Hospital Blood Pressure Machine Types.pptx

Hospital Blood Pressure Machine Types

1. BP Machine Maintaining BP Machine

2. Maintaining a Sphygmomanometer (Blood Pressure Machine) A sphygmomanometer is used to indirectly measure arterial  blood pressure . Sphygmomanometry is the process of manually measuring one's blood pressure.  Blood Pressure:  Pressure exerted on the walls of blood vessels while blood is moving through the body. This is measured in mmHg and displayed as 'systolic blood pressure/diastole blood pressure' (mmHg). It is an essential tool in healthcare settings and is also commonly used for personal health monitoring. Normal blood pressure values are around 120/80mmHg  [3] . If values are below 90/60mmHg, that would be considered low blood pressure ( hypotension ). Blood pressure values above 140/90 mmHg would be considered high blood pressure, and is classified as  hypertension. If it is 180/120mmHg, that is dangerously high and would require medical attention.  Proper maintenance of a sphygmomanometer is crucial to ensure accurate and reliable readings. Here are some guidelines for maintaining a sphygmomanometer:

3. Meaning and Function of a Sphygmomanometer A sphygmomanometer consists of an inflatable cuff, a bulb for inflating the cuff, a gauge for measuring the pressure, and a stethoscope for listening to the heartbeat. The cuff is wrapped around the upper arm, and the bulb is squeezed to inflate the cuff, which stops the flow of blood in the artery. The gauge measures the pressure required to stop and restart the flow of blood, which indicates the systolic and diastolic blood pressure readings, respectively. Definitions Systole:  The contraction phase of the cardiac cycle, when the heart fills with blood.  Diastole:  The relaxation phase of the cardiac cycle, when the heart empties the blood.  Systolic Pressure:  Pressure that is exerted on the  arteries  as blood is leaving the heart during ventricular systole.  Diastolic Pressure:  Pressure that is exerted on the arteries during ventricular relaxation (diastole). 

4. Meaning and Function of a Sphygmomanometer…. The sphygmomanometer works on the principle that when blood flows through an artery, it produces vibrations or sounds that can be heard using a stethoscope. Korotkoff sounds The sounds are heard through the stethoscope as distinct “tapping” or “knocking” sensations, known as Korotkoff sounds. The first sound heard as the cuff pressure decreases is the systolic pressure, while the last sound heard before the cuff pressure reaches zero is the diastolic pressure.

5. Types of BP Machine: Indirect measurement techniques A) Manual auscultatory techniques The auscultatory method relies on inflating an upper arm cuff to occlude the brachial artery and then listening to the Korotkoff sounds through a stethoscope whilst the cuff is slowly deflated. The patient’s systolic (phase I) and diastolic blood pressure (phase V) is recorded from the reading on the sphygmomanometer. Devices for use with the manual auscultatory technique Digital Aneroid Mercury

6. 1. Mercury Sphygmomanometer Components and Principle of Machine: A mercury sphygmomanometer is a blood pressure measuring device that uses a column of mercury to indicate the pressure. It consists of an inflatable cuff, a manometer, and a column of mercury. The cuff is wrapped around the upper arm, and the manometer is connected to the cuff. When the cuff is inflated, it temporarily obstructs the blood flow in the brachial artery. As the cuff deflates, the health care professional listens with a stethoscope to detect the sounds of blood flow resuming. The height of the mercury column at which these sounds are heard indicates the systolic and diastolic blood pressure. Advantages: High Accuracy:  Mercury sphygmomanometers are known for their high accuracy in measuring blood pressure. Easy to Read:  The mercury column provides a clear and easy-to-read visual representation of the pressure.

7. 2. Aneroid Sphygmomanometer Components and Principle of Machine: An aneroid sphygmomanometer is a manual blood pressure measuring device that uses a dial-faced gauge to indicate the pressure replacing the mercury manometer. It consists of an inflatable cuff, a pressure-sensitive mechanism (aneroid bellows), and a dial that displays the pressure. The cuff is wrapped around the upper arm, and the aneroid bellows is connected to the cuff. As the cuff is inflated and deflated, the changes in pressure are transmitted to the aneroid bellows, which in turn moves the dial to display the blood pressure. Advantages: Portability:  Aneroid sphygmomanometers are compact and lightweight, making them easy to carry and transport. No Electrical Requirements:  They do not require batteries or electricity to operate, making them suitable for use in various settings, including remote areas.

8. 3. Digital Sphygmomanometer Components and Principle of Machine: A digital sphygmomanometer is an electronic blood pressure measuring device that uses sensors and a microprocessor to display the pressure. It consists of an inflatable cuff, pressure sensors, and a digital display to replace the manometers. The cuff is wrapped around the upper arm, and the sensors measure the pressure changes as the cuff inflates and deflates. The data is then processed by the microprocessor, which displays the blood pressure reading on a digital screen.

9. Advantages of Digital BP : Ease of Use:  Digital sphygmomanometers are user-friendly and often come with features like memory storage, date and time stamps, and audible alerts for irregular heartbeats. Automated Measurements:  They provide automated and consistent readings, reducing the possibility of human error in interpreting the pressure changes. Storage and Retrieval of Data:  Digital devices often have built-in memory to store multiple readings, making it easier for healthcare professionals to track and analyze blood pressure trends over time.

10. Parts of a blood pressure machine

11. Parts of a blood pressure machine Bladder:   It is an inflatable bag that, when filled, squeezes the arms to block the artery. Cuff:   The cuff has an inflatable rubber bladder that is cloaked around the upper arm. A pressure meter indicates the cuff's pressure. controls the release of air from the cuff. It is used to slowly deflate the cuff during measurement Valve: The deflation valve allows for controlled deflation of the cuff and it’s critical for accurate measurement. An end check valve prevents air from escaping. Bulb:   A small, handheld air pump inflates the blood pressure inside the cuff. Manometer: It is the portion of the sphygmomanometer that measures the blood pressure in mmHg. This aneroid gauge contains a watch-like movement that measures the air pressure applied to the cuff. Within the gauge, there is a series of diaphragms (of copper or beryllium) that expands when air is filled and contains gears that transform the linear motion of diaphragms, turning the needle on a dial calibrated in mmHg.

12. B)Automated oscillometric technique The majority of non-invasive automated blood pressure measuring devices currently available use the oscillometric method. The oscillometric method relies on detection of variations in pressure oscillations due to arterial wall movement beneath an occluding cuff. Empirically derived algorithms are employed, which calculate systolic, mean arterial and diastolic blood pressure. Manufacturers develop their own algorithms by studying a population group and may have validated the stated accuracy by performing a clinical trial in accordance with one of the standards

13. Automated devices, generally using the oscillometric technique Automated (spot-check) device This includes an electronic monitor with a pressure sensor, a digital display and an upper arm cuff. An electrically-driven pump raises the pressure in the cuff. Devices may have a user adjustable set inflation pressure or they will automatically inflate to the appropriate level, usually about 30mmHg above an estimated systolic reading. When started, the device automatically inflates, then deflates the cuff and displays the systolic and diastolic values. The majority calculate these values from data obtained during the deflation cycle, but there are some that use data from the inflation cycle. The pulse rate may also be displayed. These devices may also have a ‘memory’ facility which stores the last measurement and previous readings. Battery powered.

14. Automated devices, generally using the oscillometric technique… 2. Wrist device - This includes an electronic monitor with a pressure sensor, an electrically-driven pump attached to a wrist cuff. Function is similar to the automated (spot-check) device above. Battery powered. 3. Finger device - This includes an electronic monitor and a finger cuff, or the device itself may be attached to the finger. Generally battery powered. Uses oscillometric , pulse-wave or plethysmographic methods for measurement 4. Spot-check non-invasive blood pressure (NIBP) monitor -This is a more sophisticated version of the automated device above and is designed for routine clinical assessment. There may be an option to measure additional vital signs, such as oxygen saturation in the finger pulse (SpO2) and body temperature. Mains and battery powered. 5. Multi-parameter patient monitors -These are designed for use in critical care wards and operating theatres and monitor a range of vital signs including blood pressure. May be possible to communicate with a Central Monitoring Station via Ethernet or Wi-Fi.

15. Automated devices, generally using the oscillometric technique… 6. Automatic-cycling non-invasive blood pressure (NIBP) monitor- This is similar to the spot-check NIBP monitor, but with the addition of an automatic-cycling facility to record a patient’s blood pressure at set time intervals. These are designed for bedside monitoring in a clinical environment where repetitive monitoring of patients and an alarm function is required. These devices may incorporate the ability to measure additional vital signs. The alarm limits can usually be set to alert nursing staff when one or more of the measured patient parameters exceed the pre-set limits. Mains and battery powered.

16. Automated devices, generally using the oscillometric technique… 7. Ambulatory blood pressure monitor This includes an upper arm cuff and an electronic monitor with a pressure sensor and an electrically-driven pump that attaches to the patient’s belt. The unit is programmed to record the patient’s blood pressure at pre-defined intervals over a 24-hour period during normal activities and stores the data for future analysis. Battery powered. Uses electronic auscultatory and oscillometric techniques.

17. Methods of Blood Pressure Measurements Blood pressure is a vital sign that provides important information about the cardiovascular health of an individual. There are various methods to measure blood pressure, classified as direct and indirect methods. Here are some common methods: Direct- a needle or a catheter are introduced into the peripheral arteries of patients and arterial BP is measured directly by means of a strain gauge . The indirect method - involves  collapsing the artery with an external cuff, providing an inexpensive and easily reproducible way to measure blood pressure. 

18. Common technical problems Incorrect technique is a common cause of inaccurate results, below are some problems that can be encountered. 1. Patient not co-operative At least 10 minutes is required to adjust to surroundings and technique Carry out with the owner present in some cases Try to avoid clipping Use headphones for Doppler technique.

19. 2. Anatomical difficulties - Short limbs (Bassett, Dashund ) may have more success with Doppler technique or tail base. 3. Unable to obtain BP values/abnormal values Low battery Incorrect positioning of the cuff Movement during measurement ( oscillometric ) Damaged cuff/incorrect size Damaged probe/equipment, check all in working order, check piezoelectric crystals are not damaged by checking your own pulse.

20. 3.Unable to palpate/detect pulse Incorrect positioning Peripheral vasoconstriction — could be seen following drug administration or in shock patients Hypotension (BP lower than normal)— could be seen during anaesthesia or following significant blood loss.

21. Direct Methods of BP measurements: Percutaneous insertion Catheterization Implantation of a transducer

22. Direct Methods of BP measurements: 1. Percutaneous Insertion: Percutaneous means "through the skin". In percutaneous insertion, a small needle is used to puncture the skin and insert a catheter (thin flexible tube) into a blood vessel. It is a minimally invasive procedure done at the bedside without imaging guidance. Common sites are the radial artery in the wrist or femoral artery in the groin. It allows for direct blood pressure measurement and blood sampling. Risks include bleeding, infection, and damage to the blood vessel.

23. 2. Catheterization (Vessel Insertion):   Catheterization involves inserting a catheter into a blood vessel using imaging guidance like ultrasound or fluoroscopy to visualize vessel anatomy. It is usually performed in the cardiac catheterization lab or radiology suite by an interventional cardiologist or radiologist . A small nick is made in the skin where a catheter is threaded into the vessel using imaging to navigate to the desired location, usually the arteries of the heart or other organs. It allows for pressure monitoring and potential interventions like balloon angioplasty or stent placement . More invasive than percutaneous insertion due to use of imaging and potential interventions but less risky than open surgery. Risks include bleeding, infection, reaction to contrast dye, and damage to blood vessels or organs.

24. 3. Implantation of a Transducer:   In this method, a pressure transducer is surgically implanted into an artery to provide continuous and accurate blood pressure monitoring. This method is often used in research settings or in patients with severe cardiovascular conditions. Advantages: Provides continuous and long-term measurement of blood pressure Minimally invasive and can be performed under local anesthesia Reduces the need for frequent clinic visits for blood pressure monitoring.

25. Blood Pressure Monitors Blood pressure monitors are essential medical devices used to measure the pressure of blood within the arteries. They are commonly used in healthcare settings, as well as for personal use at home. There are different types of blood pressure monitors available, including manual devices with a stethoscope and automatic devices with sensors.

26. 1. Stethoscope A stethoscope is a key component of manual blood pressure monitors. It is used to listen to the sounds of blood flow in the arteries while taking a blood pressure reading. The healthcare provider places the stethoscope over the brachial artery in the arm and listens for the characteristic sounds known as Korotkoff sounds. These sounds help determine the systolic and diastolic blood pressure readings.

27. 2. Sensors Automatic blood pressure monitors utilize sensors to measure blood pressure without the need for auscultation with a stethoscope. These sensors can be of various types, including pulse sensors and respiratory sensors.

28. a) Pulse Sensors Pulse sensors are commonly found in automatic blood pressure monitors. They work by detecting the pulsations of blood flow in the arteries, usually in the wrist or upper arm. The sensor measures these pulsations and calculates the corresponding systolic and diastolic blood pressure values.

29. b) Respiratory Sensors Some advanced blood pressure monitors may also include respiratory sensors to provide additional information about the patient’s breathing patterns during blood pressure measurement. These sensors can detect changes in breathing rate or depth, which may influence blood pressure readings.

30. Common Faults in Blood Pressure Machines and Monitors Blood pressure machines and monitors are essential tools used in healthcare settings and at home to monitor blood pressure levels accurately. However, like any other electronic device, they can experience faults that may affect their performance. Some common faults in blood pressure machines and monitors include:

31. Common Faults in Blood Pressure Machines and Monitors… Inaccurate Readings : One of the most common faults is inaccurate readings. This can be caused by various factors such as improper cuff placement, cuff size mismatch, irregular heartbeats, or machine calibration issues. Leakage : Another common fault is air leakage in the cuff or tubing. If there is a leak, the machine may not be able to maintain the required pressure to measure blood pressure accurately. Display Malfunction : Display malfunction can occur due to issues with the screen, buttons, or internal components of the monitor. This can lead to incorrect readings or difficulty in operating the device.

32. Common Faults in Blood Pressure Machines and Monitors… 4. Battery Issues : Blood pressure monitors that rely on batteries may experience faults related to power supply. Low battery levels or faulty batteries can result in unreliable readings or complete device failure. 5. Cuff Deflation Problems : Some machines may have issues with deflating the cuff at the right rate, leading to inaccurate readings or discomfort for the patient. 6. Sensor Problems : Sensors within the blood pressure monitor can malfunction, leading to inaccurate readings or failure to detect blood pressure properly.

33. Maintenance Procedures To ensure the proper functioning of blood pressure machines and monitors and prevent common faults, regular maintenance procedures should be followed: Calibration : Regular calibration of the device is essential to ensure accurate readings. This should be done according to the manufacturer’s guidelines. Cuff Inspection : Check the cuff for any signs of wear and tear, leaks, or damage. Replace the cuff if necessary to maintain accurate measurements. Battery Check : If the monitor uses batteries, regularly check and replace them as needed to prevent power-related faults. Cleaning and Disinfection : Follow proper cleaning and disinfection procedures as recommended by the manufacturer to prevent contamination and ensure patient safety. Regular Testing : Perform regular testing of the monitor using a known standard to verify its accuracy and functionality.

34. Safety Procedures for Using a Blood Pressure Machine When using a blood pressure machine, also known as a sphygmomanometer, it is essential to follow safety procedures to ensure accurate readings and prevent any potential harm to the user. Here are some key safety procedures to keep in mind:

35. Safety Procedures… 1.Proper Placement of Cuff: Ensure that the cuff is placed correctly on the upper arm at heart level. The cuff should be snug but not too tight to avoid restricting blood flow. 2. Rest Before Measurement: It is recommended to rest for at least 5 minutes before taking a blood pressure reading. Avoid consuming caffeine or tobacco products before measuring blood pressure. 3. Proper Technique: Sit in a comfortable position with your back supported and feet flat on the floor. Keep your arm relaxed and supported at heart level during the measurement. Avoid talking or moving during the reading to prevent inaccurate results.

36. Safety Procedures… 6. Regular Maintenance: Check the calibration of the blood pressure machine regularly to ensure accuracy. Inspect the cuff and tubing for any signs of wear and tear that may affect readings. 5. Follow Manufacturer’s Instructions: Always refer to the manufacturer’s instructions for proper usage of the blood pressure machine. If you are unsure about any aspect of using the device, consult with a healthcare professional. 6. Record Readings Properly: Keep a record of your blood pressure readings for monitoring purposes. Note down the date, time, and any relevant factors that may influence the readings.