Which number to read?

[itisneverlupus]

I'm sorry if this has already been posted, but I haven't seemed to have found the exact answer to my question.

When taking a BP, I used to hear the very faint sounds but they were uniform and became louder and louder, and they were the heart beat but just very faint.
1) Do I count those sounds as well? Or do I only begin counting them as they become loud? Same goes for counting Diastolic?

2) Which number exactly do I take down to read: the number the needle is at BEFORE it bounces or where it's at while it's at the TOP of it's bounce?

Thanks!

J

 

[Handsome Robb]

Don't look at the needle bouncing at all. Disregard it.

The systolic is when you first begin to hear the Korotkoff sounds consistently is the systolic. The diastolic is when you they go away completely.

So to hopefully answer your question those quieter consistent sounds you are hearing is what you record the systolic pressure at. When you can no longer hear the sounds that's your diastolic pressure.

 

[itisneverlupus]

So that means the number it was at before the needle bounced? It's hard to disregard it when I'm following it to see what number it's at..

Thanks,

J

 

[Handsome Robb]

The bouncing of the needle can come from a lot of things, the pt moving, shivering, the truck hitting a bump, vibrations from the truck any number of things. Don't use it to record a BP.

It just takes practice, like anything, to get good at it.

 

[itisneverlupus]

I understand that, I'm just saying that the needle usually bounces at the same time that I hear the heart rate so I get confused: at what point do I record it?

 

[Handsome Robb]

When you hear the sound... forget about the bounce of the needle. What number is the needle pointing at when you hear the sound? That's the number you record.

 

[itisneverlupus]

Alright, thanks!

J

 

[Hunter]

I understand that, I'm just saying that the needle usually bounces at the same time that I hear the heart rate so I get confused: at what point do I record it?

When you hear the sound... forget about the bounce of the needle. What number is the needle pointing at when you hear the sound? That's the number you record.

More direct answer, just before the needle bounced

 

[itisneverlupus]

Thanks, Hunter!

J

 

[daughteroftheking]

When you first hear the sounds...the needle will bounce in the back of the truck or when the patient moves...It takes some practice - I'm still learning

 

[Martyn]

Really?

 

[TheGodfather]

i guess it should also be pointed out that, in some conditions, the korotkoff sounds won't ever completely go away.. Because of this, some clinician's would argue that the diastolic pressure is the number just before the absence of all sounds (controversial, but just throwing it out there) --

Times where the patient may have a baseline korotkoff sound would be in any condition that causes a baseline turbulence ("jetting") of blood flow to the area of auscultation --- IE; aortic insufficiency or patients with AV shunts.. (but, of course, we all know not to take BPs in the shunted arm anyhow, right? )