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61 8. Fix the moment when the sound of pulse beats disappears, and then continue to pump air at 20 mm Hg.; 9. Open the valve on the cylinder counterclockwise and slowly release the air from the cuff; 10. Record on the tonometer scale the appearance of the first pulse beat, which characterizes the value of systolic blood pressure; 11. Continue to release air from the cuff, monitor the scale and listen carefully to pulse beats; 12. Mark on the tonometer scale the moment when the pulse beat disappears, which characterizes the value of diastolic blood pressure; 13. Determine blood pressure three times with an interval of 3–5 minutes; 14. Measure blood pressure on the other hand, following these recommendations; 15. after measuring blood pressure, open the valve on the balloon completely, disconnect it from the cuff and remove it from the patient’s hand; 16. Register the lowest blood pressure in the temperature sheet in the form of col- umns (systolic pressure is displayed in red, and diastolic pressure is displayed in blue); 17. Disinfect the equipment. The patient is laid on a couch, his chest and limbs are freed from clothing. Set the speed of the tape in the device‑1 mm/sec. Emergency conditions in diseases of the cardiovascular system Hypertensive crisis – an attack of a sharp sudden and individually signifi- cant increase in blood pressure, accompanied by the appearance or aggravation of previously existing vegetative, cerebral, and cardiac symptoms. Causal factors : hypertension, chronic inflammatory kidney diseases, traumat- ic brain injury, diabetic nephropathy, gestosis of pregnant women, etc. Crises of the first order are mainly caused by the release of adrenaline. Clinic: sudden onset, agitation, headache, palpitations, skin hyperemia, increased sweat- ing, predominance of systolic blood pressure, high pulse pressure. Crises of the second order are mainly caused by the release of norepinephrine, developing within 3–4 hours. Clinic: bursting headache in the occipital region, tinnitus, vomiting, «shroud» in front of the eyes, bradycardia, increased systolic and diastolic blood pressure. Complications: acute myocardial infarction, acute cerebrovascular accident, acute left ventricular failure, convulsions. An emergency reduction in blood pressure is necessary if signs of damage to target organs appear or increase: pronounced changes in the fundus, Central nervous system disorders, kidney and heart dam- age. At the same time, they achieve a decrease in blood pressure within an hour. In crises, when signs of damage to target organs are minimal or absent, blood pres- sure is reduced for several days to avoid brain ischemia. Independent assistance: 1. Call a doctor through a third party. 2. Strict bed rest.