Vital Signs - Blood Pressure

Blood Pressure Examination

Blood Pressure Examination
Blood pressure (BP) is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure. The mean BP, due to pumping by the heart and resistance to flow in blood vessels, decreases as the circulating blood moves away from the heart through arteries. Blood pressure drops most rapidly along the small arteries and arterioles, and continues to decrease as the blood moves through the capillaries and back to the heart through veins. Gravity, valves in veins, and pumping from contraction of skeletal muscles, are some other influences on BP at various places in the body.

The term blood pressure usually refers to the pressure measured at a person's upper arm. It is measured on the inside of an elbow at the brachial artery, which is the upper arm's major blood vessel that carries blood away from the heart. A person's BP is usually expressed in terms of the systolic pressure over diastolic pressure (mmHg), for example 140/90.(wikipedia)



Blood Pressure Examination
  1. Position the patient's arm so the anticubital fold is level with the heart. Support the patient's arm with your arm or a bedside table.
  2. Center the bladder of the cuff over the brachial artery approximately 2 cm above the anticubital fold. Proper cuff size is essential to obtain an accurate reading. Be sure the index line falls between the size marks when you apply the cuff. Position the patient's arm so it is slightly flexed at the elbow.
  3. Palpate the radial pulse and inflate the cuff until the pulse disappears. This is a rough estimate of the systolic pressure.
  4. Place the stetescope over the brachial artery.
  5. Inflate the cuff to 30 mmHg above the estimated systolic pressure.
  6. Release the pressure slowly, no greater than 5 mmHg per second.
  7. The level at which you consistantly hear beats is the systolic pressure.
  8. Continue to lower the pressure until the sounds muffle and disappear. This is the diastolic pressure.
  9. Record the blood pressure as systolic over diastolic ("120/70" for example).
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