Looking for Learning Resource - BP / Kortokoff Sounds

[Still Kickin]

Hi all. I feel a little silly posting this but I am having real trouble learning to take blood pressure.

I am hoping someone might know of an electronic resource that simulates a blood pressure exam - maybe synchronizing a "movie" of watching the needle on the sphygmanomometer go down with LISTENING TO THE KORTOKOFF SOUNDS. I am having real trouble with the sounds. I just hear SO MUCH stuff through the stethoscope - I know some of the stuff I am hearing is definitely the sounds but I'm having a hard time telling when the first sounds start (vs. some of the things I'm hearing are probably tube knocking, etc.). Also - it seems like the sounds change in quality about 1/2-way through - first they are just a "thump" or beat & then they become LOUD & "WHOOSHEY". Is this normal? Or are the "thumps" something else & only the "whooshey" ones the sounds? Also sometimes I have trouble hearing the END of the sounds, because they get SO QUIET before they stop completely & I'm worrying what if I just didn't hear the last 1 or 2 (esp. if when there is tube-knocking, other noise in the room, etc.)

Anyway, if you know of a web-page that has the type of learning resource I'm looking for, please point me in the right direction. I'd really prefer a web resource but would also be glad to know about CD/CD-ROM, video resource, etc.

(I'm starting to feel REALLY STUPID with repeatedly telling my clinical prof I don't think I have this down yet / I'm not comfortable with it yet. I think I will soon be officially labeled as "challenged"! [Probably have been already! Would have to get demoted from "challenged" to "hopeless".] Help!)

Thanks in advance.

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[deleted87716]

I am hoping someone might know of an electronic resource that simulates a blood pressure exam...am having real trouble with the sounds.

First, here's a definition of all the Korotkoff sounds .

Here's a decent explanation of the physiology behind each sound .

I'm not aware of any electronic resources for hearing Korotkoff sounds. It's really not all that difficult. The only important sounds as far as measurement goes are the first (systolic pressure) and last (diastolic pressure). Take a few blood pressures with an instructor and a teaching stethoscope (the kind with two sets of binaurals attached to a single headpiece), and you should be able to figure it out.

Hope this helps,
Kent

 

[deuist]

First, take your thumb off of the stethoscope's head. Next, place the head firmly on the patient's arm and do not move it, lean it, or rock it back and forth. I've seen lots of fellow classmates who press the head lightly on the patient's arm and then rock the stethoscope from side the side. The resulting collisions with the skin, although barely observable, can produce "thud" sounds that can be misinterpreted as arterial pulses. Finally, practice like crazy. Bring your stethoscope to class one day and start working on your classmates before lecture begins.

 

[coffeeluver]

Hi all. I feel a little silly posting this but I am having real trouble learning to take blood pressure.

I am hoping someone might know of an electronic resource that simulates a blood pressure exam - maybe synchronizing a "movie" of watching the needle on the sphygmanomometer go down with LISTENING TO THE KORTOKOFF SOUNDS. I am having real trouble with the sounds. I just hear SO MUCH stuff through the stethoscope - I know some of the stuff I am hearing is definitely the sounds but I'm having a hard time telling when the first sounds start (vs. some of the things I'm hearing are probably tube knocking, etc.). Also - it seems like the sounds change in quality about 1/2-way through - first they are just a "thump" or beat & then they become LOUD & "WHOOSHEY". Is this normal? Or are the "thumps" something else & only the "whooshey" ones the sounds? Also sometimes I have trouble hearing the END of the sounds, because they get SO QUIET before they stop completely & I'm worrying what if I just didn't hear the last 1 or 2 (esp. if when there is tube-knocking, other noise in the room, etc.)

Anyway, if you know of a web-page that has the type of learning resource I'm looking for, please point me in the right direction. I'd really prefer a web resource but would also be glad to know about CD/CD-ROM, video resource, etc.

(I'm starting to feel REALLY STUPID with repeatedly telling my clinical prof I don't think I have this down yet / I'm not comfortable with it yet. I think I will soon be officially labeled as "challenged"! [Probably have been already! Would have to get demoted from "challenged" to "hopeless".] Help!)

Thanks in advance.

I just want to thank you for asking this question. I have always had a confusion with the first sound. I always start out hearing a faint swishing sound then it becomes a louder thump, but confused if the systolic should be the first faint swish sound or the first loud thump sound. I hope this makes sense.

 

[XoQo]

Some Physical Exam textbooks (like hardcover Bates) have a CD with heart sounds. they focus more on mumurs than BP though so it might not be of much help.


One thing that really helped me distinguish all the sounds was that one of our volunteer sites (not part of class) had a dual headset stethoscope (i.e. two people listen at the same time). A nurse and then the physician took the BP and basically tapped on my arm each beat of the Kortokoff sounds from when they begin and when they end.

See if you can ask around if any of your teachers have such a stethoscope...or you can do a makeshift version (find a buddy who's a 3rd or 4th year) and each of you has one ear in the scope and he or she taps out the kortokoff sounds on your arm when they start and stop.

once you hear it definitively (and someone helps you weed thru the noise since they are sharing the same audio) --- it's a lot easier.

don't worry, you'll get the hang of it.

 

[Still Kickin]

Thanks for all of the suggestions! (Kent - I loved the websites that you posted.) I'd still be interested in a recording if anyone knows where to find one...

Thanks again!

 

[Antiviral22]

Hi all. I feel a little silly posting this but I am having real trouble learning to take blood pressure.

I am hoping someone might know of an electronic resource that simulates a blood pressure exam - maybe synchronizing a "movie" of watching the needle on the sphygmanomometer go down with LISTENING TO THE KORTOKOFF SOUNDS. I am having real trouble with the sounds. I just hear SO MUCH stuff through the stethoscope - I know some of the stuff I am hearing is definitely the sounds but I'm having a hard time telling when the first sounds start (vs. some of the things I'm hearing are probably tube knocking, etc.). Also - it seems like the sounds change in quality about 1/2-way through - first they are just a "thump" or beat & then they become LOUD & "WHOOSHEY". Is this normal? Or are the "thumps" something else & only the "whooshey" ones the sounds? Also sometimes I have trouble hearing the END of the sounds, because they get SO QUIET before they stop completely & I'm worrying what if I just didn't hear the last 1 or 2 (esp. if when there is tube-knocking, other noise in the room, etc.)

Anyway, if you know of a web-page that has the type of learning resource I'm looking for, please point me in the right direction. I'd really prefer a web resource but would also be glad to know about CD/CD-ROM, video resource, etc.

(I'm starting to feel REALLY STUPID with repeatedly telling my clinical prof I don't think I have this down yet / I'm not comfortable with it yet. I think I will soon be officially labeled as "challenged"! [Probably have been already! Would have to get demoted from "challenged" to "hopeless".] Help!)

Thanks in advance.

For another suggestion ... I believe that Litman, or another major brand of stethescopes, manufactures models for the hearing impaired that amplifies the sounds coming out of the scope. I don't think they're cheap, but it might be a good learning tool for BP, heart sounds, and chest auscultation. Good post and good luck.

 

[silas2642]

Dude, I know how you feel. I'm a cardiology technician and I swear that it took me forever to learn how to do a BP. One thing that helped me was pressing firmly down on the stethoschope head when taking it, and feeling for the artery so that I could place the head directly over it. Get everyone around you to shut up too, because sometimes the outside noises can screw you up.