What does this mean?

Question

"Palpating the pulse while inflating the cuff is done to avoid an auscultatory gap." and how could it affect the BP reading if not done?

Answer 1

Since there may be a range of pressures between the systolic and diastolic pressures where you don't hear the pulse (the auscultatory gap), if you didn't start the measurement at a high enough point you may not pick up that the patient is hypertensive (since you never hear the upper true systolic). By palpating as you inflate, you can tell when the blood flow has been obstructed and can then begin your measurement in the right pressure range.

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Answer 2

The auscultatory gap is a gap in the sound that you can normally hear when deflating the cuff around an artery.

Usually, the first sounds you hear indicate the pressure of the systolic (the first number), then when the sounds finish, it indicates the pressure of the diastolic. The auscultatory gap is when the sounds dissapear for a certain pressure range and then they return at a lower pressure. It is possible that a practitioner in a hurry may hear the start of the auscultatory gap and assume that is the diastolic (which will be too high).

This is the first time that I've heard of palpating the artery to avoid the gap, I usually palpate the brachial artery to roughly asses the pressure at which it is no longer palpable, which represents the systolic artery. I do this mainly so I do not have to hurt the patient by inflating the cuff to a high pressure unnesesaraly.

My only guess is that perhpas palpating the artery will prevent this occuring, although I have no clue as to what the mechanism is.

Answer 3

simply put you avoid a misreading that could happen with hypertensive patients, for example.

You are rising the pressure on the cuff to find the systolic and if you were doing it only by auscultatory means on the brachial you might think the gap- which may come at what would appear a normal systolic eg. 120mmHg so you might think at this point you're actually getting the systolic pressure and might misdiagnose;
the point would be that by palpating the radial pulse simultaneously, you will notice that if it remains it's a gap and still some way remains before the actual systolic (eg. 140mmHg)

what you should do (or what I do) is raise the pressure on the cuff without auscultating, simply checking the radial pulse. when it disappears, raise the pressure some 20-30mmHg above and then do begin auscultating. you'll get a proper Korotkov I this way.

Answer 4

After the cuff is in place the pulse is felt with fingers(palpation). The cuff is slowly inflated while pulse is palpated. The point at which pulse disappears ,is the rough systolic pressure. This is repeated by inflating the cuff just 10 mmof Hg higher and the sounds are heared . The sounds apper first at systolic pressure and disappear at diastolic pressure. If this method is not followed and cuff inflated very high , and the cuff deflated slowly a silent gap (auscultatory gap) appears in the middle and no sounds are heared even if B.P. is high.

Answer 5

To touch the artery while pumping up the BP cuff,. When you don't feel the artery beating anymore, then it's time to put the stethoscope over the artery. As you release the air out of the cuff, you will start hearing the beating........better reading.

Answer 6

This can affect the BP reading if the cuff is underinflated. It will cause a false high BP.

Answer 7

When you inflate the pressure, first pulse disappears, then reappears and disappears again. The last disappearance is true systolic pressure and the earlier one- auscultatory gap- is not.

Answer 8

By not getting a proper seal, you may not get the proper pressure for an accurate reading

Answer 9

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Answer 10

i dont know