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Hi ,Thanks for this support,and I want to join as well. Samreen Sent from my BlackBerry® wireless deviceFrom: Babinchuk <anna.babinchuk@...>Sender: Date: Wed, 13 Jun 2012 13:20:46 +0100 (BST) < >Reply Subject: blood pressure osce-kindly provided by Sadaf Ambreen Blood Pressure OSCE· Good Morning, my name is---------- ---. I’ll be checking your Blood Pressure today is it all right with you. (Introduce)· I’ll wrap a cuff around your left arm, which will be tightened and might feel a little uncomfortable. (Explain the procedure)· Do you have any questions? May I start?· Attach the equipment, check its working.· Wrap cuff around left arm with the hand at level with the heart, the bladder should lie over brachial artery, the arrow should point towards the artery.· Increase pressure while palpating brachial or radial artery (with 3 fingers coming from below the hand), when the pulse disappears, notesystolic pressure. (Palpatory method) Allow cuff to deflate.· Re-inflate the cuff to at least 20 mm Hg over the palpatory reading with stethoscope over brachial artery, then deflate slowly, listening and watching the gauge until tapping sound appears= Systolic B.P. (Korotkoff I)· Continue to deflate slowly until sound disappears= Diastolic B.P. (Korotkoff V)· Deflate the cuff. say THANK YOUClinical Methods for Measuring Systolic and Diastolic Pressures A stethoscope is placed over the antecubital artery and a blood pressure cuff is inflated around the upper arm.As long as the cuff continues to compress the arm with too little pressure to close the brachial artery, no sounds are heard from the antecubital artery with the stethoscope. However, when the cuff pressure is greatenough to close the artery during part of the arterial pressure cycle, a sound then is heard with each pulsation. These sounds are called Korotkoff sounds.The exact cause of Korotkoff sounds is still debated, but they are believed to be caused mainly by blood jetting through the partly occluded vessel. The jet causes turbulence in the vessel beyond the cuff, and this sets up the vibrations heard through the stethoscope.In determining blood pressure by the Auscultatory Method, the pressure in the cuff is first elevated well above arterial systolic pressure. As long as this cuff pressure is higher than systolic pressure, the brachial artery remains collapsed so that no blood jets into the lower artery during any part of the pressure cycle.Therefore, no Korotkoff sounds are heard in the lower artery. But then the cuff pressure gradually is reduced.Just as soon as the pressure in the cuff falls below systolic pressure, blood begins to slipthrough the artery beneath the cuff during the peak of systolic pressure, and one begins to hear tapping sounds from the antecubital artery in synchrony with the heartbeat. As soon as these sounds begin to be heard, the pressure level indicated by the manometer connected to the cuff is about equal to the systolic pressure.As the pressure in the cuff is lowered still more, the Korotkoff sounds change in quality, having less of the tapping quality and more of a rhythmical and harsher quality. Then, finally, when the pressure in the cuff falls to equal diastolic pressure, the artery no longer closes during diastole, which means that the basic factor causing the sounds (the jetting of blood through a squeezed artery) is no longer present. Therefore, the sounds suddenly change to a muffled quality, and then disappear entirely after another 5- to 10-millimeter drop in cuff pressure. One notes the manometer pressure when the Korotkoff sounds change to themuffled quality; this pressure is about equal to the diastolic pressure. The auscultatory method for determining systolic and diastolic pressures is not entirely accurate, but it usually gives values within 10 per cent of those determined by direct catheter measurement from inside the arteries.