Blood pressure
- procudure
Equipment – mercury
sphygmomanometer
Sphygmomanometer
Something to elevate
the device
Stop watch
Watch and thermometer
Cuffs
Stethoscope
Measurement tape
Equipment – automated
device
Measurement
device
Watch and thermometer
Cuffs
Measurement tape
Exclusion criteria
• Blood pressure is not measured if a
participant has
• Both arms amputated
• Cast on both arms
• Open wounds/sores on both arms
• Rash on both arms
• Malformation on both arms preventing
to place the cuff
• Lymph node malfunction in both arms
Setting up the
measurement site
• Room should be
• Quiet
• Comfortable temperature
• No disturbance
• Measurement device
placement
• Measurer has clear view
• Participant cannot see the
results
• If mercury
sphygmomanometer is
used, mercury column at
the eye level of the
measurer
Instruction to the
participants
• Before blood pressure measurement,
participants should abstain from
• Eating
• Drinking (except water)
• Smoking
• Heavy exercise
• Taking drugs that affect blood pressure
for one hour before the measurement
Position of the
subject
Back
supported
Feet resting
on the floor,
not crossed
Position of the arm
Right arm,
resting on the
desk
Palm is facing
up
In line with heart
Removal of clothing
Sleeves rolled up, not
constrictive
Remove constrictive
sleeves
Selection of the cuff
• The bladder of the
cuff should be
• Width: At least
40% of the arm
circumference
• Length: At least
80% of the arm
circumference
Measurement process
• Participant is asked
to sit still for 5
minutes
• Participant is asked
not to talk during
the measurement
• Arm circumference
is measured and
cuff selected
Cuff is placed
2-3 cm above
antecubital
fossa
By automated device
• After the cuff has
been placed, follow
the instructions of
the used device
• Measure blood
pressure 3 times,
one minutes
between
measurements
By mercury
sphygmomanometer (1)
• The radial pulse is
palpatated and the
pulse rate is
counted for 60
seconds
• Record 60 sec
pulse count and
whether or not the
pulse was regular
By mercury
sphygmomanometer (2)
• Determine the
peak inflation level
• The brachial pulse
is located and the
bell of the
stethoscope is
placed
Not touching the
cuff, rubber or
clothing
Inside the bicep
muscle tendon
By mercury
sphygmomanometer (3)
• Inflate the cuff rapidly
to the peak inflation
level
• Deflate at the rate of
2 mmHg/second
• Systolic blood
pressure: Korotkoff
Phase I
• Diastolic blood
pressure: Korotkoff
Phase IV
• Record measurement
to the nearest 2
mmHg
• Wait 1 minute
• Repeat measurement
two more times
Quality assurance –
mercury
sphygmomanometer
• Daily
• Shape of the meniscus
• Rise of the mercury
• Zero level of the
mercury
• Cracks in the glass tube
• Screw at the tops of the
calibrated glass tube
• Air tube for cracks and
tears
• Weekly
• Cuffs
• Material
• Condition
• Stethoscopes
• Condition
• Device
• Air leaks
Quality assurance –
automated device
• Daily
• AC adapter cord of the
device is securely
plugged in or
• Batteries have power
• Air tubes for cracks and
tears
• Secure attachment of
the tubes
• Weekly
• Under consideration