PULSE
AND
BLOOD PRESSURE
THE PULSE
• It is a series of multiple waves of high
pressure that was created in the arteries as
the blood is ejected from the heart during
ventricular contraction.
• The rate and strength of the pulse can be
measured easily with no special equipment.
• Common site: radial artery
THE PULSE
• PURPOSE :
1. to obtain an estimate of the quality of the
heart‘s action per minute . Irregularities might indicate a
heart problem and must be investigated.
2. provides an initial recording (“baseline”) that
will enable us to compare future measurements and monitor
changes in our patient's condition
THE PULSE
• When you assess a pulse point you will be assessing:
a. RATE: count the pulse rate for 1 full minute A normal pulse rate
in an adult is 60-100 bpm.
b. STRENGTH/TENSION: grade the strength of the pulse and check the
pulse points bilaterally and compare them.
0: absent
1+: weak
2+: normal
3+: bounding
c. RHYTHM or REGULARITY :: is the pulse regular or irregular
d. VOLUME
THE PULSE
• Common Pulse Points :
1. Temporal 5. Radial
2. Carotid 6. Femoral
3. Apical 7. Popliteal
4. Brachial 8. Posterior Tibial
9. Dorsalis Pedis
Location of
Arteries that are
well positioned
for pulse
detectetion
THE PULSE
• Normal pulse rate range, by age:
Age Pulse rate (beats per minute)
Newborn (resting) 100-180 bpm
Infant (resting) 80-150 bpm
Child 2- 6 years 75-120 bpm
Child 6-12 years 70-110 bpm
Adolescent 60-90 bpm
Adult 60-100bpm
THE PULSE
• Equipment needed:
1. wrist watch with second -hand
2. jot down notebook and pen
3. stethoscope (for apical pulse)
THE PULSE
• How to get the pulse rate:
– determine the pulse rate of a resting subject by placing the
second and third fingers on the anterior surface of the wrist.
– Do not use the thumb as this will let you feel your own pulse
(pressure waves)
> Using a watch, count the number of waves in 15 seconds
> Multiply your result by 4 to determine the pulse rate in waves
per minute.
THE BLOOD PRESSURE
• Is a measure of the force blood exerts against the blood
vessel walls.
• Biologist often measure the pressure of body fluids in
units called millimeters of Mercury (mmHg).
• This unit is based on the measuring device called the
manometer
• A sphygmomanometer is used to determine the blood
pressure.
• Unit of measurement: millimeters of mercury (mmHg)
THE BLOOD PRESSURE
• Systolic pressure - when the ventricles
contract, blood is forced into the arteries,
and the pressure reaches a maximum
value.
• Diastolic pressure - When the ventricles relax,
blood pressure in the arteries falls to a
minimum value
THE BLOOD PRESSURE
PURPOSES : 1.to aid in diagnosis
2. to monitor changes in the patient‘s condition
Contraindications for brachial artery BP measurement:
1.Surgery including the breasts , axilla , shoulder . arm or hands.
2.Venous access device such as AV shunt and IVF
3.Injury or disease to the shoulder, arm or hands such as trauma,
burn, application of cast or bandage
THE BLOOD PRESSURE
Sites for BP taking:
1. Either arm on the antecubital space
2. either leg on the popliteal space
3. dorsalis pedis
THE BLOOD PRESSURE
Factors that can cause a variation in blood pressure:
Emotional state Race/ethnicity
Temperature Tobacco use
Respiration Alcohol use
Bladder distension White coat‘ hypertension
Pain Sudden change in posture
Exercise Food consumption
Age
THE BLOOD PRESSURE
Equipment needed:
1. jot down notebook and pen
2. sphygmomanometer and stethoscope (for manual BP
taking) or digital BP apparatus
THE BLOOD PRESSURE
How to measure Blood Pressure (BP):
1. a. to measure the blood pressure of a resting subject, first clean
the earpiece of a stethoscope with an alcohol swab and place it in your
ears.
b. then, wrap the sphygmomanometer air cuff around the
subjects left upper arm (brachial region) just above the antecubital fossa.
2. a. place the stethoscope’s diagram (sensor).
b. listen to the pulse in the brachial artery
c. close the valve of the sphygmomanometer air bulb and pump
the cuff to a pressure of about 200 mmHg or so
THE BLOOD PRESSURE
How to measure Blood Pressure (BP):
3. while still listening to the artery and watching the mercury
column, open the valve slightly and slowly release the air.
- as you decrease the pressure, you will suddenly notice a loud
tapping sound which is called the Korotkoff sound in the artery:
The point at which the first sound is heard is the SYSTOLIC PRESSURE
The last Korotkoff sound heard is what we call the DIASTOLIC
PRESURE
Blood Pressure is usually expressed as systolic pressure over diastolic
pressure.
THE BLOOD PRESSURE
How to measure Blood Pressure (BP):
4. the difference between the systolic and diastolic pressure
represents the Pulse Pressure
As written in an equation:
Pulse pressure = systolic pressure – diastolic pressure
THE BLOOD PRESSURE
How to measure Blood Pressure (BP):
5. The average blood pressure in the arteries is called the Mean Arterial
Pressure (MAP). Since diastole ( ventricular relaxation period) is about twice as
long as systole (ventricular contraction period), the following equation is used to
calculate MAP.
- a MAP below 60 mmHg may indicate there isn’t enough pressure to vital organs
- MAP above 100 mmHg may indicate high blood pressure
(diastole pressure x 2) + systolic pressure
MAP =
3
Another way to write the equation for MAP is:
MAP =
BLOOD PRESSURE (BP) CLASSIFICATION
CLASSIFICATION SYSTOLIC BP DIASTOLIC BP
NORMAL <120 <80
ELEVATED 120-129 <80
STAGE 1 HYPERTENSION 130-139 80-89
STAGE 2 HYPERTENSION ≥ 140 ≥ 90
HYPERTENSIVE CRISIS > 180 >120
