Measuring blood pressure
Blood pressure is measured using a tool called a sphygmomanometer. Sphygmomanometers are either manual or digital. To take someone’s blood pressure, the NA will need the sphygmomanometer, a stethoscope (only if using a manual sphygmomanometer), a blood pressure cuff, and alcohol wipes.
Sphygmomanometers are made of an armband that tightens either through the manual use of an attached handheld squeeze-ball air pump or the arm band will tighten automatically, as well as an interface where the blood pressure is displayed, and tubing that connects the arm band with the display.
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A person’s blood pressure should not be taken if they have recently engaged in activities that raise or lower their blood pressure. Examples include exercise within the last 30 minutes, and the presence of caffeine, tobacco, and other drugs.
Be careful of placement when taking blood pressure. The sphygmomanometer’s arm band should not be placed on an arm that has an IV line, a cast, burns or injuries, recent physical trauma, a mastectomy or another surgical incision on that side, or dialysis treatment. Arms that are paralyzed or have been amputated should not be used to measure blood pressure.
Taking a person’s blood pressure manually requires substantial concentration and focused listening. After performing the opening procedure and cleaning the equipment, discuss the procedure with the person and ask them to cooperate by remaining calm, quiet, and still.
After making sure the cuff is completely deflated, the NA should wrap the blood pressure cuff around the person’s bare arm positioned palm-up at about heart level, with the cuff’s center placed about 2 inches over the inside of the elbow.
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Place the stethoscope over the artery on the inner elbow and tighten the valve on the arm cuff until it is closed but not too tight. Use the handpump to inflate the cuff to 170 – 200. The valve should slowly be opened until a pulse beat is heard; if a pulse is heard immediately at the original number, deflate and begin the process at a higher pressure.
Listen carefully while deflating the cuff. The number on the gauge when the first pulse becomes clearly audible is the systolic blood pressure and the first number in the reading. The gauge reading when the pulse beat sound changes or disappears is the diastolic blood pressure. Once the diastolic pressure is observed the NA can fully release the cuff valve before removing it. The systolic and diastolic numbers should be recorded immediately after handwashing. If the reading is abnormal or a significant change from other readings, inform the nurse.
Obtaining a blood pressure reading on someone is much simpler with an automatic sphygmomanometer than with the manual variety. After performing the opening procedure, the NA should make sure the cuff is totally deflated before positioning it so the center is right above the brachial artery. The cuff should be snug. Next, turn on the blood pressure machine and select the proper settings. After the machine performs the reading the NA should chart the blood pressure immediately and details like the arm used and the time the measurement was obtained.
RegisteredNurseRN. (2019, June 4). Blood Pressure Measurement: How to Check Blood Pressure Manually [Video]. Youtube. https://www.youtube.com/watch?v=UGOoeqSo_ws
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