How To Take Blood Pressure With Cuff

How Do I Apply The Pre

Remove tight fitting clothing from your upper arm.

Sit in a chair with your feet flat on the floor. Rest your left arm on a table so that the cuff is at the same level as your heart. Turn the palm of your hand upward.

Hold the cloth closure on the cuff with your other hand.

Turn the palm of your hand upward. Apply the cuff on your upper arm.

Align the marker on the cuff over the brachial artery on the inside of your arm.

The cuff tube should run down the center of the arm even with the middle finger.

The bottom of the cuff should be approximately ½-1 inch above the elbow.

Secure the cuff around your arm using the cloth closure.

Make sure the cuff is wrapped firmly in place.

Relax your arm and place your elbow on the table so that the cuff is at the same level as your heart.

How To Correctly Use A Blood Pressure Cuff

A blood pressure cuff is a medical device that is used to measure a persons blood pressure. It works by applying pressure to the arteries in the arm and provides medical professionals with an indication of a persons blood pressure and heart health.

In this guide to correctly using a blood pressure cuff, we will introduce the simple steps required to correctly fit a blood pressure cuff and take your blood pressure reading.

If you are seeking to measure your blood pressure at home without the assistance of a medical professional, this guide can help you obtain the most accurate reading.

In addition, there is no need to worry about complicated readings as blood pressure machines are designed to be simple to use in both clinical and home settings.

How To Use An Automated Blood Pressure Cuff Correctly

Using an upper arm blood pressure cuff might require practice, but once you get it down, its very simple. Follow the below steps suggested by Dr. Del Conde:

• Relax. Sit quietly and in an upright position for two to five minutes before checking your blood pressure.
• Keep your feet flat on the ground and your arm supported at heart levelon a table, for example.
• Place the machine on a table next to you so while youre seated, you can keep your arm next to it comfortably.
• Wear the cuff over bare skin. Place it around your upper arm about one inch above the bend of your elbow. Secure the cuff tightly and evenly, but make sure you still have room to slide two fingers under the top edge of the cuff.
• Turn the power on.
• Press the start button to begin inflation. Automatic models inflate on their own and, once inflated, release air slowly.
• Look at the screen to get your blood pressure reading, separated into two numbers: your systolic and diastolic pressures.
• Write down your blood pressure reading so you can track it over time. The systolic pressure is listed before the diastolic pressure, so it should look something like 120/80 mmHg.

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How Do I Know If My Blood Pressure Monitor Is Accurate

There are a few factors that can determine the accuracy of blood pressure monitors. The most important factor is whether or not you’re using it correctly. Beyond that, there’s also how often and reliably your monitor gives accurate measurements. You should be able to get at least three consecutive readings within ten points from one another before moving on with life without worry about an inaccurate reading affecting health decisions.

Here are the other six methods you need to take into consideration when checking your blood pressure and doing home monitoring.

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.

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Using The Wrong Cuff Size For Your Arm

Just because the cuff may fit around your arm does not mean it is the right size cuff for you. The correct cuff size is directly related to the circumference of your arm. To get accurate readings, it is important that you are using the correct sized arm cuff. To determine your arm size, use a cloth tape measure and place midway between your elbow and your shoulder around the circumference of your upper arm. Wrap the tape measure evenly around your arm. Do not pull the tape tight. Note the precise measurement in inches. Select an Omron home blood pressure monitor with the right size of cuff included, or if you already have the monitor, and need a different sized cuff, contact our consumer support line at , and they can assist you to purchase the right size accessory cuff for your unit.

New Aha Recommendations For Blood Pressure Measurement

LIZ SMITH

Am Fam Physician. 2005 Oct 1 72:1391-1398.

Diagnosis and treatment of hypertension depend on accurate measurement of auscultatory blood pressure. The lowering of target blood pressure for patients with diabetes or renal disease has made detection of small differences more important. However, blood pressure reading is one of the most inaccurately performed measurements in clinical medicine.

True blood pressure is defined as the average level over a prolonged duration. Thus, in-clinic blood pressure measurement, which generally makes no allowance for beat-to-beat variability, can be a poor estimation and may fail to catch high blood pressure that occurs only outside the clinic setting. In addition, faulty methods and the white coat effect may lead to misdiagnosis of hypertension in normotensive patients.

To increase accuracy of clinic readings, and in recognition of major changes over the past 10 years , the American Heart Association has published a new set of recommendations for the measurement of blood pressure. The AHA scientific statement, written by Pickering and colleagues, was first published in the January 2005 issue of Hypertension and also appears in the February 8, 2005, issue ofCirculation. It can be accessed online at. A summary of the AHA scientific statement follows.

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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.

What Can I Do To Help Better Manage My Blood Pressure

Managing your blood pressure doesnt have to take a lot of work. In fact, small improvements to your lifestyle can help.

• Exercise: Just be a little more active. Walk instead of drive take the stairs instead of the elevator, etc.
• Eat Smart: Try to find low-fat, low-sodium substituted that also taste great. Potassium found in bananas and carrots is natures best medicine for your heart.
• Kick the Habits: Minimize your alcohol and cigarette intake.
• Stifle Your Stress: Stress is a normal part of life. But too much can increase the risk of heart disease. Relax by doing things you enjoy and your heart can benefit.
• Monitor Your Blood Pressure at Home: Monitoring your blood pressure at home on a regular basis provides you and your doctor with the information to best manage your blood pressure.

These are just some examples. Discuss with your doctor on other ways how you can better your heart.

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Current Drawbacks Of Cuff

Several limitations pertain to the currently available cuff-less BP technology.

Second, the current measurement methods based on PTT and tonometry are sensitive to motion artifact and loss of signal upon movement. In several of the aforementioned studies on cuff-less PTT-based devices, researchers encountered a high rate of measurement errors and calibration errors . Tonometry-based cuff-less devices need to be tightly coupled to the underlying artery usually with an adhesive tape to prevent loss of coupling and loss of measurements .

Additionally, the software and data transfer on the back end of most of the cuff-less BP measurement modalities is critically underdeveloped. This is a clinically relevant concern, since frequent BP self-measurement without a co-intervention from a healthcare provider does not seem to affect BP control much .

Finally, for all of the current cuff-less BPT technologies, it is presently unclear how the measured values in real life will relate to clinical or cuff-based home BP measurements. Because cuff-less methods make it much easier to perform measurements on the go, it is likely that these measurements are substantially different from resting BP values. Prospective clinical studies would need to assess how these measurements compare to conventional BP measurements, and what values or trends are ultimately associated with adverse outcomes. This would provide a scientific basis for medication adjustments using cuff-less BPT.

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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When To Check Blood Pressure

If youre using a blood pressure monitor on your doctors advice, he or she should tell you when to take readings. As a rule, though, you should take them at the same time of day on each occasion, so youre comparing like with like.

Take a few readings each time, a couple of minutes apart, and calculate the average to make the figures more representative. And if your blood pressure monitor doesnt store your readings for you, jot them down in a notebook to get an idea of long-term trends.

References:

Bupa . High blood pressure. Retrieved from www.bupa.co.uk/health-information/heart-blood-circulation/high-blood-pressure-hypertension

American Heart Association . Monitoring your blood pressure at home. Retrieved from www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/monitoring-your-blood-pressure-at-home

Is It Normal For My Blood Pressure To Vary

Yes, it is quite normal for peoples blood pressure to change throughout the day and night, or in different settings where you may measure your blood pressure. Many things, such as stress levels, food or drink intake, activity levels, even time of day can all affect a persons blood pressure reading at any given time. In fact, there are published studies that show a given persons blood pressure can change by up to 20mm within a day, based on activity levels, food/drink intake, stress, etc. This is why it is important to take your blood pressure on a regular basis, and review the overall trend of your blood pressure readings with your doctor.

For a convenient tool to help you easily track your blood pressure readings, click here.

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Choose A Validated Monitor

When in doubt, Dr. Nguyen you make sure the monitor is validated, which means it meets testing standards. And because that can be hard knowledge to glean off-hand, you can check it through ValidateBP.org, an American Medical Association-hosted site that lists only blood pressure monitors that meet rigorous testing standards. You can go to the site, use the different built-in filters to find the right cuff for you based on what you need and then search online to actually purchase it.

A& d Blood Pressure Cuff Sizes

A& D offers a fit chart that lists the correct cuff size to use with their products based on your arm size. While many peoples arms will fall into the 8.6- to 16.5-inch circumference range covered by the standard AccuFit Plus Wide Range cuff , which is available with most A& D blood pressure monitors, including the UA-651BLE commonly used by MyNurse members, you may need a larger or smaller cuff.

If your arm circumference is larger than 16.5 inches and you want to stick with an A& D monitor, youll need the X-Large cuff , which is only compatible with the UA-789AC blood pressure monitor. If you suspect this is the case or need help with measuring your arm, contact us and well be happy to help you find a cuff or new device that suits your needs.

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My Own Blood Pressure Cuff Study

I wanted to conduct my own study about how my blood pressure was affected using my home monitor with a proper cuff size. First, I measured my blood pressure with the cuff wrapped with the proper tightness.

I measured my blood pressure three times to achieve accurate results. The following were my blood pressure measurements:

• 116/71
• 118/72
• 117/71

After resting for one minute, I immediately tightened the cuff too tight. I was barely able to slip one finger under the lower edge of the cuff. I measured my blood pressure three more times with the following results shown in the table below.

BP With Proper Cuff Adjustment	BP With Cuff Too Tight
116/71

The following were my average blood pressure readings:

• Proper Tightness: 117/71.3 mmHg
• Cuff Too Tight: 112.3/70.5 mmHg

After making the cuff too tight, the systolic blood pressure dropped almost 5 mmHg and diastolic almost dropped 1 mmHg. The results of my study confirmed the research saying blood pressure will measure lower when more of the arm circumference is squeezed by the cuff bladder.

A cuff secured too tight doesnt always indicate a lower reading. Remember, the cuff used in my study is the correct size for my arm. If the cuff is too tight for a different reason, as discussed in the articles next section, the measurement may be higher.

What Are Some Common Reasons Why My Blood Pressure Readings Seem Higher Than Expected

There are many reasons why blood pressure readings may seem high. Below are some of the common reasons and the estimated ranges of how much readings can vary. It is important to ensure you are using the monitor as it was intended, so please make sure you are following the directions in the instruction manual, or call our consumer support line at if you have questions. It is also important to note that if you can continue to see high readings, discuss with your doctor or a medical professional it is possible that your blood pressure is actually higher than what you believe it to be.

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How Do I Assemble And Apply The D

When the cuff is assembled correctly, the hook material will be on the outside of the cuff loop and the metal d-ring will not touch your skin. If the cuff is not assembled, pass the end of the cuff furthest from the tubing through the metal d-ring to form a loop. The smooth cloth should be on the inside of the cuff loop.

Remove tight fitting clothing from your upper arm.

Sit in a chair with your feet flat on the floor. Rest your left arm on a table so that the cuff is at the same level as your heart. Turn the palm of your hand upward.

Put your left arm through the cuff loop. the bottom of the cuff should be approximately ½ inch above the elbow. The cuff tab should lie over the brachial artery on the inside of the arm. The cuff tube should run down the center of the arm even with the middle finger.

Secure the cuff around your arm using the cloth closure. Pull the cuff so that the top and bottom edges are tightened evenly around your arm.

Make sure the cuff is wrapped firmly in place. You should be able to fit your index finger between the cuff and your arm easily.

Relax your arm and place your elbow on the table so that the cuff is at the same level as your heart.

Be sure there are no kinks in the air tubing.

Manual Blood Pressure Readings

Blood can only be heard through a stethoscope if it is turbulent. As the cuff is inflated, the artery is compressed, making the blood flow through the artery turbulent. When the artery is completely closed, there is no blood flow and no sound. As pressure in the cuff is reduced, the point at which the artery is open just enough to let the blood pass, is the systolic blood pressure.

This is detected by turbulent blood flow heard through the stethoscope. As pressure in the cuff is further reduced, the vessel will once again be completely open and non-turbulent. At this point, no more sound is heard and diastolic blood pressure has been reached.

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