PART I principle of surgery
FIG. 1-2 A, Measurement of systemic blood pressure. Cuff of proper size placed securely around upper arm so that lower edge of cuff lies 2 to 4 cm above antecubital fossa. Branchial artery is palpated in Fosse, and stethoscope diaphragm is placed over artery and held in place with fingers of the hand. Squeeze bulb is held in palm of right hand, and valve screwed closed with thumb and index finger of that hand. Bulb is then repeatedly squeezed until pressure gauge reads approximately 220 mm Hg. Air is allowed to escape slowly from cuff by partially opening valve while dentist listens through stethoscope. Gauge reading at point when faint blowing sound is first heard is systolic ‘blood pressure. Gauge reading when sound from artery disappears is diastolic pressure. Once diastolic resure reading is obtained, valve is opened to deflate cuff completely. B, Pulse rate and rhythm most commonly evaluated by using tips of middle and index fingers of right hand to palpate radial artery at the wrist. Once rhythm has been d6,,-;ni;-;cd to be regular, IlL”’1h”r orpulsations to occur during 30 seconds is multiplied by 2. to give number of pulses per minute. If weak pulse or Irregular rhythm is discovered while palpating radial pulse, heart should be auscultated directly to determine heart rate and rhythm.