Measuring Blood Pressure

Fieldwork students were asked by supervisors to measure patients' blood pressure. This is a skill that develops over time, and becoming comfortable with it requires lots of practice. Never measure BP more that twice on one arm, and wait at least 30 seconds before measuring a second time on the same arm. The best way to know which arm to measure is to ask the patient which arm is routinely measured or ask the doctor. Never take it on the involved side (i.e., breast cancer, CVA, traumatic injury).

The class spent about 30 minutes taking each other's BP as an introduction to the skill after a short lecture and video. We'll have more of an opportunity next semester. Here is what I learned by making all the common mistakes:

1. Don't go above 200mm HG (millimeters of mercury) if you can't hear a beat. That's the point! I kept thinking I was supposed to hear something as I pumped up the rubber cuff and cut circulation off my "patient" (fellow student). When I looked up in frustration, his red face told me I should release the air. Usually, 30mm HG above normal Systolic pressure (i.e., 120mm HG) is enough, generally, 150mm HG.
2. Remember that your patient's blood flow has been cut off, which is either very uncomfortable or--in the case of my patient--painful. Once the cuff is full of air, don't take your sweet time looking for all the instruments you should have arranged beforehand. Be quick about it before the patient knocks you out with the arm that still has blood flow.
3. Make sure the room is quiet or else all your efforts are for naught. If you can't hear, you can't measure BP.
4. Know where the brachial artery is, and demonstrate this by feeling the pulse. Don't try to hear the pulse with the stethoscope because it won't happen. Press firmly enough to leave a mild press mark so you know where the artery is and where to place your cuff after lifting your finger. The cuff has an arrow that's to be placed right above the brachial artery.

As a YouTube addict, I felt compelled to search for a video on measuring BP. This one is adequate enough for an overview.



And here's a link to a website that gives the basics.