Blood pressure

Blood pressure:

• patient relaxed (preferably sitting quietly for >5mins)
• position arm at heart level (if seated, arm should be resting on table or other surface)
• place inflatable bladder around arm
• palpate radial pulse and inflate cuff until pulse disappears – read this value and add 30mmHg
• place bell of stethoscope over brachial artery – inflate cuff rapidly until reach the previously determined value +30mmHg
• slowly deflate cuff and note level at which can hear two consecutive beats  systolic pressure
• continue to deflate cuff until sounds disappear  diastolic pressure

Common errors in blood pressure measurement:
• taking blood pressure when patient is anxious  falsely elevated
• arm above or below level of heart
• inaccurate cuff size
• deflating cuff too quickly  false low systolic pressure or false high diastolic
• deflating cuff too slowly  false high diastolic
• observer error (eg bias, haste

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