Health answers:

Korotkoff sounds in the arteries are caused by turbulence of the blood.

When using a BP cuff, several conditions occur:

When cuff pressure is above systole pressure – No blood can get through the artery.

When the cuff pressure is equal to the systole pressure – Blood is able to burst through the artery – I use the term “burst” as it is not a constant flow, as the diastolic pressure is still below the cuff pressure. At this point, you will hear your first Korotkoff sound.

As the cuff pressure lowers Korotkoff sounds continue – although they get softer. These sounds are caused, as previously stated, by turbulence of the blood, which is caused by the squeezing of the artery by the cuff. This squeezing leads to two areas of the artery having different diameters. The turbulence occurs when the blood from the squeezed artery is released into a wider diameter artery. This location is usually around the elbow – Which is why the stethoscope is placed there.

The last sound occurs when diastolic pressure equals cuff pressure. Once the diastolic pressure is above cuff pressure, then no squeezing of the artery occurs, thus no Korotkoff sounds.

In summary:

First sound – is when cuff pressure = Systole pressure
Last sound – is when cuff pressure = Diastolic pressure

Note: This is the most common way of measuring BP

Health answers:

No, you cannot. You must listen for the Korotkoff sounds to get an accurate systolic and diastolic blood pressure reading. The bumping of the needle often seen on the sphygmomanometer may or may not correlate with the blood pressure and should not be used to determine the blood pressure reading.

health answers:

The basic Korotkoff sound is caused by pressure exerted on the brachial artery. The first is heard when the pressure in the cuff drops below the systolic pressure, and blood “spurts” through the artery. The sound disappears when the cuff pressure drops below diastolic pressure and there is no longer any restriction of blood flow.

Depending on the actual cuff pressure, the sounds vary in quality and amplitude.

Health answers:

To answer your specific question, no provision is made, either by doctors (who can be forgiven) or the manufacturers of digital monitors (who should know better), to differentiate between the true readings, of the internal blood pressure, and the additional pressure required to collapse hardened arterial walls to induce the appearance and disappearance of Korotkoff’s sounds, which are of course, those of turbulence when laminar flow breaks down.

The structural integrity of the conduits is much greater when arteriosclerosis is present, and can add as much as 80% of the actual internal, true pressure, which more than accounts for the apparent rise in systolic and diastolic pressures ascribed to so-called “age-related hypertension”. This is an almost entirely spurious concept, but it seems to have never occurred to the medical profession to question it, and ask why the numbers don’t add up. Admittedly, greater pressure is actually needed, to eject a volume of blood across the aortic valve into the root of a less elastic aorta, but the flawed measurement technique hugely exaggerates this, rendering the readings virtually meaningless.

It’s not just sphygmomanometry that’s at fault of course. Tonometry suffers from exactly the same defect, in relying on deformation of the arterial wall, – and this is affected by stiffness and structural integrity – despite being considered the preferred and more accurate technique, which needless to say, it isn’t.

Health answers:

Hmmmm…..
I am not exactly sure what to tell you. When trying to auscultate a BP the head/drum of the stethoscope is partially under the cuff above the bend in the elbow. I would recommend practicing on anyone that will sit still for 30 seconds.

If you can find a radial pulse you can palpate the BP as well. This method is not always as accurate, but it should give you an indication or a way to high or way to low BP.

If you currently have a job in EMS ask a medic that you feel comfortable with to help you out. I suggest that medics make their new EMT’s practice on them… even to the point of starting IV’s… You also need to make sure you are relaxed and that the bell of the steth is turned the correct direction, if you are using a double sided one and you have the ear pieces facing the correct direction in your ears. (simple things that can make a big difference)

If you are not hearing it then something is going wrong… cause I can promise you that most of your patients will have a BP 🙂 Just keep trying to practice on others.