How To Measure Orthostatic Blood Pressure.
Orthostatic blood pressure is a vital sign measured in patients who may have problems in the blood. The so-called “orthostatic hypotension” is characterized by a significant drop in blood pressure of someone who is standing – and generates stunning sensations and dizziness. It is diagnosed if the systolic blood pressure (which has a larger value) of a person falls in 20 units or diastolic (the lower value) falls by 10 units when it rises. To make a diagnosis on your own, measure these pressures in different positions.
Part 1 : Measuring the blood pressure with the patient lying
1. Ask the person to lie down and stand upright on a couch, desk or bed for five minutes.
Pass the sphygmomanometer on the right arm of the patient and secure the Velcro strip.
2. Put the stethoscope over the brachial artery.
With the sphygmomanometer involved in the person’s arm, ask her to leave the palm facing up and put the stethoscope on the inner point of the elbow. This equipment has a large surface and therefore can reach the entire artery (which goes there). You will hear the sounds to take the pressure of the patient.
3. Use the pump to inflate the cuff.
Inflate it to reach the initial value of 200 and then empty it. In this process, see the value of systolic blood pressure; it is the force with which blood is pumped through the arteries (and usually get between 110 and 140).You recognize the systolic blood pressure at the time you hear the “thumps” in the stethoscope. These are the sounds of the blood through the brachial artery.
Memorize this value and keep listening as well as empty the cuff.
4. Note the reading of diastolic pressure after the sound is extinguished.
It will be lower (60 to 90). Diastolic is the pressure in the arteries in between heartbeats.Note the values of systolic and diastolic blood pressure, separating them with a bar. They are measured in millimeters of mercury or Hg. For example: “120/70 mmHg.”
5. Finally, measure the radial pulse of the patient.
To find it, put the index and middle finger over the inside of the right wrist. When you feel the pulse, see a clock for exactly 60 seconds, counting the beats.Most people are between 60 and 100 beats per minute (BPM). If you find a higher value, your patient may not be able to get up and continue the examination.
Note the pulse (or heart rate) and then get ready for the next stages of the examination – which will have to ask the person to get up.
Part 2 : Measuring the blood pressure with the patient standing
1. Ask the person to stand up in a place where they can be supported (if you feel weakness in feet).
Also, ask to hold something with your left hand while you measure the pressure and the pulse of the right arm.Wait until the patient is stable. – But take the exam as soon as possible (within one minute) after getting him to stand up
Ask the person to talk to if they experience lightheadedness or dizziness, so you help him/her sit. Although she/he has to stand for the test to be done right, do not risk worsening the situation.
2. Inflate the sphygmomanometer cuff again.
Measure the systolic and diastolic blood pressure and note values. Then repeat the pulse examination and record the results.
3. Wait for two minutes while the patient is still standing.
After those two minutes (and three minutes after the person has risen), you will get another value for the blood pressure. Inflate the cuff again and note the values systolic and diastolic. In normal physiology, the values should be higher in the second time, since the body had more time to get used to the change in posture.
4. Measure the patient’s pulse again and record the result.
Ask him to sit while you calculate the changes in pressure and examine values.
Part 3 : Assessing the results
1. Evaluate the results.
Subtract the values of the minute the person stood the values on which she lay. Subtract also the three minutes he was lying; so you can compare it and see how long the body has adapted.Diagnose and consider if the person suffers or not of orthostatic hypotension. If the systolic blood pressure dropped by 20 mmHg or diastolic drop in 10 mmHg, they are likely to have this problem.
Warning: the diagnosis of this condition is based on the value of blood pressure the minute the person stood, not the amount of pressure from the other three minutes (which only serves to make a comparison and see the speed at which the body adapts when it takes longer to get up).
See also the patient’s pulse increased at a normal rate. Generally, this value increases between 10 and 15 beats per minute. However, if amounts to 20 beats or more, advise the person to seek medical attention for a more professional examination.
2. Consider the person’s symptoms.
The difference between the pressure values while she was lying down and while standing does not matter; if the patient feels dizzy or giddy whenever they get up, they should see a doctor to do a more professional examination and detect the cause of these problems. These symptoms are enough to make you make the diagnosis of orthostatic hypotension, whatever be the pressure values. So it is important to know what a person feels when he stands suddenly.
3. Understand why it is important to measure orthostatic blood pressure.
Orthostatic hypotension (blood pressure when the person gets low after it up) is very common, especially among the elderly. Symptoms such as lightheadedness or dizziness and can cause the patient to faint due to low blood flow. Be aware of this condition to correct it or learn to live with it.Here are some common causes of orthostatic hypotension in elderly:
- use of medications,
- inadequate salt intake (although exaggerate this consumption may increase pressure) or simple delay in the normalization of blood pressure when it stands – which, in a fashion has to do with the natural aging process.
While orthostatic hypotension is rare in young individuals, it can also occur as a consequence of other diseases or due to extreme dehydration or loss of large amounts of blood in trauma.