring pressure. Moreover, this can be a signal of a serious, yet hidden from adults, disease. The cuff for the child should be narrower, in accordance with his anatomical features for this age.

Blood pressure (BP) is constantly monitored in pregnant women. Low blood pressure, which is called hypotension, is also dangerous for its manifestations. Therefore, drowsiness, weakness, swaying in an upright position should be checked with a tonometer for anomalies in blood pressure.

An increase in pressure may have a somatic or emotional reason. We ourselves are able to regulate the latter, excluding in our lives the negative of quarrels, insults, strife, and filling it with positively colored events, pleasant communication with people and nature, favorite activities and in a healthy way life.

How to measure pressure with a manual tonometer, if such a need arises? Increased delivers a lot of inconvenience to people of completely different ages. Indeed, a symptom of high blood pressure can even be headache. To find out the exact blood pressure, you need to use special device called a tonometer. Automatic blood pressure monitors are available in almost every house where people live. old age or with heart disease.

In addition, if a person has a difficult job associated with constant stress and excitement, then the occurrence and development of hypertension is very difficult to avoid. That is why measuring pressure with an automatic tonometer regularly is extremely important procedure, which will help to establish the frequency of hypertensive surges and timely seek help from a specialist.

Regular use of the tonometer by healthy people - good way prevention. Diabetics, hypertensive patients suffering from diseases of the endocrine system and kidneys should use a sphygmomanometer at least 2 times a day at the same time. All obtained indicators must be recorded in a special calendar, with which it will be possible to monitor changes in a person's condition. However, before we learn how to measure pressure correctly, we will consider why this procedure is necessary.

Why measure blood pressure?

Blood pressure (BP) - extremely important indicator, which demonstrates the quality of functioning of cardio-vascular system. The norm of blood pressure is different when examining people of different age categories. At good health hearts and good health one pressure measurement with a tonometer for several days will be enough to see approximately the same indicators.

Not everyone understands why regularly measure blood pressure. Severe symptoms with a decrease or increase in blood pressure occur only with its strong jumps. Most heart diseases in the early stages of development affect the pressure slightly and cause it to deviate from the norm by only a few mm Hg. Art. Such deviations, although occurring on an ongoing basis, will not cause changes in well-being. Considering given fact, we can conclude that the pressure is measured regularly in order to timely identify the disease.

Automatic blood pressure monitors are different types, their constituent parts depend on this. A mechanical tonometer for measuring pressure consists of the following parts: a cuff, a rubber bulb and a phonendoscope. Such blood pressure monitors are often used in hospitals and are older versions of these devices. Semi-automatic and automatic devices, consisting of a cuff and an electronic screen. When using semi-automatic, it is enough just to pump in air, and the electronic scoreboard will independently show the results. Automatic versions of devices are simplified as much as possible - you just need to put on the cuff correctly and press the button.

Consider the technology of using an older, manual tonometer mechanical type. How to measure pressure correctly with it? The procedure consists of several stages:

1. Take a comfortable sitting position, relax your hand and place it on a hard, flat, supporting surface.
2. Take the deflated cuff from the previous procedure and put it on your arm. It should be a few cm above the elbow joint. Secure it tightly with Velcro.
3. Insert a phonendoscope into your ears.
4. Now give the correct position to the membrane amplifier. To do this, place it in the inner part of the elbow on the pulsating vein.
5. Close the air release valve tightly. Inflate the cuff with light squeezing movements until the pressure gauge scale exceeds your usual readings.
6. Stop pumping and slowly open the pear valve. At this moment, it is very important not to miss the first jolt of blood during the contraction of the heart. It will be an indicator of systolic pressure (upper).
7. After the clear rhythm of the pulse subsides, the value of diastolic pressure can be determined (with relaxation of the heart muscle). This result is called lower pressure.
8. After completing the test, deflate the cuff and remove it from your arm.

Blood pressure can also increase in children, pregnant women and people experiencing constant stress. Therefore, it is necessary to measure the pressure with any attack of headache that has arisen without obvious reasons ( loud noise, for example).

Schedule and technique for measuring blood pressure

How to measure pressure with a tonometer in such a way that it is possible to determine the daily blood pressure profile in a person? After all, hypertensive patients and people with heart disease should monitor changes very carefully. this indicator. A more accurate idea of ​​the state of the heart muscle will give repeated conduct of the procedure in question during the day. The first time the pressure is measured early in the morning, 1 hour after waking up. The second indicator is recorded 1 hour after lunch. Best watch for evening measurement - 19:00-20:00.

To measure blood pressure, you need to prepare a little. Here are some conditions that must be observed in order for automatic blood pressure monitors to show a reliable result:

• the last meal should take place at least 2 hours before the procedure;
• smoking, drinking alcohol and caffeinated drinks are prohibited;
• before the procedure can not be used vasoconstrictor drops and sprays;
• before measuring blood pressure, a person should exclude any type of physical activity, and if they are present, it is necessary to rest for half an hour;
• during the procedure itself, a person should not strain his muscles, talk, laugh or worry - all this can significantly distort the results;
• if before the procedure a person long time been out in the cold or extreme heat, at least an hour must elapse before starting a blood pressure measurement.

Reliable results can only be expected if all of the above conditions are met. Moreover, we should not forget about the stress received by the body during the procedure. It is the latter that can become several tens of mm Hg. Art.

As mentioned above, the technology for using improved new devices is somewhat different from that described. If all conditions are met before the measurement procedure and the cuff is correctly positioned on the arm, the device will do almost all the work on its own. After the start of the procedure, after some time, the results will be displayed on the electronic scoreboard. Models of tonometers developed during last year, have a built-in memory function that allows them to memorize and save the results.

Measurement of blood pressure lying down

In the event that a person feels unwell (for example, suffers severe dizziness), pressure can be measured in the supine position. However, it should be remembered that reliable results are guaranteed only if correct location body. The hand should be relaxed, lie along the body and be raised to the middle. chest. In order to make this easy to do, a pillow is placed under the elbow and shoulder.

Caring for your tonometer

For getting reliable results important condition is not only human body but also a tonometer. In order for the device to work correctly, the following recommendations for caring for the tonometer must be observed:

• if the device becomes dirty, wipe it with a slightly damp cloth;
• the device must be used as carefully as possible (do not drop, do not beat);
• to check the accuracy, it is necessary to take the tonometer to a service center annually;
• do not wet the lining on the strap;
• in case of incorrect operation of the device, disassembly and assembly of the tonometer should be carried out only by a specialist;
• you need to put the device in the box as carefully as possible: you can not bend the tubes and bend the cuff.

Measurement of blood pressure is an important procedure that should be carried out regularly. The ease and speed of its implementation allows you to spend only a few minutes a day on the procedure. At the same time, the work of the heart muscle will always be under your control!

Many people are faced with the need to measure blood pressure in themselves or their loved ones. Therefore, it is important to be able to measure pressure correctly at home, since inaccurate measurement results can lead to incorrectly chosen actions to stabilize it. Measurement of blood pressure does not require special medical knowledge. Enough to digest simple rules carrying out this procedure.

What to measure?

To measure blood pressure, I use a device called a tonometer (sphygmomanometer). They are of two types - mechanical and electronic. The latter are divided into semi-automatic and automatic. Mechanical tonometer are mainly used medical workers, since when measuring pressure, the pulse rate is heard with a stethoscope, but not every person can do it on their own. Therefore, it is considered that it is more convenient to use an electronic tonometer. Experts recommend using a semi-automatic. Compared to an automatic, a semi-automatic is more durable, cheaper and more accurate. When buying a machine, it is recommended to choose a model equipped with a cuff on the shoulder, since the wrist cuff is less accurate.

Enter your pressure

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The wrist cuff is commonly used by athletes or people with very large forearms.

How often to measure?

For absolutely healthy person it is enough to carry out control measurements once a quarter. At the same time, it is necessary to know your “working” pressure - one at which a person feels normal. To accurately know the "working" pressure, you need to measure blood pressure for several days and record the indicators. Measurements are taken twice a day - an hour after waking up and in the evening. The most frequent indicator is fixed - this will be the "working" pressure.

Hypertensive patients often need to control blood pressure. Cardiologists recommend checking blood pressure at least twice a day. It is necessary to take readings several times - 2-3 times with an interval of several minutes. received average result will be the most accurate. Hypotension patients need to control pressure, based on general well-being and the appearance of unusual symptoms.

Norm of arterial pressure

Criteria normal pressure are relative and depend on many parameters: gender, age, heredity, physical and psychological state, the presence of diseases internal organs. The indicators accepted by physicians as the norm for a healthy person of a certain age are indicated in the table:

What influences the measurement results?

Smoking and alcohol adversely affect blood vessels, thereby causing heart problems.

Blood pressure depends on the speed and strength of heart contractions, on the elasticity of blood vessels and the properties of blood. The pressure can be influenced by various diseases as well as external factors. Among external factors the most common are:

• smoking and alcohol;
• Tea coffee;
• fatty and spicy foods;
• medicines;
• increased physical activity;
• stress.

How to measure pressure correctly?

Mechanical tonometer

Put the cuff on the forearm above 2-3 cm of the bend of the elbow and fix it. Attach the acoustic head of the phonendoscope to the inner bend of the elbow, and insert the olives into the ears. Pump air with a pear to the mark of 200-220 mm. Then slowly lower the air valve bolt at a speed of 2-4 mm / sec. The first beat that is heard in the stethoscope indicates top pressure- systolic. The mark at which the beats become inaudible shows the lower pressure - diastolic. Take several measurements with breaks of 3-4 minutes and take the arithmetic average. When measuring with a manual blood pressure monitor, you need to practice to get used to it.

Electronic blood pressure monitor

It is much easier to measure blood pressure with electronic sphygmomanometers. Their programs provide for automatic recording of pressure and pulse indicators. The only difference is that when measuring with a semi-automatic tonometer, you need to manually inflate the air. The machine pumps air on its own up to desired border. In both devices, the results obtained are highlighted on the display. Some devices store data from several previous measurements. The instructions for the electronic sphygmomanometer are quite simple, so even old man.

Which hand to measure?

To determine the “correct” hand for measurement, a series of measurements is taken. First, a measurement is made on one limb, and after a short break (3-4 minutes) - on the second. It is necessary to take about 10 measurements, writing down the indicators in the table. Usually, the one in which the average values ​​are higher is chosen as the “working” one for measuring blood pressure. Doctors recommend that right-handers use their left hand to measure blood pressure, and left-handers use their right hand.

How to put on a cuff?

Rules for measuring blood pressure.

The forearm cuff is worn 2 cm above the elbow and tightly, but not too tight. If tightened too loosely or too tightly, the tonometer readings may be unreliable. The size of the cuff affects the accuracy of the indicators, so you need to choose it based on the volume of the forearm. You can read about the size in the user manual. Typically, the devices are equipped with a medium-sized cuff. Existing sizes indicated in the table:

Arm circumference, cm	The size
15-22	S
22-32	M
32-42	L

Pose for measurements

If the patient's condition does not require lying position, then the best position for measuring blood pressure is sitting on a chair. In this case, you need to slightly lean back with your body and relax your muscles. Legs should be parallel (you can not cross your legs or throw one on top of the other). Before starting the measurement, it is better to sit in a calm state for 5-10 minutes. Then the non-tensioned limb is placed on the table. If necessary, measurements are taken while standing, while it is important that the arm is not lowered. The correct position of the limb in any position is for the cuff to be in line with the heart. To measure blood pressure correctly, the cuff should not be worn over clothing. If it is not possible to roll up the sleeve, then it is better to remove it.

When is the best time to measure?

For more accurate data, it is recommended to measure the pressure several times a day. The first time the pressure is measured an hour after waking up. If the pressure is measured immediately after sleep, then you can get more low rates. This is the so-called "night" pressure. Before this, you do not need to drink coffee or tea, smoke, do gymnastics or take hot shower. The second time you can check the pressure in the evening. When re-measuring, you must follow the same rules as described above. If possible, you can spend a daily measurement. In any case, it is not necessary to take measurements 10 times in a row, as this will not add accuracy to the indicators and will give an extra load on the vessels.