California Career and Technical Education Standards

• PS.C.C9.1 Understand the skills required to deal effectively with emergency situations.
• PS.C.C9.3 Understand the management of crisis negotiations to promote the safety of indivi...

California Academic Content Standards (Reinforced)

• ELA.9-10.R.CAGT.2.5 Extend ideas presented in primary or secondary sources through original analysis...3

• Teacher guided questions - Hooks / Set

  1. What is blood pressure?

  Answer: Blood pressure is the pressure of circulating blood against the wall of the arteries.

  2. Why is it important to have an adequate blood pressure?

  Answer: Adequate blood pressure is necessary to maintain proper circulation and perfusion of the vital organ cells.

  3. How many components are there when you measure blood pressure?

  Answer: Blood pressure has two components: systolic and diastolic pressure.

  4. What does the pulse represent?

  Answer: The pulse represents the heart beat.

  Excercise:

  How to feel your pulses:

  The teacher will explain and demonstrate at the same time.

  1. Radial pulse: Place the index finger and the middle finger on the thumb side of the wrist

  2. Brachial pulse: Place the index finger and the middle finger on the interior side of the elbow

  3. Carotid pulse: Place the index finger and the middle finger on groove on the side of the neck

  • How to take the radial or brachial pulse [ View Image ] [ Download Original ] How to take the radial or brachial pulse
  • Brachial pulse [ View Image ] [ Download Original ] How to take the brachial pulse
  • Carotid pulse [ View Image ] [ Download Original ] How to take the carotid pulse
  • Main arteries [ View Image ] [ Download Original ] Palpable pulses
• Blood pressure - Lecture

  Definitions:

  Blood pressure has two components: systolic pressure and diastolic pressure. Systolic pressure is the pressure caused by the contraction (systole) of the ventricles. Diastolic pressure is the residual pressure that remains in the arteries during the relaxing phase (diastole) when the left ventricle is at rest.

  • The blood pressure is measured in in millimeters of mercury (mmHg).
  • Blood pressure is reported as a fraction in a form of systolic pressure over diastolic pressure.
  • For example if the patient has a systolic blood pressure of 120 and a diastolic blood pressure of 80 you would record it as "BP 120/80 mmHg".

  A decrease in the blood pressure may indicate loss of blood or fluids, or a heart pumping problem. A patient has hypotension when the blood pressure is lower than the normal range and hypertension when the blood pressure is higher than the normal range.

  Equipment:

  Blood pressure cuff:

  • a wide outer cuff
  • an inflatable wide bladder sewn into a portion of the cuff
  • a ball-pump with a one way valve
  • a pressure gauge calibrated in millimeters of mercury

  There are different sizes of blood pressure cuffs: adult, thigh, and pediatrics.

  Stethoscope: is a medical device for auscultation or listening to the internal sounds of the body. The main parts of the stethoscope are:

  • chest piece - consists of two parts: a diphragm (plastic disc) and bell (hollow cup)
  • air-filled hollow tubes
  • ear piece
  • Desk or wall BP cuff [ View Image ] [ Download Original ] Desk or wall BP cuff
  • BP cuff 1 [ View Image ] [ Download Original ] BP cuff
  • Mercury Sphygmomanometer [ View Image ] [ Download Original ] Mercury Sphygmomanometer
  • Stethoscope [ View Image ] [ Download Original ] Stethoscope
  • Equipment [ Go to Site ] Tools necessary to take the blood pressure
• Skills - Demo / Modeling

  There are two ways to obtain the blood pressure: by auscultation and by palpation. The teacher will explain and demonstrate at the same time with the help of a volunteer.

  A. Obtaining blood pressure by auscultation :

  1. Follow standard precautions (BSI - body substance isolation)
  2. Apply the cuff snugly around the patient's arm about 1" above the antecubital space (elbow). Make sure the arrow on the cuff lies over the brachial artery.
  3. Once the cuff was properly secured around the arm, palpate the brachial artery (in the anterior aspect of the elbow).
  4. Place the stethoscope over the brachial artery and hold it firmly against the artery with the fingers of the nondominant hand. Hold the rubber ball pump in the palm of your other hand and the valve between your thumb and first finger.
  5. Close the valve and pump air until you no longer hear pulse sounds. Continue pumping an additional 30 mm Hg. Then slowly open the valve until air is steadily escaping from the cuff. Note the systolic pressure (reading on the gauge when you first hear the heart) and diastolic pressure (reading on the gauge when the sound stopped).
  6. Once the pulse sound stopped open the valve and release the remaining air quickly. Document your findings.

  B. Obtaining blood pressure by palpation (feeling):

  1. The palpation method does not depend on the ability to hear sounds and should be used when it's not possible to hear the heart.
  2. Follow standard precautions (BSI - body substance isolation)
  3. Apply the cuff snugly around the patient's arm about 1" above the antecubital space (elbow). Make sure the arrow on the cuff lies over the brachial artery.
  4. With your nondominant hand palpate the radial pulse on the same arm as the cuff without moving your fingers once you have located the pulse until you have completed taking the blood pressure.
  5. Hold the ball pump in the other hand, close the valve and slowly inflate the cuff until the pulse disappears and then continue to inflate another 30 mm Hg.
  6. As the cuff inflates you no longer feel the pulse. Open the valve so that air escapes from the cuff and carefully observe the gauge. When you can feel the radial pulse you should note the reading as the patient's systolic blood pressure. You will not be able to determine the diastolic pressure with this method.
  7. Open the valve and completely deflate the cuff. Document your findings. For example you can record the blood pressure as "120/P" for a systolic blood pressure of 120 mm Hg.

   

  • Sound of the heart beat [ Go to Site ] Sound of the heart beat
  • How to take the blood pressure [ Go to Site ] Step 1: How to take the blood pressure
  • How to take the blood pressure [ Go to Site ] Step 2: How to take the blood pressure
• Students' practice - Group Work

  Students will practice in groups of 2 to 4 students per group with the assistance of the teacher. At the beginning the students will practice the correct placement of the blood pressure cuff and will try to feel both radial and brachial pulse.

  After that they will practice the correct placement of the stethoscope. Students will practice the auscultation method first and then the palpation method.

  Once the students are comfortable with listening to the sound of the heart they will start measuring the blood pressure.