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Concept
Sphygmomanometer
Summary
A sphygmomanometer (ˌsfɪɡməʊməˈnɒmɪtər ), a blood pressure monitor, or blood pressure gauge, is a device used to measure blood pressure, composed of an inflatable cuff to collapse and then release the artery under the cuff in a controlled manner, and a mercury or aneroid manometer to measure the pressure. Manual sphygmomanometers are used with a stethoscope when using the auscultatory technique.
A sphygmomanometer consists of an inflatable cuff, a measuring unit (the mercury manometer, or aneroid gauge), and a mechanism for inflation which may be a manually operated bulb and valve or a pump operated electrically.
Both manual and digital meters are currently employed, with different trade-offs in accuracy versus convenience.
A stethoscope is required for auscultation (see below). Manual meters are best used by trained practitioners, and, while it is possible to obtain a basic reading through palpation alone, this yields only the systolic pressure.
Mercury sphygmomanometers are considered the gold standard. They indicate pressure with a column of mercury, which does not require recalibration. Because of their accuracy, they are often used in clinical trials of drugs and in clinical evaluations of high-risk patients, including pregnant women. A frequently used wall mounted mercury sphygmomanometer is also known as a Baumanometer.
Aneroid sphygmomanometers (mechanical types with a dial) are in common use; they may require calibration checks, unlike mercury manometers. Aneroid sphygmomanometers are considered safer than mercury sphygmomanometers, although inexpensive ones are less accurate. A major cause of departure from calibration is mechanical jarring. Aneroids mounted on walls or stands are not susceptible to this particular problem.
Digital meters employ oscillometric measurements and electronic calculations rather than auscultation. They may use manual or automatic inflation, but both types are electronic, easy to operate without training, and can be used in noisy environments.
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Korotkoff sounds
Korotkoff sounds are the sounds that medical personnel listen for when they are taking blood pressure using a non-invasive procedure. They are named after Nikolai Korotkov, a Russian physician who discovered them in 1905, when he was working at the Imperial Medical Academy in St. Petersburg, the Russian Empire. The sounds heard during the measurement of blood pressure are not the same as the heart sounds heard during chest auscultation that are due to vibrations inside the ventricles associated with the snapping shut of the valves.
Millimetre of mercury
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