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Procedure
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1. Steps 1–4 of General Guidelines.
2. Cleanse ear pieces and bell/diaphragm of stethoscope with an alcohol wipe. Reduces transmission of microorganisms from practitioner to practitioner and from client to client.
3. Position child.
a. Arm: Sitting or recumbent position with forearm supinated and slightly flexed and supported at heart level. If arm is below level of heart, BP reading is higher than normal; if it is above the level of the heart, BP reading is lower than normal.
b. Leg: Prone or if unable to lie prone, supine with knee slightly flexed to permit placing stethoscope over popliteal area.
4. Remove clothing as necessary to expose extremity.
5. Place correct size cuff around the extremity with the center of the bladder cuff over the artery. Too narrow a cuff will give false high reading; too wide a cuff will give a false low reading.
a. Arm: Cuff should be placed around upper arm with the lower edge about 3 cm above the antecubital fossa.
b. Leg: Cuff should be placed around the mid thigh with the lower edge about 2 cm above the popliteal space.
6. Locate the artery by palpation. Allows for proper placement of stethoscope to hear BP.
7. Palpate a pulse distal to the cuff, e.g., brachial or radial. Close air valve and rapidly inflate cuff to 30 mm Hg above where pulse no longer felt or above expected systolic blood pressure. Ensures cuff is inflated to a pressure exceeding the child’s systolic BP.
8. Place stethoscope gently over artery. Too firm a pressure will occlude blood vessel.
NOTE: While the diaphragm of the stethoscope is frequently used, the American Heart Association recommends using the bell of the stethoscope.
NOTE: To obtain a blood pressure reading by palpation, keep fingers on a distal pulse.
9. Open the valve and slowly release the air, permitting the pressure to drop 2–3 mm Hg per heart beat while auscultating for BP sounds or palpating for a pulse. Slower or faster deflation yields false readings.
NOTE: Do not reinflate cuff without letting cuff totally deflate. Reinflating cuff results in erroneously highreadings.
10. Obtain a blood pressure reading.
a. Auscultation.
1. Systolic pressure: The pressure at which you first hear sounds.
2. Diastolic pressure: The American Heart Association recommends the onset of muffling as the diastolic pressure in children up to 13 years of age; the pressure when sounds become inaudible is the diastolic pressure in children > 13 years of age.
b. Palpation: Continue to slowly release pressure until a pulse is felt. This is the systolic pressure. The diastolic pressure is recorded as P, e.g., 100/P. The systolic
pressure obtained by palpation is 5–10 mm Hg lower than that obtained by auscultation.
NOTE: If using a mercury manometer read at eye level. Ensures accuracy.
11. Do not leave the cuff inflated for a prolonged period. Inflated cuff is uncomfortable.
12. Deflate the cuff rapidly and completely and remove from the arm. Prevents discomfort (from numbness or tingling) and arterial occlusion.
13. Wait 2 minutes before taking another blood pressure. Releases blood trapped in vessels.
Дата публикования: 2014-10-17; Прочитано: 552 | Нарушение авторского права страницы | Мы поможем в написании вашей работы!
