How to Take Manual Blood Pressure | Sphygmomanometer
The patient's blood pressure can be taken while the patient is supine, seated, standing.
In the common seated position, the patient's arm should be at the level of the heart.
The arm should be supported and flexed a little.
If the subject is anxious, wait a few minutes before taking
Use a properly sized blood pressure cuff. The length of the
cuff's bladder should be at least equal to 80% of the
circumference of the upper arm.
Wrap the cuff around the upper arm with the cuff's lower edge
one inch above the antecubital fossa.
Lightly press the stethoscope's bell over the brachial artery
just below the cuff's edge. Some health care workers have
difficulty using the bell in the antecubital fossa, so we suggest
using the bell or the diaphragm to measure the blood pressure.
Rapidly inflate the cuff to 180mmHg. Release air from the
cuff at a moderate rate (3mm/sec).
Listen with the stethoscope and simultaneously observe the
sphygmomanometer. The first knocking sound (Korotkoff) is the
subject's systolic pressure. When the knocking sound disappears,
that is the diastolic pressure (such as 120/80).
Record the pressure in both arms and note the difference;
also record the subject's position (supine), which arm was used,
and the cuff size (small, standard or large adult cuff).
If the subject's pressure is elevated, take two additional
blood pressure measurements, waiting a few minutes between
Blood pressure ca rises as a result of the patient's stress level,
smoking, recent exercise, exposure to cold temperatures and
A BLOOD PRESSURE OF 180/120mmHg OR MORE REQUIRES IMMEDIATE
Aneroid and digital manometers may require periodic calibration.
Use a larger cuff on obese or heavily muscled subjects.
Use a smaller cuff for pediatric patients.
For pediatric patients, lower blood pressure may indicate the
presence of hypertension.
Don't place the cuff over clothing.
Flex and support the subject's arm.
In some patients, the Korotkoff sounds disappear as the systolic pressure is bled down. After an interval, the Korotkoff sounds reappear. This interval is referred to as the "auscultatory gap." This pathophysiologic occurrence can lead to a marked underestimation of systolic pressure if the cuff pressure is not elevated enough. It is for this reason that the rapid inflation of the blood pressure cuff to 180mmHg was recommended above. The "auscultatory gap" is felt to be associated with carotid atherosclerosis and a decrease in arterial compliance in patients with increased blood pressure.
General Guide to Blood Pressure Readings
140/90mmHg or higher indicates possible high blood pressure
120/80mmHg to 140/90mmHg indicates pre-high blood pressure
90/60mmHg up to 120/80mmHg indicates ideal blood pressure