SPHYGMOMANOMETER

PRODUCT DEVELOPMENT LABORATORY

SOURAV MISHRA | ROLL no- 215BM1002 |

December 4, 2015

PRODUCT DEVELOPMENT LAB

A
Product Report
Submitted as Part of Course
For
Completion of Semester

SPHYGMOMANOMETER

PROJECT GROUP

SI NO.
1
2
3
4

NAME
SOURAV MISHRA
GAURAV MOHAN
SAKHARE
RAHUL SARKAR
VIVEK PRATAP SINGH

REGISTRATION NO.
215BM1002
215BM1003
215BM1443
215BM1444

DEPARTMENT OF BIOTECHNOLOGY AND MEDICAL

ENGINEERING
NATIONAL INSTITUTE OF TECHNOLOGY
ROURKELA-769008
ODISHA

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PRODUCT DEVELOPMENT LAB

Sphygmomanometer
M.TECH 2015-16 (1st Semester)

TITLE:
DEGREE:

SUBMITTED BY
NAME

REGISTRATION NO.

SOURAV MISHRA

215BM1002

DATE OF SUBMISION
04/12/2015

DEPARTMENT OF BIOTECHNOLOGY AND MEDICAL

ENGINEERING
NATIONAL INSTITUTE OF TECHNOLOGY
ROURKELA-769008
ODISHA

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Table of Contents

AIM OF THE EXPERIMENT ............................................................. 4

INTRODUCTION ............................................................................. 4
APPARATUS REQUIRED .................................................................. 5
PROCEDURE.................................................................................... 6
CARE AND MAINTAINANCE ........................................................... 9
CAUTION ......................................................................................... 11
REFERENCE ..................................................................................... 11

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AIM OF THE EXPERIMENT:To develop a sphygmomanometer working model and test its functionality.

INTRODUCTION:The circulation of blood within the body has been a subject of study for many
thousands of years. In ancient times, the Chinese recognized the fact that
blood circulated through the blood vessels and developed theories on how
such systems worked. Evidence also suggests that scholars in India had
developed some knowledge of the circulatory system, with an emphasis on
the pulse and its dynamic nature.
A broader understanding of circulation and the circulatory system was
developed in the early 1600s by a doctor named William Harvey. He began
teaching about circulation in 1615 and later published his work in 1628
entitled Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus
(On the Movement of the Heart and Blood in Animals). His work became a
foundation for the study of the circulatory system, and is still highly regarded
even to this day.
Once the correlation between heart rate and pulse was discovered, it was
possible to determine blood volume and blood pressure. In 1733 Reverend
Stephen Hales recorded the first blood pressure measurement on a horse. He
did this by inserting a long glass tube upright into an artery, observing the
increase in pressure as blood was forced up the tube.
In 1881, the first sphygmomanometer was invented by Samuel Siegfried Karl
Ritter von Basch. It consisted of a rubber bulb that was filled with water to
restrict blood flow in the artery. The bulb was then connected to a mercury
column, which would translate the pressure required to completely obscure
the pulse into millimeters of mercury.
In 1896, the device was further improved by Scipione Riva-Rocci.
Improvements included a cuff that could be affixed around the arm to apply

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even pressure to the limb that would become the standard design for such
devices going forward.
Modern blood pressure measurement was not developed until 1905, when Dr.
Nikolai Korotkoff discovered the difference between systolic blood pressure
and diastolic blood pressure. These pressures corresponded to the appearance,
and disappearance of, sounds within the arteries as pressure was applied and
then released. Known as Korotkoff sounds, the use of systolic and diastolic
sounds is now standard in blood pressure measurement.
Since that time, further advances have been made to sphygmomanometers.
Now available in a variety of styles ranging from mercurial to aneroid and
electronic versions, blood pressure measurement has become more accurate
and widely accepted as an important vital sign when diagnosing a patient.

APPARATUS REQUIRED:I.

II.

III.

MANOMETER
The portion of the sphygmomanometer that measures the air pressure
in mmHg. The aneroid contains a watch-like movement that measures
the air pressure applied to the cuff. Within the gauge is a series of
copper/berrylium diaphragms that expand when filled with air. Gears
convert the linear movement of the diaphragms, turning the needle on
a dial calibrated in mmHg.
BULB
The bulb pumps air into the cuff. An end (check) valve prevents air
from escaping. ADCs latex-free bulbs are made from either spin cast
PVC or dip molded neoprene, Available in a large size for use with
bigger cuffs. ADLFOW filter screen-protected end valves provided an
additional dust barrier.
VALVE
The deflation valve allows for controlled deflations of the cuff-critical
for accurate measurement.

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IV.

CUFF
The cuff is design to hold the bladder around the limb during
measurement. A properly designed cuff will ensure proper placement
and positioning- essential for accurate measurement.
A cuff has following parts:

SHELL
The cuff is typically made from nylon and is design to secure the bladder
around the limb. They are made from patient- friendly 210 denier nylon and
sewn with nylon thread for easy cleaning. These are available in 6 sizes fitting
limb ranges from 9 to 66 cm, and in up to 12 colours for sizing, departmental
coding, or personal preferences.
GAUGE HANG TAB
A sewn strap that allows a pocket aneroid to be clipped to the cuff for
convenience. Some cuff brands dont include a hang tab, making use with a
pocket-style aneroid more difficult.
HOOK AND LOOP ADHESIVE
Consist of the male and female components that engage to secure the cuff.
V.

BLADDER
The bladder is the inflatable bag that, when filled, compresses the arm
to occlude the artery. Bladders should follow very specific sizing
parameters to ensure full arterial compression.

PROCEDURE :I.

Assembly:Cuffs are made of two wholes each of which then fitted with two
pressure tubes.
One of the pressure tube is fitted with manometer and another via
deflation valve with the bulb to pump the air.

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II.

Testing for performance:Gauge Accuracy

One of the most critical components of any sphygmomanometer is the
gauge. The accuracy of the gauge is a key factor in creating a quality
sphygmomanometer.
Gauge DurabilityIt is not only the cuff that can wear out from repeated uses, gauges are
subjected to varying pressures regularly as the sphygmomanometers
are inflated to take measurements. Care should be taken to ensure its
durability.
Valve LeakagePreventing systems leakage is key to ensuring that a
sphygmomanometer gives reliable, accurate readings. When we close
the valve, air should not leak out.
Dimensions-

III.

If the component parts of a sphygmomanometer do not fit properly, the

entire system can leak. Leakage can throw off your blood pressure
measurements through excessive deflation. This is why we use
calibrated calipers to inspect each and every component used in our
sphygmomanometer to ensure the best possible fit, and consistency, in
quality time after time.
Procedure to measure blood pressure:Patient Positioning:
The patient should sit or lie comfortably. The arm should be fully
supported on a flat surface at heart level. (If the arms position varies,
or is not level with the heart, measurement values obtained will not be
consistent with the patients true blood pressure). When seated, the
patient should have their back and arm supported, and their legs should

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not be crossed. The patient should relax prior to measurement

comfortably for five minutes, and should refrain from talking or moving
during measurement. The observer should view the manometer in a
direct line to avoid Parallax error.
Application of the Cuff:
Range markings are part of the cuff system. Using an inappropriately
sized cuff can affect blood pressure readings.
Cuffs are specially designed to promote the precisely accurate
determination of blood pressure. Index and range markings ensure use
of the correct cuff size. The artery mark indicates proper cuff
positioning.
Place the cuff over the bare upper arm with the artery mark positioned
directly over the brachial artery. The bottom edge of the cuff should be
positioned approximately one inch (2-3cm) above the antecubital fold.
Wrap the end of the cuff not containing the bladder around the arm
snugly, and smoothly and engage adhesive strips. To verify a correct
fit, check that the Index Line falls between the two Range Lines.
Cuff Inflation:
Close the valve by turning thumbscrew clockwise. Palpate the radial
artery while inflating the cuff. Be sure to inflate cuff quickly by
squeezing bulb rapidly. Inflate cuff 20-30 mmHg above the point at
which the radial pulse disappears.
Positioning the Stethoscope:
The correct positioning of the cuff, as shown by the Artery Mark, and
stethoscope for optimal measurement.
Position the chestpiece in the antecubital space below the cuff, distal to
the brachium. Do not place chestpiece underneath the cuff, as this

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impedes accurate measurement. Use the bell side of a combination

stethoscope for clearest detection of the low pitched Korotkoff (pulse)
sounds.
Deflate the cuff:
Open the valve to deflate the cuff gradually at a rate of 2-3 mmHg per
second. Record the onset of Korotkoff sounds as the systolic pressure,
and the disappearance of these sounds as diastolic pressure. (Some
healthcare professionals recommend recording diastolic 1 and diastolic
2. Diastolic one occurs at phase 4).
NOTE: It is recommended that K4 be used in children aged 3 to 12, and
K5 should be used for pregnant female patients unless sounds are
audible with the cuff deflated, in which case K4 should be used. K5
should be used for all other adult patients.
After measurement is completed, open valve fully to release any
remaining air in the cuff and remove the cuff. Do not leave the cuff on
the patient for an extended period of time.
Factors Affecting Measurements:
When taking blood pressure, it is vital that all of the steps involved in
the process are properly observed. Small variations in technique can
cause large variances in measurements, even on the same patient. The
chart below shows some common issues that could affect readings:

CARE AND MAINTAINANCE:STORAGE:

After measurement, fully exhaust cuff, then wrap cuff around gauge
and bulb and store in zippered carrying case.

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In order to ensure that we have the best experience with your

sphygmomanometer, it is stored at temperatures ranging from 50F to
104F (10C to 40C) at a relative humidity level of 15% to 85%.
Manometer: The manometer (gauge) attached to your
sphygmomanometer requires minimal care and maintenance. The
manometer may be cleaned with a soft cloth, but should not be
dismantled under any circumstances. Gauge accuracy can be checked
visually; simply be certain the needle rests within the printed oval when
the unit is fully deflated.
Should the indicator needle of the manometer rest outside of this
calibration mark, then the manometer must be re-calibrated to within
3 mmHg when compared to a reference device that has been certified
to national or international measurement standards. A manometer
whose indicator needle is resting outside of this mark, is NOT
acceptable for use.
Cuff Cleaning and Disinfecting:
Use one or more of the following methods and allow to air dry:

Wipe with mild detergent and water solution (1:9 solution).

Rinse.
Wipe with Enzol per manufacturers instructions. Rinse.
Wipe with .5% bleach and water solution. Rinse.
Wipe with 70% isopropyl alcohol.
Launder with mild detergent in warm water, normal wash cycle.
(Note: Remove bladder first. Cuff is compatible with 5 wash
cycles).

Low Level Disinfection:

Remove the bladder from the cuff. Prepare Enzol enzymatic detergent
according to the manufacturers instructions. Spray detergent solution
liberally onto cuff and use a sterile brush to agitate the detergent
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solution over entire cuff surface for five minutes. Rinse continuously
with distilled water for five minutes. To disinfect, first follow the
cleaning steps above, then spray cuff with 10% bleach solution until
saturated, agitate with a sterile brush over entire cuff surface for five
minutes. Rinse continuously with distilled water for five minutes. Wipe
off excess water with sterile cloth and allow cuff to air dry.

CAUTION:
I.
II.

Do not iron cuff.

Do not heat or steam sterilize cuff.

REFERENCES:1. William H. McMicken, M.D. (n.d.). Hardening of the Arteries,

Inevitable
or
Preventable?
Retrieved
from
http://familydoc.tripod.com/ascvd1.htm
2. (n.d.) The History of Blood Pressure Monitoring. Retrieved from:
http://www.healthperfect.co.uk/Index/dphistry.htm
3. Georgia Alton. (n.d.) The History of Sphygmomanometers. Retrieved
from:
http://www.ehow.com/about_5339926_historysphygmomanometers.html
4. 4. Sphygmomanometer. (8 January 2013 at 15:32). Retrieved from
Wikipedia: http://en.wikipedia.org/wiki/Sphygmomanometer
5. Adiyaman Ahmet, Tosun Nevin, Elving LammyD, Deinum Jaap,
Lenders JacquesWM, Thien Theo. The effect of crossing legs on
blood pressure. Blood Press Monit June 2007; 12:3: 189-193.
6. Campbell NormanRC, McKay DonaldW. Accurate blood pressure
measurement: Why does it matter? CMAJ 1999; 161(3): 277-278.
7. Cushman WilliamC, Cooper KarenM, Horne RichardA, Meydrech
EdwardF. Effect of back support and stethoscope head on seated
blood pressure determinations. Am J Hypertens 1990; 3: 240-241.
8. Fonseca-Reyes Salvador, Garcia de Alba-Garcia Javier, ParraCarrillo JoseZ, Paczka-Zapata Jose Antonio. Effect of standard cuff
on blood pressure readings in patients with obese arms. How
frequent are arms of a large circumference? Blood Press Monit
2003 8:3: 101-106.
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9. Foster-Fitzpatrick Lucille, Ortiz Anna, Sibilano Helena,

Marcantonio Richard, Braun LynneT. The effects of crossed leg on
blood pressure measurement. Nursing Research Mar/Apr 1999;
48:2: 105-108.
10. Geddes LA, Whistler SJ. The error in indirect blood pressure
measurement with the incorrect size cuff. Amer Heart J July 1978;
96:1: 4-8.
11. Gomez-Marin O, Prineas RJ, Rastam L. Cuff bladder width and
blood pressure measurement in children adolescents. J of
Hypertens Oct 1992; 10:10: 1235-1241.
12. Iyriboz Y, Hearon CM, Edwards K. Agreement between large and
small cuffs in sphygmomanometry: A quantitative assessment. J of
Clin Monitoring Mar 1994; 10:2:127-133.
13. Keele-Smith Rebecca, Price-Daniel CeCilia. Effects of crossing legs
on blood pressure measurement (Research Data). Virginia
Henderson Internat Nurs Lib Aug 2007.

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