How Do I Use a Stethoscope for Blood Pressure?

There are two main methods for non-invasive measurement of blood pressure: auscultation and oscillometric method. The auscultation method is also called the Koch method, which is to bind the arm band of a pressure gauge (commonly called a sphygmomanometer) to the pulsating position of the brachial artery of the upper arm, inflate and pressurize the brachial artery, and then deflate. With the decrease of external pressure, the blood flow rushes back to the blood vessel and emits the same rhythmic sound as the heart beat. This is the Coriolis sound. When the "first tone" is heard with a stethoscope, the external pressure displayed by the pressure gauge is recorded as systolic pressure, and the "last tone" is recorded as diastolic pressure. This method was proposed by Russian doctor Korotkoff in 1905 and was quickly recognized by the international medical community as the Coriolis method. All international documents, clinic manometry, hypertension classification standards, textbooks, etc., refer to blood pressure measured by the Coriolis method. This is the international gold standard for non-invasive blood pressure measurement and the clinical standard for testing the accuracy of all non-invasive blood pressure monitors. The oscillometric electronic sphygmomanometer test is also performed in accordance with this standard.

Auscultation sphygmomanometer

Name: Auscultation Sphygmomanometer

Phonetic script (Hanyu Pinyin): tng zhn f xuè y jì

The method of using a stethoscope to listen to the blood pressure Coriolis for measuring human blood pressure is called auscultation, and the blood pressure meter that uses auscultation to measure blood pressure is called auscultation sphygmomanometer. Such as mercury sphygmomanometers, sphygmomanometers, etc. For more than 100 years, people have been exploring more reliable methods and devices for blood pressure measurement, but they have been unsuccessful, including oscillometric electronic sphygmomanometers. Therefore, regular hospitals in China have to continue to use mercury sphygmomanometers. Reasons have banned the use of mercury sphygmomanometers and their medical institutions use sphygmomanometers. Facing the facts of previous failures, some people internationally call auscultation the gold standard for blood pressure measurement. Hundreds of years of historical facts have proved that auscultation is irreplaceable so far, and auscultation sphygmomanometers are scientific and classic blood pressure measurement and measuring instruments.

The auscultation method is also known as the Coriolis method, because the Coriolis method is implemented and proposed by the auscultation method, and it has been used in medical institutions around the world. It has a century of history so, later, the auscultation method and the Coriolis method were used. Two different ways of sounding as a method.

What is the Coriolis method? The Coriolis method is a method of measuring blood pressure with the Coriolis sound. This is the only name for a blood pressure measurement and measurement method recognized by international medicine. In 1905, the Russian scholar Korotokoff reported the Königs sound he found, and proposed that the external pressure corresponding to the first sound of an audible pop sound be used as the systolic pressure, and the cardiac systolic pressure in the highest blood formed in the brachial artery. The pressure is equivalent; when the disappearing sound (the "change sound" when the tapping sound changes to the cover sound when there is no disappearing sound) is recorded as the diastolic pressure, which is equivalent to the lowest blood pressure formed in the brachial artery of the heart. This method was quickly accepted by the international medical organization at the time and was named the Coriolis method. For more than 100 years, people have been exploring more reliable methods and devices for blood pressure measurement, but they have been unsuccessful, including oscillometric electronic sphygmomanometers. Therefore, regular hospitals in China have to continue to use mercury sphygmomanometers. Reasons have banned the use of mercury sphygmomanometers and their medical institutions use sphygmomanometers. Facing the facts of previous failures, some people internationally call auscultation the gold standard for blood pressure measurement. Hundreds of years of history have proven that auscultation is irreplaceable so far. Auscultation is a scientific and classic blood pressure measurement and measurement device.

The World Health Organization and the Alliance for Hypertension have regulations or recommendations for auscultatory blood pressure measurement:

1. Detectors, such as stethoscope probes, should detect the Coriolis sound at the brachial artery fluctuation point of the upper arm; 2. The width of the cuff should not be less than 14cm to ensure that it can be effectively stopped above the measurement position after sufficient pressure is applied Blood flow; 3. The subject is sitting or lying to ensure that the detector is at the same level as the heart; 4. For adults, determine the systolic pressure by the first tone of the Coriolis sound and the diastolic pressure by the fifth phase disappearance sound; for children And some adults who have no disappearing sound, judge the diastolic blood pressure according to the "transition" when the tap sound changes to the cover sound; 5. The test subject should sit still for more than 5 minutes in a quiet room;

6. Measure blood pressure twice in a row, the interval should be more than 2 minutes, and take the average value as the measurement result. If the difference between the two measurements is more than 5 mm Hg, the third blood pressure should be measured, and the average of three blood pressure measurements should be taken. The value is the measurement result.

Auscultation sphygmomanometer is divided into artificial auscultation sphygmomanometer, semi-automatic auscultation sphygmomanometer and automatic auscultation sphygmomanometer. Artificial auscultation sphygmomanometers include mercury sphygmomanometers and sphygmomanometers; semi-automatic auscultation sphygmomanometers include reading-type sphygmomanometers; automatic auscultation sphygmomanometers include auscultation automatic sphygmomanometers.

1. Artificial auscultation sphygmomanometer is using mercury or the like as a pressure gauge. The measurer uses the human ear to listen to the original blood pressure Coriolis sound (from heavy to light, to disappear or change sound) through a stethoscope, and cooperates with the Coriolis sound heard. The pressure gauge reads out systolic and diastolic blood pressure. Although auscultation is the most accurate method for measuring blood pressure, artificial auscultation is affected by the following factors: (1) level of training; (2) hearing; (3) ) Attention; (4) Poor sightings during judgment. Whether blood pressure measurement is reliable or not depends entirely on the professional level, hearing, fatigue, and work attitude of the person who measures the blood pressure, and because blood pressure is an instantaneous value, it cannot be repeated and cannot be recombined. 2. The semi-automatic auscultation sphygmomanometer is to use an electronic probe similar to a stethoscope to listen to the blood pressure Coriolis sound and use electronic technology to increase the volume. People next to the blood pressure monitor can hear the rhythmic screaming blood pressure Coriolis sound (both are It is the same sound), and read the systolic and diastolic pressures according to the Coriolis sound and the manometer. This method excludes (1) the level of training; (2) hearing; (3) attention and other effects, but it is still affected by poor sightings when judged, although it can make more people use it to measure blood pressure However, some people find it difficult to use. 3. The fully automatic auscultation sphygmomanometer uses an electronic probe similar to a stethoscope to listen to the blood pressure Coriolis sound, and converts the blood pressure Coriolis sound to a digital signal through modern digital technology, and finally displays it on the blood pressure monitor display, that is, to achieve Automated blood pressure measurement. This type of sphygmomanometer is also divided into semi-automatic and full-automatic: manual pumping and automatic deflation are called semi-automatic; automatic pumping and automatic deflation are called full-automatic. This type of sphygmomanometer has no influence on the level of training, hearing, attention, and poor sighting in judgment, and everyone can use it to accurately measure blood pressure.

Electronic sphygmomanometers that do not use a stethoscope are oscillometric sphygmomanometers. In 1896, German pathologist Von Recklinghausen discovered that during the use of the armband to deflate, as the external pressure decreased, a shock wave appeared in the armband airbag, and its amplitude was related to human blood pressure. He believes that by measuring the amplitude of this oscillating wave, systolic and diastolic blood pressure can be obtained through some conversion relationship. In the 1950s, some people in the former Soviet Union proposed using shock waves to measure the blood pressure of athletes, and called it the oscillometric method. Since the 1960s, electronic technology has developed rapidly, and it is exactly what it is capable of dealing with oscillating waves. Therefore, scientific and technological personnel in Japan and the United States have researched and developed oscillometric electronic sphygmomanometers using oscillating waves. Now, there is no need for a stethoscope to measure blood pressure on the market. Sphygmomanometer. However, the oscillometric method has fatal flaws, and regular hospitals do not use electronic sphygmomanometers for clinical diagnosis. Because the oscillometric method has errors in measuring blood pressure, and the development of oscillometric methods has not been able to overcome this shortcoming for more than 60 years, the root cause is: (1) The source of the oscillating wave is complex, and the Coriolis sound pressure is only one of its components, and it only accounts for a large portion (2) There are many differences in human individuals, especially blood pressure. There is no universally applicable conversion relationship for calculating systolic and diastolic blood pressure from shock wave amplitudes. Oscillometric sphygmomanometers are suitable for this group of people. , The error is very large for other people; sometimes it is applicable to a certain body, and the situation is not applicable, the fundamental reason is this conversion relationship. Blood pressure should be measured directly, not counted.

Auscultation sphygmomanometer is a legal instrument for clinical diagnosis in medical institutions. Chinese medical institutions use mercury sphygmomanometers. In developed countries such as Europe and the United States, because mercury sphygmomanometers have been banned, their medical institutions can only use sphygmomanometers. In addition, it is also an essential tool for effective control of blood pressure in patients with hypertension.

Blood pressure is an important indicator of human condition. Due to changes in living conditions, the number of patients with hypertension is increasing. Because blood pressure is too complicated, so far, no medicine can cure hypertension, and hypertension can only be controlled with medicine. However, medical research and practice have shown that high blood pressure without effective control will inevitably lead to high blood pressure complications such as stroke paralysis and sudden death in the future, which is very harmful. At present, the effective control rate of hypertension in China is only 6.1%, and 93.9% of the people have not effectively controlled hypertension. This problem is now very prominent. The part of the patients with hypertension who have a longer illness has or is undergoing various types of concurrent hypertension. The condition is very serious. Why do so many people fail to effectively control high blood pressure? The main reason is that people with hypertension cannot accurately measure their blood pressure.

Because the first condition for people with high blood pressure to effectively control high blood pressure is to know the goal of control and their own blood pressure. Control the target to find a doctor to know that the doctor will tell the patient the goal of controlling blood pressure based on the patient's condition and comorbidities. But knowing your blood pressure is not that easy. Because auscultation mercury sphygmomanometers require blood pressure measurement, many people mistakenly think that it is difficult to measure blood pressure, and many people rely on medical institutions to measure blood pressure. The problem is that the measurement of blood pressure in medical institutions will be affected by external factors such as the "white coat effect". The blood pressure measured by patients is often not the actual blood pressure of the patient. Moreover, due to the limited number of blood pressure measurements in medical institutions, blood pressure changes day and night and It is very volatile, and people who rely on medical institutions to measure blood pressure do not know when they are their highest blood pressure period in a day. What is the systolic blood pressure? What is the diastolic pressure? When is your own minimum blood pressure period? What is systolic blood pressure? What is the diastolic pressure? The blood pressure value that is always measured in a medical institution is often compared with the target blood pressure, which often causes the blood pressure to reach the standard in imagination, but the hypertension is not effectively controlled in practice.

Some people with hypertension are misled by an inaccurate sphygmomanometer, and take blood pressure that has a huge error with their real blood pressure as their blood pressure. Compared with the target blood pressure, it is also imagined that the blood pressure has reached the standard, but it is not effective in practice. Control of hypertension.

Accurate blood pressure measurement is very important for patients with hypertension. In addition to enabling patients with hypertension to know exactly whether their blood pressure is effectively controlled, it can also help patients take antihypertensive drugs. Because many patients with hypertension who have been suffering for many years often have difficulty controlling their blood pressure, they need to work closely with their doctors to take antihypertensive drugs. This cooperation is that after the doctor has issued the first doctor's order, while taking the medicine, he will measure the blood pressure several times a day at a certain time and place and record it. After 5 to 7 days, he will return to the doctor for a follow-up visit. The main basis for formulating a treatment plan, generally speaking, severely ill patients with hypertension, such cooperation needs to be repeated many times before taking antihypertensive drugs, in order to control hypertension within an effective range. This is based on the fact that the patient can give accurate blood pressure data to the doctor. If the patient's data is inaccurate, it is conceivable that this cooperation will not be successful.

Therefore, accurate measurement of blood pressure is very important for the effective control of hypertension in hypertensive people, and auscultation sphygmomanometer is an indispensable and important tool for effective hypertension.