14.13 : 血圧測定時の特別な考慮事項

Consider the following aspects during blood pressure or BP measurement.

During an initial assessment, assess BP in both arms. The systolic value may differ by 10mmHg. For subsequent assessments, use the arm with the higher BP reading.

When the blood pressure is high, reassess in other extremities to compare the findings. Also, check the patient's position, cuff size, stethoscope placement, and equipment accuracy. 

Assess for hypertensive symptoms like facial flush, headache, epistaxis, and fatigue.

When blood pressure is low, compare the value with the baseline, restrict activities that could lower blood pressure, and place the patient in a supine position to increase circulation.

Assess for signs of hypotension like tachycardia, dizziness, and pale or cyanotic skin.

In addition, assess the factors contributing to hypotension, including hemorrhage, hyperthermia, and medication side effects.

If unable to obtain BP, use another extremity or alternative method like palpation or Doppler ultrasound.

Raise the arm with the cuff over the head for thirty seconds before rechecking the BP. Then, inflate the cuff and gently lower the arm while supporting it.