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Instruments for Checking heart beats
As most of the times a hypertensive patient has no specific complaints or problems ( symptoms), there can be a possibility of finding yourself suffering from hypertension either at a friend’s place ( where he has a digital blood pressure apparatus) or at a doctor’s clinic ( where you may have gone to seek cure for some other ailment). Blood pressure measurement is traditionally done with the help of an instrument called sphygmomanometer. This instrument has an inflatable cuff and a glass tubing filled with mercury. The cuff is tied around the upper arm and the air pressure in the cuff is raised. A stethoscope is then placed o the inner portion of the same elbow. Once the air pressure is increased beyond the blood pressure in the artery, there is no sound. Slowly and carefully the pressure is reduced. The point at which the arterial pressure and the pressure in the cuff equalize, the arterial blood flow starts. One starts to heart the lub-dub, lub-dub sound. This is the systolic blood pressure. As the pressure is further reduced, this sound gets muffled and finally disappears. This is the reading of the diastolic blood pressure. (The blood pressure is denoted as systolic blood pressure / diastolic blood pressure. In normal individuals it should be 110-30 / 70-85 of Hg).
Gizmos
In the race for instrumentation, medical science has indeed been in the forefront. Thus, the market is flooded with all sorts of latest and not-so latest gizmos. The commonly used instruments are :
1) Mercury sphygmomanometer which is the commonly seen instrument at most clinics and hospitals. It is still widely used as it is :
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Very accurate
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Extremely inexpensive
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Easy to maintain.
The drawbacks are :
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It is cumbersome. It cannot be used easily as it is not a portable instrument.
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It is non-friendly to ecology as it uses mercury which can be a potential source of pollution.
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It is difficult to use as the usage of stethoscope entails a proper coordination of hand, ear, eyes and commonsense.
Nevertheless most practitioners use the mercury apparatus in India as this is, by and large, the most accurate instrument.
2) The second instrument is the aneroid or the spring type of blood pressure apparatus. It is a small, portable, round – dial instrument attached to a cuff and rubber tubing. This is also light and inexpensive but less accurate than the mercury apparatus.
3) The third type is the digital blood pressure monitor or apparatus. This can be of different types. It could be a cuff type, self-inflatable type or a cuff auto-inflatable type. The latter-day versions are the wrist type or the finger type monitors. The advantages of these are :
§ East to use .
§ Easy to carry.
§ Possess the facility to store information like the previous blood pressure reading with date and times as it has memory.
The drawbacks need to be discussed in detail :
Indiscriminate use of the instrument by normal blood pressure patients can be a source of headache for doctors. This reminds me of a very interesting patient. one day, a patient sailed into my chamber and started searching for something in his many pockets. After a never-ending search that seemed to go on and on, he extracted out a small bit of paper from one of his pockets. On this paper, he had jotted down 20 readings of his blood pressure for the past 24 hours. As I glanced through the readings which were all normal, I looked up at him in exasperation. He clarified , “ Doctor, I wanted to check if my new apparatus was alright as the salesperson at the counter had asked me to return it within 24 hours if I was not satisfied.” I could not bring myself to ask him why he had disturbed his sleep and recorded his blood pressure at 12 midnight. Anyhow, the apparatus was fine, his blood pressure was find and all’s well that ends well.
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