Measuring Blood Pressure
Step Fifteen
Clean the earpieces and the chest piece of the stethoscope with an antisceptic wipe, and replace the equipment properly.
Step Ten
Close the valve on the bulb by turning the thumbscrew clockwise (to the right) with the thumb and forefinger of your dominant hand until it feels tight but but can still be loosened with the thumb and forefinger of one hand when you need to deflate the cuff. Pump air into the cuff as rappidly as possible to at least 30 mm Hg about the previously measured systolic pressure.
Step Twelve
Continue to deflate the cuff while listening to the Korotkoff sounds. Listen for the onset of the muffled sound that occurs during phase IV. Continue to deflate the cuff, and note the point on the scale at which the sound ceases (phase V). Continue to steadily deflate the cuff for another 10 mm Hg to ensure that there are no more sounds.
Step Two
Greet patient and introduce yourself. Identify patient, explain the procedure. While explaining look for signs that may alter their readings such as anger, fear, pain or recent physical activity. Determine how high to pump the cuff by checking the patient's chart for previous systolic readings.
Step Three
Have the patient sit quietly in a comfortable position. Should have them relax for 5 minutes before taking BP. Roll up patient's sleeve if long or have them remove their arm from the sleeve if obstructing their arm. Arm should be positioned at heart level and well supported with their palm face up.
Step Eight
Instruct the patient not to talk or move. Place the earpieces of the stethoscope in your ears, with the earpieces directed slightly forward. During blood pressure measurement, the tubing of the stethoscope should hang freely and should not be permitted to rub against any object.
Step Five
Locate the brachial pulse with your fingertips. The brachial pulse is located near the center of the antecubital space but slightly toward the little finger-side of the arm. Center the inner bladder over the brachial pulse site. Place cuff approximately 1-2 inches above the bend of their elbow.
Step Nine
Making sure the arm is well extended, locate the brachial pulse again, and place the diaphragm of the stethoschope over the brachial pulse site. The diaphragm should be positioned to make a tight seal against the patient's skin. Enough pressure should be exerted to leave a temporary ring on the patient's skin when the disc is removed. Do not allow the chest piece to touch the cuff.
Step Seven
Position the manometer for direct viewing and at a distance of no more tahn 3 feet.
Step Thirteen
Quickly and completely deflate the cuff to zero. If you could not obtain an accurate blood pressure reading, wait 1 to 2 minutes before taking another measurement on the same arm. Remove the earpieces of the stethoscope from your ears, and carefully remove the cuff from the patient's arm.
Step Eleven
Release the pressure at a moderately steady rate of 2 to 3 mm Hg/sec by slowly turning the thumbscrew counterclockwise (to the left) with the thumb and forefinger. This opens the valve and allows the air in the cuff to escape slowly. Listen for the first clear tapping sound (phase I of the Korotkoff sounds). This represents the systolic prssure. Note this pount on the scale of the manometer.
Step One
Sanitize hands, and assemble the equipment. Clean earpieces and chest piece of the stethoscope with antiseptic wipe.
Step Fourteen
Sanitize your hands, and chart the results. Include the date, the time, and the blood pressure reading. Blood pressure is recorded using even numbers. Make a notation in the patient's chart if the lying or standing position was used to take blood pressure. Abbreviations that can be used are L (lying) and St (standing).
Step Four
Select proper cuff size. Cuff bladder must encircle 80% but no more than 100% of the patient's arm and wide enough to cover two thirds of the distance from the axilla to the antecubital space.
Step Six
Wrap cuff smoothly and snugly around the patient's arm, and secure the end of it.
