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How To Measure Blood Pressure Manually

How To Interpret The Blood Pressure Reading

Blood Pressure Measurement: How to Check Blood Pressure Manually

American College of Cardiology 2017 Updated Guidelines for High Blood Pressure:

  • Normal BP- SBP: < 120 DBP: < 80 mm Hg
  • Elevated BP- SBP: 120-129 DBP: < 80 mm Hg
  • Hypertension Stage 1- SBP: 130-139 or DBP: 80-89 mm Hg
  • Hypertension Stage 2- SBP: 140 or DBP: 90 mm Hg

For a patient to be diagnosed as having hypertension, they need an average reading based on 2 readings or more that are obtained on 2 or more occasions.

References

Is There Anything Else I Need To Know About A Blood Pressure Measurement

If you were diagnosed with high blood pressure, your provider may recommend one or more of the following lifestyle changes.

  • Exercise regularly. Staying active can help lower your blood pressure and also help manage your weight. Most adults should aim for 150 minutes of physical activity per week. Check with your provider before beginning an exercise program.
  • Keep a healthy weight. If you are overweight, losing as little as 5 pounds can lower your blood pressure.
  • Eat a healthy diet that includes fruits, vegetable, and whole grains. Limit foods high in saturated fat and total fat.
  • Reduce salt in your diet. Most adults should have less than 1500 mg of salt per day.
  • Limit alcohol use. If you choose to drink, limit yourself to one drink a day if you are a woman two drinks a day if you’re a man.
  • Don’t smoke.

How Do You Check Your Blood Pressure With Your Fingers

  • How Do You Check Your Blood Pressure With Your Fingers? Center
  • Most doctors recommend the use of a blood pressure machine to check blood pressure. An individual may check heart rate with their fingers, but not blood pressure. Data shows checking blood pressure using fingers may not be accurate though there is an obscure method to correlate the pulse reading with systolic blood pressure. Blood pressure must be always measured using validated equipment.

    Place the fingers on the inside of the wrist to locate the pulse. Now, take two fingers and place them just below the wrist creases on the thumb side of the hand. A strong pulse felt at the wrist correlates to the systolic blood pressure of at least 80 mmHg. This method is not always correct and hence not recommended.

    It is important to use the correct technique to obtain an accurate measurement. Blood pressure is the force the blood exerts on the sides of the blood vessels as it moves ahead and is an important indicator of health. The pulse will give the basic information required to estimate the systolic blood pressure . Keep in mind this is a very rough estimate and only indicates if the systolic blood pressure is not low. Blood pressure monitoring should be done with a cuff and a stethoscope. However, recent advances in technology have made budget-friendly automatic blood pressure monitors easily available in pharmacies.

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    Understanding Your Blood Pressure Reading

    Blood pressure is measured in millimetres of mercury and is given as 2 numbers:

    • systolic pressure the pressure when your heart pushes blood out
    • diastolic pressure the pressure when your heart rests between beats

    The highest number is always the systolic pressure and it’s always given first. For example, a blood pressure given as “120 over 80” or 120/80mmHg means a systolic pressure of 120mmHg and a diastolic pressure of 80mmHg.

    As a general guide:

    • normal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
    • high blood pressure is considered to be 140/90mmHg or higher
    • low blood pressure is considered to be 90/60mmHg or lower

    If your reading is between 120/80mmHg and 140/90mmHg, you may be at risk of developing high blood pressure. There are things you can do to help prevent high blood pressure.

    Attaching The Blood Pressure Cuff

    manual blood pressure measurement steps

    1. Check that the blood pressure cuff size is appropriate for the patients arm and that it is fully deflated.

    2. Confirm the location of the brachial artery by palpating medial to the biceps brachii tendon and lateral to the medial epicondyle of the humerus.

    3. Wrap the blood pressure cuff around the patients upper arm, lining up the cuff marker with the brachial artery.

    • Ensure the cuff size is appropriate
    • Ensure the cuff marker is aligned with the brachial artery

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    Preparing To Check Your Blood Pressure

  • 1Verify that you have the right cuff size.XResearch source A standard size blood pressure cuff purchased from a drugstore will fit around the arm of most adults. However, if you have an especially narrow or wide arm, or if you plan to take the blood pressure of a child, you may need a different size.
  • Check the size of a cuff before buying it. Look at the “index” line. This is the range line on the cuff that tells you if it fits.XResearch source Once it is on the patient’s arm it will tell you whether or not the circumference of your arm fits within the “range” area of the cuff.
  • If you do not use the proper cuff size, you may end up with an inaccurate measurement.
  • 2Avoid factors that can increase blood pressure. Certain conditions can cause blood pressure to spike temporarily. In order to get an accurate measurement, you or your patient should avoid these conditions before taking your blood pressure.
  • Factors that can affect blood pressure include: stress, smoking, exercise, cold temperatures, a full stomach, a full bladder, caffeine, and some medications. XTrustworthy SourceAmerican Heart AssociationLeading nonprofit that funds medical research and public educationGo to source
  • Blood pressure can change throughout the course of the day. If you need to check the patient’s blood pressure regularly, try to do so at the same approximate time each day.XTrustworthy SourceAmerican Heart AssociationLeading nonprofit that funds medical research and public educationGo to source
  • Measure The Blood Pressure Accurately

    Now that you have an approximate systolic pressure, you can perform an accurate assessment of systolic and diastolicbloodpressure.

    1. Close the valve on the blood pressure cuff.

    2. Position the diaphragm of your stethoscope over the brachial artery.

    3. Re-inflate the cuff 20-30 mmHg above the systolic blood pressure you previously estimated.

    4. Then slowly deflate the cuff at around 2-3 mmHg per second.

    5. Using your stethoscope, listen carefully for the onset of a pulsatile noise. The first of these pulsatile noises is known as the first Korotkoff sound. The pressure at which the first Korotkoff sound becomes audible represents the patients systolic blood pressure.

    6. Continue to deflate the cuff, whilst listening through your stethoscope until the pulsatile sound completely disappears. The final pulsatile noise you hear is known as the fifth Korotkoff sound and represents the patients diastolic blood pressure.

    7. If the patients blood pressure is outside of the normal range you should repeat the assessment on the same arm after a few minutes and also consider assessing blood pressure using the patients other arm.

    • Palpate the brachial artery
    • Place the stethoscope over the brachial artery
    • Re-inflate the blood pressure cuff
    • Slowly deflate the cuff
    • Listen for first Korotkoff sound and note the systolic blood pressure
    • Listen for fifth Korotkoff sound and note the diastolic blood pressure
    • Remove the blood pressure cuff
    Blood pressure abnormalities

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    How Often Should You Measure Your Blood Pressure

    When and how often you take your readings will depend on your blood pressure. Speak to your doctor or nurse about whats suitable for you.

    It can be useful to monitor your blood pressure closely to begin with, then less often but at regular intervals.

    When you first start using your home monitor

    When you first start using a home monitor, measure your blood pressure in the morning and evening, every day for a week.

    Take three readings in the morning, one to two minutes apart, and the same again in the evening, and record all the readings. Take an average of the readings, but discard the first one if its much higher than the others. To take an average simply add the two readings together and divide by two. Divide by three if you use all three readings.

    Ignore the first days readings altogether, because they might not be accurate as youre not familiar with your monitor yet.

    At the end of the week you will have a useful picture of what your blood pressure is normally like.

    Your doctor might ask you to keep a record like this when they first think you might have high blood pressure and would like to know more before making a .

    After the first week

    Once you have a record of your blood pressure over a week, you can take readings less often once every one to two weeks perhaps. Your doctor or nurse can talk to you about this, theres no need to measure it too often.

    Instructions For Case Studies

    How to measure blood pressure using a manual monitor

    In our case studies you will be able to use a blood pressure cuff simulator. Using it is similar to using an actual cuff. Follow these steps: 1) Inflate the cuff by pressing the ‘Inflate Cuff’ button several times 2) Deflate the cuff by selecting one of the ‘Open Valve’ settings 3) Close the valve 4) Read the blood pressure values while listening for Korotkoff Sounds 5) Switch between dial and mercury sphygmomanometers 6) Please note that the image to the left is not a working simulation. It is an image for instructions only. Use our cases for the working simulation.

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    Introduction: How To Manually Take Blood Pressure

    Introduction

    Blood pressure is an important indicator of health. Knowing one’s blood pressure is the first step to preventing heart disease. Though most physicians take blood pressure using an automatic blood pressure monitor, knowing how to use a manual blood pressure monitor is an important skill for anyone interested in health. If you or someone you know is at risk for high or low blood pressure, it may be beneficial to invest in a blood pressure monitor for home use.

    Materials

    • test subject

    Cost

    The cost of an inexpensive manual blood pressure monitor is $16.99 at the local drug store.

    Time

    5 minutes or less

    Safety Considerations

    Do not keep blood pressure cuff inflated for long periods of time as this will limit blood circulation to the cuffed arm.

    Stethoscope Usage And Korotkoff Sounds

    The stethoscope is used on bare skin so that a clients clothing does not affect the sounds. The stethoscope does not make sounds louder it simply blocks out extraneous noises so you can better hear the Korotkoff sounds. These sounds are heard through a stethoscope applied over the brachial artery when the blood pressure cuff is deflating. You will not hear anything when you first place the stethoscope over the brachial artery because unobstructed blood flow is silent. The Korotkoff sounds appear after you inflate the cuff and then begin to deflate the cuff. The Korotkoff sounds are the result of the turbulent blood caused by the inflated cuff compressing the artery and oscillations of the arterial wall when the heart beats during cuff deflation.

    Here are a few tips:

    • Use a high quality stethoscope with durable, thick tubing. Avoid stethoscopes with long tubing because this can distort sounds.
    • Ensure quiet surroundings so that you can better hear the Korotkoff sounds.
    • Make sure that the slope of the stethoscope earpieces point forward or toward your nose.
    • Use a stethoscope that has both bell and diaphragm capacity. See Figure 5.4 for bell and diaphragm.

    Film clip 5.2: Opening and closing the bell and diaphragm

    Alternatively, if viewing textbook as a PDF, use this link: https://www.youtube.com/embed/rp_4h-tCmvs?rel=0

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    Buying And Maintaining A Monitor

    When you first get a blood pressure device, check its accuracy. Do this by comparing its readings with those you get at the doctorâs office. Ask your doctor or nurse to watch you use your device to make sure that you are doing it right and that it works right. Itâs a good idea to have your device checked every year at the doctorâs office.

    The size of the blood pressure cuff and where you place it can greatly affect how accurate your device is. If the cuff is too small or too large, the results wonât be right. You may have to measure your arm and choose a monitor that comes in the right size.

    A monitor that measures blood pressure in your arm is recommended for most people. Blood pressure monitors used on the wrist arenât as reliable as those that use arm cuffs. Wrist monitors should be used only by people who canât use arm cuffs for physical reasons. And devices that use finger monitors arenât recommended at all.footnote 1

    Check your blood pressure cuff often. Make sure all of the parts of your monitor are in good condition. Even a small hole or crack in the tubing can lead to inaccurate results.

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    Before Checking Your Blood Pressure

    Blood pressure measurement
    • Find a quiet place to check your blood pressure. You will need to listen for your heartbeat.
    • Make sure that you are comfortable and relaxed with a recently emptied bladder .
    • Roll up the sleeve on your arm or remove any tight-sleeved clothing.
    • Rest in a chair next to a table for 5 to 10 minutes. Your arm should rest comfortably at heart level. Sit up straight with your back against the chair, legs uncrossed. Rest your forearm on the table with the palm of your hand facing up.

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    Estimate An Approximate Systolic Blood Pressure

    To begin with, you need to determine an approximate systolic blood pressure. This is helpful in preventing over-tightening of the cuff during the accurate measurement of blood pressure.

    1. Ensure the valve on the blood pressure cuff is closed.

    2. Palpate the patients radial pulse, located at the radial side of the wrist, with the tips of your index and middle fingers aligned longitudinally over the course of the artery.

    3. Inflate the blood pressure cuff until you can no longer feel the patients radial pulse. Note the reading on the sphygmomanometer at the point at which the radial pulse becomes impalpable. This reading is an approximate estimate of the patients systolic blood pressure.

    4. Open the valve and deflate the blood pressure cuff.

    • Palpate the radial pulse
    • Inflate the cuff until the radial pulse is no longer palpable
    • Note the reading when the radial pulse is no longer palpable

    Blood Pressure Monitoring At Home

    Many people monitor their blood pressure at home. They often do this to manage or treat a certain health condition. If you monitor your blood pressure at home, keep a record, or log, of the measurements. The record shows your doctor how your blood pressure changes throughout the day. If you take medicines to control your blood pressure, it will help document if they are working. Measuring your blood pressure at home is a good way to take part in managing your health.

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    Wrap Cuff Around Partner’s Arm

    • Tuck the end of the cuff through the metal loop and slide onto your partners arm. Using the Velcro on the cuff, secure the cuff roughly one half inch above the bend of the elbow.
    • The cuff will have a line or arrow marked on it so that it can be properly placed around the arm.
    • Make sure the line or arrow lines up with the brachial artery in the inner elbow. The pulse felt in step one gives the general position of the brachial artery.
    • The cuff should fit snugly so that the skin is not pinched.
    • It should be possible to fit two fingertips under the cuff, but not the entirety of the fingers.

    How To Take Blood Pressure Manually

    How to: Measure Blood Pressure

    This article was co-authored by Michael Corsilles, ND. Dr. Corsilles is a Naturopath and a Physician Assistant in Washington. He completed his Naturopathic medical training at Bastyr University in 2003, and received his Physician Assistant certification from the University of Washington in 2010.There are 12 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article has 15 testimonials from our readers, earning it our reader-approved status. This article has been viewed 574,893 times.

    If you or someone you know is at risk for high or low blood pressure, you may want to invest in a manual blood pressure kit for home use. Learning how to take your blood pressure manually may take a little practice, but it is actually quite easy once you learn how. You’ll need to know what to wear, when to take your blood pressure, how to take it accurately, and how to interpret the results. With a little practice you’ll know how to find your systolic and diastolic pressure readings and what those numbers actually mean.

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    Working With Your Doctor Or Nurse

    You wont usually make a decision about treatment based solely on the readings you have taken at home. But they may find it useful to know what youre blood pressure is like when youre away from the clinic.

    Talk to your doctor or nurse before you start to measure your blood pressure at home. They advise you on when to measure your blood pressure and how often, and this can help you both to be clear about what you are doing and why.

    Bring your records with you to your appointments so they can use it to review your treatment.

    Make sure your monitor is suitable and you know how to use it

    It is a good idea to bring your monitor to the appointment so that your doctor or nurse can check that it is validated and accurate, that it fits properly, and that you know how to use it. They can show you if youre not sure.

    Read more

    For further information on home monitoring, download our booklet, .

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