Blood pressure- procudure

Equipment – mercury sphygmomanometer

Sphygmomanometer

Cuffs

Watch and thermometer

Stethoscope Measurement tape

Stop watchSomething to elevate the device

Equipment – automated device

Watch and thermometer

Measurement tape

Cuffs

Measurement device

Exclusion criteria

• Blood pressure is not measured if a participant has• Both arms amputated• Cast on both arms• Open wounds/sores on both arms• Rash on both arms• Malformation on both arms preventing

to place the cuff• Lymph node malfunction in both arms

Setting up the measurement site

• Room should be• Quiet• Comfortable temperature• No disturbance

• Measurement device placement• Measurer has clear view• Participant cannot see the

results• If mercury

sphygmomanometer is used, mercury column at the eye level of the measurer

Instruction to the participants

• Before blood pressure measurement, participants should abstain from • Eating• Drinking (except water)• Smoking• Heavy exercise• Taking drugs that affect blood pressure

for one hour before the measurement

Position of the subject

Feet resting on the floor, not crossed

Back supported

Position of the arm

Right arm, resting on the desk

Palm is facing up

In line with heart

Removal of clothingSleeves rolled up, not constrictive

Remove constrictive sleeves

Selection of the cuff

• The bladder of the cuff should be• Width: At least 40%

of the arm circumference

• Length: At least 80% of the arm circumference

Measurement process

• Participant is asked to sit still for 5 minutes

• Participant is asked not to talk during the measurement

• Arm circumference is measured and cuff selected

Cuff is placed 2-3 cm above antecubital fossa

By automated device

• After the cuff has been placed, follow the instructions of the used device

• Measure blood pressure 3 times, one minutes between measurements

By mercury sphygmomanometer (1)

• The radial pulse is palpatated and the pulse rate is counted for 60 seconds

• Record 60 sec pulse count and whether or not the pulse was regular

By mercury sphygmomanometer (2)• Determine the

peak inflation level• The brachial pulse

is located and the bell of the stethoscope is placed

Inside the bicep muscle tendon

Not touching the cuff, rubber or clothing

By mercury sphygmomanometer (3)• Inflate the cuff rapidly

to the peak inflation level

• Deflate at the rate of 2 mmHg/second

• Systolic blood pressure: Korotkoff Phase I

• Diastolic blood pressure: Korotkoff Phase IV

• Record measurement to the nearest 2 mmHg

• Wait 1 minute• Repeat measurement

two more times

Quality assurance – mercury

sphygmomanometer• Daily

• Shape of the meniscus • Rise of the mercury• Zero level of the

mercury• Cracks in the glass tube• Screw at the tops of the

calibrated glass tube• Air tube for cracks and

tears

• Weekly• Cuffs

• Material• Condition

• Stethoscopes• Condition

• Device• Air leaks

Quality assurance –automated device

• Weekly• Under consideration

• Daily• AC adapter cord of the

device is securely plugged in or

• Batteries have power• Air tubes for cracks and

tears• Secure attachment of

the tubes