How to measure blood pressure with a tonometer. How to correctly measure blood pressure with an electronic tonometer? What needs to be done to bring the pressure to a state of stabilization

Today, the most common method of measuring blood pressure, which is used in medical institutions and at home, is the Korotkoff method. This method is carried out using a hand-held tonometer.

It should be remembered that pressure can change throughout the day and depends on the environment. For example, blood pressure values are lower at night, while blood pressure increases during wakefulness or stress.
When measuring blood pressure, two values are taken into account:

Systolic or upper - shows the force of contraction of the heart muscle, i.e. the pressure with which blood from the heart cavity enters the vessels.
Diastolic or lower - shows vascular tone, i.e. pressure created by the walls of blood vessels.

Conditions for measuring blood pressure.

The blood pressure value will be more reliable if measurements are taken an hour before meals, physical activity and drinking coffee.
Measurement position: sitting with legs down and back reclined or lying on your back. In this case, the patient should rest for 5-10 minutes.
Blood pressure should be measured dynamically - at different times of the day.
The position of the hand during measurement should be free - at the level of the heart with the elbow joint extended.

Method of measuring blood pressure.

The cuff is placed on the shoulder so that its lower edge is 2 cm higher from the elbow.
When applying the cuff, a finger must pass between the shoulder and the cuff.
The cuff should not be placed on the fabric.
The cuff should cover 2/3 of the surface of the shoulder, and the phonendoscope should be in the cubital fossa (where the brachial artery is located closer to the surface of the body).
Air must be pumped into the cuff quickly using a bulb, after closing the valve. It is necessary to pump air above the estimated systolic blood pressure (by 20 -30 mmHg).
Then, holding the phonendoscope diaphragm in the right place, you need to open the valve on the bulb so that the air descends at a speed of about 2 mmHg per second. At the same time, listen carefully for the appearance of clear, loud heart tones. Strong pressure of the phonendoscope diaphragm on the brachial artery can distort blood pressure values.
Systolic blood pressure is noted at the moment when the first clear heart sound is heard, and diastolic blood pressure is noted when the sound of clear heart sounds stops.
Measurements are taken on both hands three times with an interval of 2-3 minutes.

If the difference in values during the first measurements does not exceed 5 mm Hg, then the final blood pressure value is displayed as the average of the two measurements. If during the first two measurements the difference exceeds 5 mmHg, then the measurement is repeated a third time, and, if necessary, a fourth. If the difference in systolic blood pressure in both arms exceeds 20 mm Hg, and diastolic blood pressure exceeds 10 mm Hg, you should think about vascular pathology and conduct additional research methods.

If the tones are muffled when measuring blood pressure, then you need to raise your hand and make several squeezing movements, and then repeat the measurement.
In case of atherosclerotic changes in blood vessels, blood pressure must also be measured in the lower extremities.
In pregnant women, blood pressure should be measured alternately on both arms. If the difference in systolic blood pressure is 10 mm Hg, and diastolic blood pressure is 5 mm Hg, the measurements must be repeated.

Errors in pressure measurement.

Incorrect hand position.
Incorrect position of the cuff or discrepancy between the cuff size and shoulder volume (shoulder coverage must be at least 80%).
Rapid deflation of air from the cuff (more than 2 mmHg per second).

How to measure blood pressure correctly.

Normally, pressure readings should constantly be at approximately the same level. Minor fluctuations in one direction or another are acceptable, but only temporarily, for example, as a result of stress, overwork, or mental strain. If there are increases in blood pressure, then this is a sign of the development of hypertension and cardiovascular pathology.

Important! High blood pressure is the main enemy for patients diagnosed with hypertension. Complications (hypertensive crisis, stroke, myocarditis infarction) can be fatal. It is important to keep your blood pressure readings under strict control, regularly measure your blood pressure with a hand-held tonometer and keep it always at hand so that you can find out the values at any time in a calm home environment, if necessary, and promptly seek help from doctors.

Preparing to measure pressure

Measuring pressure with a manual tonometer is quite problematic, so you should first adapt and acquire some skills. Although, according to reviews from many users, the home mechanical device is the best and most accurate today. Contains:

rubber bulb with attachment to the cuff;
pressure gauge;
phonendoscope for listening to sound signals.

On a note! If the patient has vision problems, then the best choice is an automatic or semi-automatic device, then specific operating skills are not required.

It is most convenient to measure blood pressure at home, since it is advisable to calm down and relax in order to get more accurate results. In a clinical setting, this is not always possible. The preferred temperature is room temperature. For preparation purposes you need:

eliminate alcohol intake 12 hours before;
do not smoke 1.5 hours before the session;
refrain from eating for 0.5 hours.

Algorithm of actions

To get more reliable blood pressure results, it means following simple sequential steps:

lean your elbows on the back of the chair, taking a comfortable sitting position;
release your right hand from clothing or lift your sleeve to avoid pinching the artery;
place your hand on the table surface so that it does not hang;
put the cuff on just above the elbow 2–3 cm;
secure with Velcro;
insert the hearing part of the stethoscope into the ears;
apply the membrane amplifier to the wrist - the place of the pulsating artery;
make sure that the needle on the tonometer is at level – 0;
release all the air if there is any in the cuff, otherwise the measurements may be false;
tighten the valve on the bulb so that during the period of air injection it does not come out;
inflate the cuff, periodically squeezing the bulb until the needle on the pressure gauge shows an extremely high number;
stop air injection;
start slowly unscrewing the valve on the bulb, tracking the arrow moving down;
the appearance of 1 knock on the auditory part of the endoscope will indicate the upper pressure indicator, then it should decline.

When the sound disappears completely, this will be the lower diastolic pressure. All that remains is to deflate the cuff and remove it from your arm.

Attention! When choosing an indicator for self-measurement of pressure, it is necessary to take into account the previous indicators. Thus, bring the arrow slightly higher than the old pressure value.

It is important to position the cuff correctly on the arm so that the air tube runs down the back of the arm, parallel to the radial carpal joint and in relation to the middle finger.

If measurements are taken for the first time, it is recommended to adjust the needle on the dial to 220 mmHg. Art., then stop squeezing the bulb, begin to gradually unwind the wheel to slowly release air. It is worth reading the highest blood pressure readings with three measurements as reliable. At all subsequent times, it is recommended to measure the pressure on the arm where it is highest. It is advisable for older people to write down the obtained indicators in a notebook in order to analyze and evaluate pressure surges in one direction or another.

You cannot cross your legs or cross your legs. The position of the back should be straight, and the hand should be as relaxed as possible and freed from under the clothes.

If pressure measurements are being taken for the first time, it is advisable to measure the readings on each arm in turn. Carry out the procedure three times with an interval of 5–7 minutes. As a result, calculate the average value, i.e., sum the 3 parameters of systolic pressure, divide by the number 3. Perform the same calculations with diastolic pressure.

Types of tonometers

The most common types:

Mechanical consisting of a cuff, pressure gauge, connecting hose, pneumatic chamber, rubber bulb, stethoscope.
Semi-automatic with a pneumatic chamber and air supply into it. All information is reflected on the display, the person only has to pump up the bulb and reveal his blood pressure readings.
Oscillometric – as a fairly effective tonometer with the most accurate readings. The downside is the need to recharge, otherwise the device will not work without a battery.
An automatic tonometer is a modern electronic microlife with independent reproduction of almost all manipulations. All a person needs to do is place the cuff on his arm just above the elbow and start the device. Pressure measurement is carried out independently, the results are displayed on the panel.

If a person is right-handed, then measurements should be taken on the left hand. It is advisable to measure blood pressure at approximately the same time of day, preferably in the morning. Moreover, for hypertensive patients with jumps in systolic and diastolic parameters, this should become an integral, daily procedure.

Common mistakes

Patients often make mistakes when working with a tonometer, which is why pressure readings may not be completely inaccurate. Here are the main nuances:

You cannot talk or move while measuring blood pressure.
The cuff should be positioned at heart level and fit snugly around the arm.
Clamping of blood vessels on the arm is unacceptable, as is hanging from the table. If necessary, you can place a pillow under your elbow.
If you roll up your sleeve, the arm will be compressed, normal blood circulation will be disrupted, and ultimately false results will occur.
The cuff should not slip on the arm, so it is advisable to select it in size taking into account the girth of the arm.
If the upper and lower pressure readings are close or almost equal to each other, then this is not the norm, a sign of hypertension. It is better not to put off visiting a cardiologist.
Between measurements you need to take breaks of 3-4 minutes, and between the second and third it is advisable to wait 5-7 minutes in order to get more reliable results.

If you start measuring the pressure on the other arm immediately after the first, the pressure may be slightly higher due to the cuff squeezing the primary arm for a long time.

High blood pressure leads to stroke and heart failure. These are deadly diseases. Main symptoms: dizziness, headache, hand tremors. These are warning signs that you need to check your blood pressure immediately. If the indicators go off scale much higher than the usual values, then measures need to be taken. Inaction is fraught with death.

Probably every family has a device for measuring blood pressure. However, not everyone knows how to measure blood pressure correctly.

So, let's figure out step by step how to properly prepare for pressure measurement and carry out the measurement itself correctly. After all, due to improper operation of the device and procedural errors, we once again take medications, which only harms our body.

First of all

The most important condition for the subject is to sit down in the place where the pressure will be measured 10 minutes before the procedure. During these 10 minutes a person should calm down and relax. There is no need to watch TV, eat or even talk at this time. Excessive activity will only lead to increased blood pressure and increased heart rate. You need to measure your blood pressure in a state of complete rest.

1 hour before measuring blood pressure, you should avoid drinking coffee and tea. You should not smoke at least 15-20 minutes before the procedure.

Correct posture

When measuring pressure, it is very important to take the correct position. You need to lean back in your chair (armchair) and completely relax your muscles. In this case, you do not need to lean on anything with your hands. The hand should lie quietly, and under no circumstances should it hang.

You cannot sit cross-legged. This way you will squeeze large arteries, which will introduce a greater error in the result.

Avoid taking medications

One and a half to two hours before the measurement, you should not take medications that affect the functioning of the cardiovascular system. This also applies to eye and nasal drops and sprays that increase pressure level.

How to choose a hand?

Surely many people are wondering: which hand to put the cuff on? In order to determine whether to measure the pressure on your left or right hand, you need to take a series of measurements. Measurements are taken on both hands. In this case, you need to maintain an interval of 2-3 minutes between procedures to restore blood circulation. Usually 10 measurements on each hand are enough. After each measurement, all data must be entered into a table divided into 2 columns (for the left and right hands). After all the work is done, we begin the calculations. First you need to cross out the largest and smallest pressure values. If you notice that the pressure on one arm is consistently higher than on the other, then from now on the pressure should be measured on the arm with higher pressure. Such asymmetry should not scare you, since it is not a pathology.

If the pressure on both hands is the same, then it is recommended to measure it on the left hand for right-handers, and on the right hand for left-handers.

How to put on the cuff?

To begin, install the cuff at a level of 2 centimeters above the elbow. The cuff must be tightened evenly so that it covers the entire surface of the hand. Due to the fact that the thickness of the arm is not the same in different places, the cuff must be tightened slightly obliquely. If you tighten the cuff evenly, you risk receiving unreliable device data.

Be sure to check your blood pressure monitor every 6 months. The sphygmomanometer needle must be exactly at zero before starting the measurement.

Measurement procedure

After the cuff is installed, we begin to pump air. This needs to be done quickly. You need to pump air to a level that is approximately 20 mmHg. Art. exceeds systolic pressure (when the pulse).

The pressure in the cuff should not be reduced quickly, at a rate of 2-3 mm. Hg Art. The mark at which the first tone was heard corresponds to systolic pressure. The mark at which the last tone was heard corresponds to diastolic pressure.

When measuring pressure, you do not need to press hard on the phonendoscope. This will compress the artery.

If the tones are heard very weakly, then the subject is recommended to raise his arm and bend and straighten it several times.

Article publication date: December 29, 2016

Article updated date: 12/18/2018

From this article you will learn: how to measure blood pressure with an electronic tonometer in order to obtain a reliable measurement result. Frequent errors in measurement.

Compared to mechanical blood pressure monitors, electronic blood pressure monitors are more likely to show false data. They are more sensitive, and the main reasons for incorrect results are caused by violation of the measurement rules. Therefore, it is important to comply with absolutely all requirements for the tonometry technique with an electronic tonometer - we will discuss them later in the article.

Measuring blood pressure using an electronic tonometer

Rules for measuring pressure with an electronic tonometer

Here is the correct procedure:

Prepare for the study: it is advisable to conduct it after you have rested (sit quietly) for 5 minutes. This requirement can be neglected if the patient's condition requires emergency medical care.
If a person undergoing tonometry with an electronic tonometer smoked or drank coffee 1–2 hours before the test, the pressure readings may be overestimated.
Sit or seat the subject on a chair with a back, make sure that the body position is correct - the back is relaxed with support on the back of the chair, the legs are lowered, not tense or crossed.
Free your left or right shoulder from clothing. Make sure that it does not cause compression or interfere with the application of the cuff. Ideally, measurements should be taken on both arms. Of course, if you are right-handed, it will be more convenient to do this on your left hand. But if the difference in pressure on the left and right exceeds 10 mm Hg, it is better to measure on the arm on which the readings are higher.
Place your hand on a stand (for example, on a table) so that it is bent at the elbow, rests on the surface of the support with the extensor surface of the forearm and is completely relaxed.
Take an electronic tonometer and make sure that there is no obvious damage to the device, kinks or kinks in the hose.
Unfasten the cuff and put it on the shoulder by circular wrapping so that it is located 2 cm above the elbow bend, the pneumatic hose going to the device is facing the hand, located in the center of the cubital fossa (along the conventional line connecting it with middle finger).
If there is a mark on the cuff, make sure it is located in the middle part of the inner shoulder.
Press the device's power button.
Wait for the air to automatically inflate and deflate. Do nothing during this time.
Numbers will appear on the device’s electronic display – the top one displays systolic pressure, the bottom one – diastolic pressure. Most devices also show the pulse rate, the indicator of which is located below the others. In this case, the numbers will be located above the pulse (middle column).
Press the button, turn off the device and wait for it to turn off automatically.
Remove the cuff and the measurement is complete.

Rules for measuring pressure with an electronic tonometer

Rules for applying a tonometer cuff to the arm

Features of measurement with a semi-automatic electronic tonometer

A semi-automatic tonometer is a device that independently determines blood pressure numbers, but you need to pump the air yourself using a bulb. According to some reports, its results are more reliable than a fully automatic device. In general, you need to measure using the same algorithm, the only differences are in the following points:

Once you have correctly placed the cuff on your upper arm, turn on the tonometer by pressing the start button on its body.
Take the rubber bulb of the device in your free hand and pump air into the cuff to a level of 20–30 mmHg. Art. higher than usual or expected pressure. If you do not know these numbers, you can pump air up to 200 mmHg. Art., this will not be a mistake.
After inflating the desired pressure in the cuff, press the button near the bulb so that the air smoothly begins to leave it. At this time, the device itself will determine the pressure.
The results will appear on a digital display, similar to the numbers described in the section “Rules for measuring with an automatic electronic tonometer - point 11.”
To complete the procedure, press the device start button and the button near the bulb again and remove the cuff.

Common mistakes

Typical errors that distort the results of measuring pressure with an electronic tonometer:

Failure to comply with the requirements for carrying out measurements in a state of complete physical and psycho-emotional rest is a false overestimation of the device’s performance.
The arm on which the cuff is worn is tense or suspended.
The cuff is worn over clothing.
The shoulder is not properly freed from clothing - it compresses the fabric, the cuff catches its edge.
The cuff is too high or too low in relation to the cubital fossa.
The device is turned on before the cuff is applied.
Incorrect position of the hoses (along the outer surface of the shoulder) or the mark on the cuff does not correspond to the middle of the inner surface of the shoulder.
The fit of the cuff to the shoulder is too tight or, conversely, too loose.
Conversation or any tension during the measurement.
There is no pause of 1–2 minutes between several changes on one hand.

If you have any doubts about the results of measuring blood pressure with an electronic tonometer (the readings do not correspond to how you feel), be sure to take a control measurement with a classic mechanical tonometer!

If you regularly measure your blood pressure with an electronic tonometer, keep a record of the readings of each study, noting the date, time and value of the readings.
Be sure to periodically monitor your blood pressure with a mechanical tonometer. It is better for a specialist to do this (preferably the attending physician).
If the readings of a mechanical and electronic tonometer differ, you must trust the first.
For greater reliability, it is better to measure the pressure several times on both hands during one session, pausing 1-2 minutes between changes.
The results of three measurements are considered reliable, the difference between which does not exceed 5 mm Hg. Art.