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BLOOD PRESSURE MEASUREMENT

Procedur Blood Pressure Measurement

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Indicatio 1. To aid diagnosis
ns 2. To aid assessment of the cardiovascular system during and after disease
3. To assess efficacy of antihypertensive medication
4. Preoperatively to assess the patients usual range of blood pressure

Procedur
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Step 1 Ensure the patient is relaxed and sitting comfortably, and that their upper arm
is at the same level as the heart.

Step 2 Assess their knowledge of the procedure and explain if necessary.

Step 3 Ask the patient to roll their sleeve up to expose the upper arm. If the sleeve
folds into a restrictive band around the upper arm, you will need to ask them to
remove their arm from the sleeve.

Step 4 Choose an appropriate sized cuff

(too small will over-estimate BP
and too large will under-estimate
it). Wrap the cuff around the
upper arm with the bladder over
the brachial artery.

Step 5 (a) Locate the radial artery, and

with your other hand, squeeze
the bulb to inflate the cuff until
the pulse is no longer felt.
(b) Release the valve and note the
pressure at which the pulse
returns. This gives you an
estimate of what the systolic
pressure is.
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Step 6 (a) Close the valve and re-inflate

the cuff to 20-30mm Hg higher
than your estimate of systolic
BP.
(b) Place the diaphragm of your
stethoscope over the brachial
artery. Remember that it can
be uncomfortable for the
patient to have the cuff
inflated to this pressure do
not forget this and do not
waste time.
(c) Release the valve a little so
that the pressure drops very
slowly. Meanwhile you should
listen intently for the Korotkoff
sounds faint thudding
sounds.
(d) Note the pressure at which
you first hear the sounds this
represents systolic pressure.
(e) Note the pressure at which the
sounds disappear this
represents diastolic pressure.
(Cuff pressure is now less than
diastolic pressure and flow is
continuous throughout the
cardiac cycle.) Once the
sounds have disappeared, open
the valve fully to completely
deflate the cuff.