Arterial pressure is measured in position sitting more often, but sometimes it is necessary to do it in a prone position, for example, at hard sick or when the patient costs (at functional tests). However irrespective of position surveyed a forearm of its hand on which the HELL is measured, and the device should be at a level of heart. The bottom edge have approximately on 2 sm above an elbow bend. Blank by air should not squeeze a subject fabrics.
Air quickly force in Hypertension symptoms up to a level on 40 mm hg above at what pulse on a beam artery owing to vessels disappears. A phonendoscope put to an elbow pole in a point of a pulsation of an artery directly under the bottom edge. Air from it needs to be let out slowly, with a speed of 2 mm hg on one impact of pulse. It is necessary more precisely to define a level the HELL. The point of a scale of a manometer in which have appeared impacts (tones), is marked as pressure, and a point in which they disappear, - as. Change of loudness of tones, their easing in calculation are not accepted. Pressure in ΠΌΠ°Π½ΠΆΠ΅ΡΠΊΠ΅ reduce to a level of zero. Essential value has accuracy of fixing
And registration of the moments of occurrence and disappearance of tones. Unfortunately, it is frequent at measurement the HELL prefer to approximate results to zero or five, that complicates an estimation of the received data. The HELL necessarily should be registered to within 2 mm hg
It is impossible to make readout of a level Hypertension symptoms the HELL at first visible approximately fluctuations of a mercury column, the main thing - occurrence of characteristic sounds; during measurement the HELL tones which subdivide into separate phases are listened.
Phases of tones of N.S.Korotkov
1-st phase - the HELL at which constant tones are audible. Intensity of a sound gradually accrues in process of Hypertension symptoms. The first at least from two consecutive tones is defined as the HELL.
2-nd phase - occurrence of noise and a "rustling" sound at the further.
3-rd phase - the period during which a sound reminds a crunch and accrues on intensity.
4-th phase corresponds sharp, to occurrence of a soft "blowing" sound. This phase can be used for definition the HELL at audibility of tones before zero division.
5-th phase is characterized by disappearance of last tone and corresponds to a level the HELL.
But remember: between 1-th and 2-nd phases of tones of Korotkov the sound temporarily is absent. So occurs at high the HELL and proceeds during ΡΠ΄ΡΠ²Π°Π½ΠΈΡ air from Hypertension symptoms up to 40 mm hg
Happens, that the level the HELL is forgotten in time between the moment of measurement and registration of result. For this reason it is necessary to write down obtained data immediately - before removal
In cases when there is a necessity of measurement the HELL on a leg, impose on an average third of hip, a phonendoscope bring to a popliteal pole in a place of a pulsation of an artery. A level pressure upon a popliteal artery about same, as well as on humeral, and - on 10-40 mm hg above.
The level the HELL can change even in short time intervals, for example during measurement that is connected with a lot of factors. Therefore at its measurement it is necessary to observe the certain rules. The temperature in should be comfortable. One hour prior to measurement the patient should not eat the HELL, physically to strain, smoke, influence a cold. Within 5 minutes before measurement the HELL to it needs to be sat in a warm room, having relaxed and not changing the accepted convenient pose. Sleeves of clothes should be free enough, it is desirable to bare a hand, having removed a sleeve. To measure the HELL follows two times with an interval of not less than 5 minutes; average value on two parameters is registered.
Besides it is necessary to remember and lacks of definition a HELL, caused an error of the method of Korotkov which in perfect conditions, at a normal level the HELL makes ±8 mm hg the Additional source of mistakes can be infringements of an intimate rhythm at the patient, wrong position of its hand during measurement, bad overlaying ΠΌΠ°Π½ΠΆΠ΅ΡΠΊΠΈ, non-standard or faulty ΠΌΠ°Π½ΠΆΠ΅ΡΠΊΠ°. For adults last should have length of 30-35 sm at least once to turn back around of a shoulder surveyed, and width - 13-15 see Small ΠΌΠ°Π½ΠΆΠ΅ΡΠΊΠ° - the frequent reason of erroneous definition raised the HELL. However for corpulent people it can be demanded Hypertension symptoms by greater, and for children - the smaller size. Discrepancy of measurement the HELL can be connected and with superfluous squeezing ΠΌΠ°Π½ΠΆΠ΅ΡΠΊΠΎΠΉ a subject fabrics. Overestimate of parameters the HELL happens and at inflating poorly imposed
Recently it was necessary to speak from patients to whom the medical sister in a polyclinic has told, having measured the HELL, that it is raised. Having come home, the patient has measured the HELL by own device and with surprise has noted considerably smaller parameters. Typical display of a hypertension of " a white dressing gown ” speaks emotional reactions (our fear before a verdict of the doctor) and is considered at diagnostics of an arterial Hypertension symptoms and definition of an optimum level of arterial pressure during treatment. The hypertension of " a white dressing gown ” meets quite often - at 10 % of patients. In it is necessary to create corresponding conditions: it should be silent and cool. It is inadmissible messages extraneous conversations. To talk with surveyed it is necessary easy, benevolently.
And at last... We far are not powerless before artful disease. It well enough gives in to treatment to what large-scale preventive programs of struggle against the arterial Hypertension symptoms convincingly testify, spent as in our country, and abroad and allowed to lower within five years desease of an insult on 45-50 %. All patients received adequate treatment and strictly carried out doctor's instructions.
If you have more than 40 years, regularly measure arterial pressure. It would be desirable to emphasize once again, that the arterial Hypertension symptoms often proceeds Π±Π΅ΡΡΠΈΠΌΠΏΡΠΎΠΌΠ½ΠΎ, but it does disease even more dangerous, putting “ impact because of a back ”. The device for measurement of arterial pressure should be in each family, and learn to measure it follows each adult person as it does not represent essential difficulties.
“ The knowledge which more all is necessary for a human life, is a knowledge itself ”. 100 years which have lived exactly the known French writer and philosopher Bernard Fontenel (1657-1757) has come to such actual and now to the conclusion.
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