Blood Pressure
Introduction:
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Wash your hands
Introduce yourself with name and status. Check patients name and DOB
Outline the procedure and warn about any discomfort eg. I will inflate a cuff
around your upper arm it will feel like a tight band around your arm but it
should not last too long
Ask the patient if it is ok to continue on with the examination (Taking their B.P)
Prepare the sphygmomanometer:
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Sphygmomanometer places on a surface with the dial facing you, on a level
with the patient’s heart.
Select the appropriate size cuff
Disconnect tubing and squeeze out excess air from cuff
Ensure the dial is centred at 0
Position Patient Correctly:
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Seated and relaxed
Upper arm fully exposed
Arm positioned to allow easy application of cuff
Arm should be supported at the same level as the heart.
Apply BP cuff:
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Apply correct side of the cuff around the upper arm
Cuff tubing should be central but not in the way of stethoscope position
Place the cuff as high up as possible to allow as much space for the
stethoscope to go over the brachial artery
Reconnect tubes
Close the valve on the inflation bulb (one handed)
Locate Brachial Artery:
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Radial artery can be used for palpation only never auscultation
Estimate Systolic Pressure by Palpation to identify the presence of an
auscultator gap:
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Palpate brachial pulse with thumb
Use the other hand to inflate the cuff until you cannot feel the pulse and note
what pressure this is (sometimes easier to record when the pulse returns) this
is the estimated systolic pressure.
Deflate cuff rapidly to 0
Auscultate Systolic and Diastolic Pressure:
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Place stethoscope diaphragm on site of brachial artery
Re inflate stethoscope straight up to 30mm Hg above your estimated systolic
pressure
Slowly release the valve so the pressure falls slowly
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When you can hear tapping beats for the first time which can be very soft this
is systolic pressure.
Continue to let air out slowly from the cuff, the noises you hear become louder
and softer until the completely disappear. When the noises disappear this is
diastolic pressure. Some patients the sound does not disappear the diastolic
pressure is when the sound of the breats becomes muffles (Korotkov 3)
document this.
Now rapidly deflate cuff.
Document your results:
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When writing in notes don’t use units it appears like a fraction 120/80 usually
recorded to nearest 2mmHG
On sews chart V-shaped arrows are used to locate the systolic and diastolic
values on the chart and use a dotted line to join them.
Closure:
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Thank the patient
Help make comfortable
Wash hands