• Using your middle and index fingers, gently palpate (feel) for the pulse in the bend of the elbow. This is the brachial artery. It will be easier to find if the patient’s elbow is straight.
• Place the diaphragm of the stethoscope over the brachial artery pulse and listen for the patient’s heartbeat.
• Inflate the BP cuff by squeezing the bulb. If the cuff does not inflate, ensure the pressure release screw is tightened.
• Continue inflating until the gauge reads about 160 or at least 10 points higher than when you last heard the heartbeat.
• Slowly loosen the screw to let air escape from the cuff, letting the gauge fall about 5 points per second. Watch the gauge and note where you first hear the heartbeat again. This is your systolic reading.
• Continue to release pressure and listen, making sure you note where the heartbeat stops. This is the diastolic reading.
• Release all pressure from the cuff and remove it from the patient’s arm.
Regardless of which device you use, it is imperative that you write down the blood pressure reading, date, time and which arm was used to take the BP.
Typically, a BP reading on the left arm will be slightly higher than the right. This is due to anatomy. The plumbing from the heart to the left arm is more direct than it is to the right arm. Regardless of which arm you choose, continue to monitor BP on the same arm. This will give you a more accurate set of vital signs.
STROKE
Stroke is another type of cardiovascular disease. It affects the arteries in and around the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts and begins to bleed. When that happens, part of the brain does not receive the blood it needs and thus, begins to die.
Stroke, this nation’s 3rd leading cause of death, was once viewed as unpreventable and untreatable. With advances in medicine, stroke is now being treated aggressively. Management of stroke now centers around getting help quickly.
3 MAIN TYPES OF STROKE
A CLOT occurs as a result of an obstruction within a blood vessel supplying blood to the brain. Usually, the underlying cause of this type of stroke is the buildup of fatty deposits on the walls lining the vessels. This occurs in the brain just as it does in the heart. This common type of stroke accounts for about 83% of all strokes.
A BLEED occurs when a weakened vessel ruptures and bleeds into the surrounding brain tissue. The blood accumulates and puts pressure on the surrounding brain tissue. This type of stroke accounts for about 17% of stroke cases.
An ANEURYSM is a ballooning of a weakened region of a blood vessel. If left untreated, the aneurysm continues to weaken until it ruptures and bleeds into the brain.
58 Central Nervous System
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