What is arterial blood pressure?

Arterial blood pressure is the pressure exerted by blood against the walls of arteries. The heart acts like a pump and with each beat causes a certain level of the arterial pressure. There are two types of the arterial blood pressure: the highest one is called the maximum or systolic blood pressure and it corresponds to the contraction of the heart that pushes the blood into the arteries; the lowest measurement is called the minimum or diastolic blood pressure and corresponds to the pressure of the blood between two contractions.

Each increase of 10 mm Hg in blood pressure increases risk of progression of cardiovascular diseases by 30%. In people with high blood pressure, disorders of cerebral circulation (strokes) occur 7 times more often, ischemic heart disease - 4 times more often, damages of blood vessels of the legs - 4 times more often. Analysis of reasons for such frequent discomfort signs as headache, weakness, vertigo, should be started with measurement of blood pressure, in particular. In many cases regular blood pressure monitoring is required, and the measurements should be performed several times a day.

How is arterial blood pressure measured?

Arterial blood pressure is measured with a blood pressure monitor; its cuff should be wrapped around the upper arm or the wrist. Measurements should be performed after a five-minute rest, in the sitting or supine position. Upper arm pressure is measured while deflating the cuff. There are several types of devices used to measure blood pressure: digital blood pressure monitors with display of the measurements and aneroid sphygmomanometers.

What is hypertension?

Hypertension is defined as blood pressure equal or greater than 140/90 mm Hg on several blood pressure readings taken at rest at the doctor’s office. That means that a systolic pressure is/or above 140 mm Hg and a diastolic pressure is/or above 90 mm Hg.
Regular use of blood pressure monitor is important since it helps to detect hypertension – that generally asymptomatic – in the early stages.

What causes high arterial blood pressure?

In the great majority of cases high arterial blood pressure is called “essential”; in other words, the cause is unknown. In some patients with high blood pressure kidney and adrenal disorders are found. In these cases we speak about “secondary” or symptomatic hypertension. There are plenty of factors favouring high blood pressure. They are: skin pigmentation, genetic predisposition, age, overuse of salt, excessive alcohol consumption, etc.
However certain patients can normalize their arterial blood pressure level through lifestyle modifications. Particularly we would like to mention physical exercises, moderate salt and alcohol consumption, weight loss.

What are the consequences of high blood pressure?

An excessively high arterial blood pressure impairs blood vessels, making vessel walls thick and stiffer. Over time impact of this extra pressure can cause functional disorders of such organs as the heart, the brain or the kidneys. It remains a considerable risk factor in progression of cardiovascular diseases. Without corresponding therapy such consequences as heart attack and stroke can occur. Untreated arterial hypertension can cause kidney damage, stenocardia, paralysis, aphasia, and dementia.

Why is 3-5-minute interval necessary between pairs of measurements?

The interval is individual for each person and, as a rule, the older a person the longer interval between pairs of measurements is necessary. That is determined by reaction of the vessel walls to compression caused by the cuff.
If you make a new measurement without an interval, the blood pressure reading will deviate, typically to a lower number, since blood circulation has not yet adjusted. It is not recommended to make measurements several times a day for no particular reason as compression of the arteries does put extra stress on the vessels.

Every successive reading is lower than the previous one when arterial blood pressure measurements are made sequentially without interval. Why?

The reason is a time interval is insufficient for the vessels to readjust after compression. It’s enough to increase intervals between measurements to allow blood circulation to adjust.

Why do blood pressure readings can vary on different blood pressure monitors?

Almost all models of digital blood pressure monitors are equal in accuracy and reliability. Different blood pressure readings on different blood pressure monitors can be caused by the following reasons: blood pressure level is not a constant parameter: blood pressure is constantly changing based on unstable internal body parameters and side factors; measuring inaccuracy may occur when using aneroid sphygmomanometer, as the results are taken subjectively, and often are rounded off. Proper training is highly important for blood pressure measurement with an aneroid sphygmomanometer, as well as an accurate compliance with the measurement procedure; wrist blood pressure level differs from upper arm pressure level due to a long distance between the artery and the heart, moreover the difference can be caused by sclerotic changes of the blood vessels which appear with age; by all constitutional peculiarities, such us: poor vessel wall elasticity, deeply positioned blood vessels at the cuff area, extra layer of fat, etc.; too frequent measurements and short intervals in between cause arterial blood pressure jumps (due to reaction of the vessel walls to compression).

What are nebulizers (inhalers) necessary for?

Inhalation therapy is the most efficient approach to the management of asthma and inflammatory airway diseases. Firstly, this method allows direct delivery of medicines to the airways, lungs, bronchi, ensuring deep penetration of drugs into the inflammatory areas. Secondly, for the purposes of prevention and treatment, as well as for residual effects, inhalation treatment is safer contrary to stress-effects of pills on the liver. Lastly, this is the only method of treatment appropriate for children under 5 years old, elderly and debilitated patients.

Where are nebulizers used?

Nowadays nebulizers are widely used for domiciliary treatment as well as for emergency treatment. Inhalation therapy by using a nebulizer is the fastest method to deliver medicines to the lungs and bronchi. Therefore nebulizers (inhalers) provide effectively help to treat bronchial asthma, chronic bronchitis and other lung diseases. Nebulizer is efficient in treatment of the upper and lower airways at all stages.

What are indications for using nebulizers?
- ARVI (rhinitis, pharyngitis, laryngitis, tracheitis) and respective complications (rhinosinusitis, laryngotracheitis);
- Acute chronic rhinitis, acute chronic sinusitis, acute chronic tonsillitis;
- Bronchial asthma;
- Pneumonia (resolution stage);
- Acute bronchitis and acute exacerbations of chronic bronchitis;
- Bronchiectatic lung disease;
- Fungal lesion of the upper and lower airways;
- Pulmonary and bronchial tuberculosis;
- Mucoviscidosis;
- For the prevention of post-surgery complications.

What are benefits of nebulizer therapy?

Simple procedure.

Medicines are delivered directly to the target organ – respiratory system.

Fast effect on mucous membranes.

Intermittent aerosol delivery to the airways during the inspiratory phase saves medicines and allows generating of an individual breathing cycle, specific for a particular person. Aerosol medications effect on a large surface of mucous membranes of the respiratory system (nose, nasal accessory sinuses, pharynx, trachea, larynx, large bronchi and bronchial tubes), providing increase of medications activity and fast effect extension.

Nebulizer inhalation therapy can be used for elderly, debilitated patients with external respiratory impairment and for children under 5 years old. Nebulizer therapy is indicated for patients, which cannot use metered dose inhalers due to their inability to take a breath with synchronous activation of the inhaler.

Possibility to dose medications and deliver large doses of medications to the lungs.

Absence of propellant (supplementary substances, such as in metered dose inhalers).

Are there any contradictions for nebulization therapy, what are they?

Yes, there are. Basic contradictions are listed below:
- Bronchial hemorrhages;
- Traumatic or spontaneous pneumothorax;
- Bullous emphysema;
- Cardiac arrhythmia;
- Severe cardiac failure;
- Idiosyncrasy of prescribed medications.

What solutions are not recommended for nebulization therapy?

- Herbal teas (high allergenic capacity);
- Suspensions;
- Oil-based solutions (essential oils, etc.).

May all family members use the same nebulizer? Or some individual accessories should be used?

The same nebulizer is allowed to be used by several persons when they follow the recommendations: disassemble the nebulizer cup after a treatment, dip them in boiling water for at least 10 minutes. Then put the parts on a clean paper towel and let them dry. Do not boil masks and the air tube! The mask and the air-tube shall be washed with warm water after each use. The device should be cleaned with a damp cloth once a day.

To prevent the spread of infections through contact-parts of the nebulizers – it is recommended to use individual mouthpieces/nosepieces for nebulization!

What medications can be used in nebulizers?

Medications and their dosage must be approved by your doctor. Use only such solutions which were recommended by your doctor.

What is the difference between a digital and a mercury thermometer?

Safety - is the main benefit of a digital thermometer, since it is free of mercury and glass.

Mercury and its vapor are highly-toxic and in case of a mercury thermometer breakage, a body can be exposed by mercury that will cause severe poisoning. Also these two types of thermometers differ from each other in principles and methods of body temperature detection.

Mercury-in-glass thermometers are based on the property of materials to change their volume according to the temperature. Digital thermometers – their operation is based on function of temperature sensors as a change in temperature causes a change of their resistance. Data received from the sensors is converted and displayed in digits.

How to measure body temperature with a thermometer?

Rectally (in the anus):

Such measurements are considered to be the most accurate and have the minimum range of results.

Normal temperature: from 36.2 °C to 37.7 °C
Measuring time: from 10 seconds to 1 minute

Orally (in the mouth):

When taking a temperature orally, place the thermometer tip under the tongue at the heat pocket. Keep the mouth closed during the process to prevent the temperature sensor from being influenced by environment. Temperature readings taken in the mouth (orally) are generally 0.3 – 0.8 °C lower than oral readings.

Normal temperature: from 35.5 °C to 37.1 °C
Measuring time: from 10 seconds to 3 minutes

Axillary (in the armpit):

The least accurate method for taking body temperature. Thermometer sensor needs to be in direct contact with the skin, i.e. to be pressed tightly, in order to prevent the temperature sensor from being influenced by environment. When taking temperature in the armpit it is recommended to continue measuring for 1 – 1.5 minutes after the beep.

This method is the longest one and the results are 0.5 -1.5 °C lower than rectal readings.

Normal temperature: from 35.2 °C to 36.7 °C
Measuring time: from 30 seconds to 5 minutes