http___www.insideout.hr_dobar-osjecaj_zdravlje_kako-mjeriti-krvni-tlak.php_1.xml
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- Remove the cuff, stethoscope, pressure gauge, and bulb (also known as a "bladder") from the kit, taking care to untangle the various tubes. - Sit down at a table or desk where you can easily rest your arm so that when you bend your elbow, your elbow is parallel to your heart. (Some experts recommend you use your left arm; others suggest you test both arms. But while you're first adjusting to self-testing, use the left arm if you're right-handed, or vice versa.) - Bend the arm you're going to test. - Wrap the cuff around your upper arm (upper middle arm), slipping the top part of the cuff through the metal bar that's attached to the cuff. If your shirt has long sleeves, roll them up first. You can put the cuff over very thin clothing. Most cuffs have Velcro, making it easy to keep the cuff in place. - Make sure the cuff is snug, but not too tight -- if you cut off your circulation and become agitated, you're going to get an alarming blood pressure reading! - Gently put the earpieces of the stethoscope in your ears. They should feel comfortable in your ears. If not, try holding the stethoscope out in front of you and slightly shifting the earpieces away from you. - Place the wide head of the stethoscope (the diaphragm) entirely on your skin just above the elbow, on the inside of your now straightened arm; the brachial artery. Do not hold the head of the stethoscope with your thumb-your thumb has its own pulse and this will confuse you while you try to obtain a reading. A good method is to hold the chestpiece between your index and middle fingers with your fingertips in the vertical space between the diaphragm and bell. You will not normally hear a thumping until you have begun to inflate the cuff. To aid in finding this you can press two fingers (not your thumb) to the area where it should be and move around until you feel a pulse. - If the pressure gauge is clipped to the cuff, unclip it and attach the clip to something sturdy, such as a hardcover book, that you can place on the table so you can watch it. It's important to keep the gauge anchored and stable. Make sure there is adequate light and you can see the needle and pressure markings well before you begin to test. - Take the rubber bulb and tighten the valve at the base. Be sure to turn the valve all the way clockwise to shut it off so that air doesn't escape when you pump. DO NOT OVER-TIGHTEN THE VALVE. This is key, doing so will not allow you to release air from the cuff slowly enough at first. This is because you will twist it open too far and let out air too fast due to the force needed to open it. Only turn the valve closed until you feel it stop. - Pump the bulb using slow but very steady pressure until the needle on the gauge is at about 20-30 points above your usual systolic (top) number. Now, gently turn the bulb's valve counter-clockwise slightly so that air is released slowly and steadily. Doing this yourself as you listen is a little tricky, you should release the valve with the hand on your cuff arm and hold the stethoscope with your free arm. The needle should ideally be moving down at a rate of two marks per second for accuracy. - As you watch the needle fall back down the gauge, listen for a thumping sound (The clinical name for this is "Korotkoff sounds"). Keep your eyes on the gauge -- when you first hear thumping, you have your systolic number, which represents the greatest amount of pressure exerted on the artery walls as your heart pumps blood. - Keep watching the gauge and listening to the beats. Eventually the hard thumping sound will turn into a "whooshing" sound (these are called the 4th Korotkoff sounds). These sounds are helpful to listen to because they tell you that you are close to your diastolic blood pressure. When the thumping fades to silence, you have your diastolic (bottom) number, the lowest amount of pressure. - If you miss the exact measure of either number, it's perfectly acceptable to pump the cuff back up a little to catch it. Just don't do it too much (like more than twice) because that can affect accuracy. Switch to the other arm in that event and start again. Teringat zaman belajar measure blood pressure masa pre-medical year dulu. Tak puas rasanya. Nak belajar lagi!
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Pravilno mjerenje krvnog tlaka ključ je za dijagnozu hipertenzije kao i za praćenje terapijskog učinka. Za mjerenje se najčešće koriste živin tlakomjer, tlakomjer na pero i automatski (elektronički) tlakomjer. Općenite preporuke Prije početka korištenja bilo koje vrste tlakomjera, preporuča se odnijeti ga u ordinaciju izabranog obiteljskog liječnika gdje ćete dobiti upute kako ga koristiti i gdje ćete provjeriti njegovu točnost. - Ne uzimajte kofein alkohol ili duhanske proizvode barem 30 minuta prije mjerenja krvnog tlaka. - Ako imate nagon na stolicu ili mokrenje, obavite to prije mjerenja krvnog tlaka. - Prije samog mjerenja odmorite 3-5 minuta. Nemojte razgovarati. - Sjednite u udoban položaj, nemojte prekrižiti natkoljenice ili gležnjeve, naslonite se leđima na naslon. - Zasučite visoko rukav na ruci na kojoj ćete mjeriti tlak, postavite ruku u razini srca na stol i mirujte. - Odgovarajuća veličina manšete je od ključne je važnosti za precizno mjerenje krvnog tlaka. Širina manšete mora odgovarati 2/3 dužine od lakta do ramena, a njena dužina mora biti dovoljna da obujmi 80% nadlaktice. Ako kupite tlakomjer s premalenom manšetom, dobit ćete lažno visoke vrijednosti tlaka. - Ako je izmjerena vrijednost tlaka neočekivano visoka, malo odmorite pa ponovite mjerenje. U obzir uzmite nižu izmjerenu vrijednost. Mjerenje tlaka mehaničkim tlakomjerom: - Postavite manšetu oko nadlaktice, ne prejako, toliko da ispod nje možete staviti vršak prsta. Budite sigurni da je donji rub manšete 2,5 cm iznad lakatne jame. - Stavite stetoskop u uši pazeći da su gumeni dijelovi koji ulaze u uši usmjereni prema naprijed. - Postavite membranu stetoskopa na unutarnju stranu lakta - u lakatnu jamu. - Brzo napušite manšetu koja je već postavljena na nadlaktici stišćući gumenu pumpicu i to za 30 do 40 jedinica iznad zadnje izmjerene vrijednosti sistoličkog tlaka. Ne napuhujte manšetu polako, jer možete dobiti lažne vrijednosti. - Polagano otpuštajte ventil, po 2 do 3 milimetra u sekundi. Nemojte ga otpuštati prebrzo, jer nećete moći odrediti pravu vrijednost. - Kako polako ispuhujete manšetu otpuštajući ventil, nakon tišine, u jednom trenutku čuti ćete kucanje srca. Pažljivo slušajte pojavu prvog tona i pročitajte vrijednost u tom trenutku. Ta vrijednost je vrijednost sistoličkog tlaka. - Nastavite jednakom brzinom otpuštati ventil, slušajući kucanje srca. Koncentrirajte se na trenutak kada se kucanje više ne čuje i pročitajte vrijednost u tom trenutku. Ta vrijednost je vrijednost dijastoličkog tlaka. - Zapišite izmjerene vrijednosti, prvo sistolički, a potom dijastolički tlak. - Ako želite ponoviti mjerenje, pričekajte 2-3 minute prije ponovnog napuhavanja manšete. Mjerenje tlaka automatskim tlakomjerom: - Postavite manšetu oko nadlaktice, ne prejako, toliko da ispod nje možete staviti vršak prsta. Budite sigurni da je donji rub manšete 2,5 cm iznad lakatne jame - Uključite uređaj. - Manšeta će se početi napuhavati nakon pritiska na odgovarajuću tipku. Ako se radi o poluautomatskom modelu, manšetu ćete napuhati uz pomoć gumene pumpice. Nakon što je manšeta napuhana, automatski mehanizam će polako smanjivati pritisak. - Kako se manšeta se polagano prazni, vi promatrajte ekran kako biste očitali vrijednosti tlaka. Na ekranu se na kraju mjerenja ispisuju obje vrijednost, i sistolički i dijastolički tlak. - Zapišite izmjerene vrijednosti, prvo sistolički, a potom dijastolički tlak. - Pritisnite tipku za potpuno ispuštanje zraka iz manšete. - Ako želite ponoviti mjerenje, pričekajte 2-3 minuta prije ponovnog napuhavanja manšete. Izvor: www.plivazdravlje.hr