Anaeroid blood pressure cuffs are the type of blood pressure monitoring device that has a cuff and a dial. These cuffs are much more accurate than the "free" machines found in the supermarket that are not always maintained and often give false results and the "automatic" machines used to monitor blood pressure that have to be replaced much more often. Directions for measuring blood pressure with an aneroid cuff are necessary for measuring blood pressure with this device until experience is gained. Aneroid cuffs are the most cost-effective and accurate way to take blood pressure readings but also require several steps that need to be done carefully.
Instructions
1. Check the cuff to make sure that it is the proper size. It should not be loose on the bare arm and should have room for a finger to slide in before it is inflated. According to the 12th edition of the Handbook of Nonprescription Drugs (APhA, 2000) the upper-arm size for the regular adult cuff should be less than 31cm, while the large adult cuff should be used if the arm size is between 31 to 40cm. If the arm is greater than that, it is recommended that a thigh cuff is used. On the cuff should be an indicator that shows where the Velcro should attach if the cuff is to fit properly. If the cuff is too big, the indicator will be covered up with the excess cuff and it will detach as it inflates and give number that are not accurate. If the arm is too small for the regular adult cuff a small or child sized cuff may be used as appropriate. Mark the cuff size used in a record of blood pressure kept in a small notebook or on a piece of paper. Also record the arm being measured from as right of left.
2. Prepare for the measurement by removing restrictive clothes from the arm. The arm should be bare where the cuff will be placed. Move the legs so that the feet are resting flat without cutting off circulation in shorter patients. The patient should not cross legs while seated because it can interfere with the readings. Place the arm to be measured palm-up with the cuff a few inches above the bend of the elbow. The positioning of the arm should be at about nipple level so that it is not above of below the heart. A pillow may be required for some patients to bring the arm to this level for a consistent blood pressure measurement. Rest the arm for at least 5 minutes in this position. Place the dial in a readable position (clip is somewhere or hold it loosely).
3. Locate the brachial and radial pulses. The radial pulse is found by placing the index and middle finger tips into the outer crease of the wrist next to the tendons. Press firmly and a pulse should be felt. This is the radial pulse. Using the stethoscope, find the brachial pulse just two to three fingers above the slightly bent elbow on the inner third of the arm. This is found by firmly pressing with the finger tips. The brachial pulse pressure point should run parallel on the inner side of the arm. If the pulse is not immediately apparent, feel around for it until the pulse is found. Position the marker on the cuff (a line on the cuff) directly above the brachial artery when it is found. Make sure that the room is quiet before proceeding further.
4. It may be necessary to move the cuff up an inch or more to make space. The brachial pulse pressure point is where to place the stethoscope to listen for a pulse. Place the stethoscope lightly on the location and do not let it touch the cuff, if possible. If you are taking your blood pressure alone, this may be the only way to keep the stethoscope in place while you listen to the brachial pulse. Without inflating the cuff, take a thirty seconds measurement of the heartbeats per minute using the radial pulse. Close the thumb valve (the metal dial/valve on the hose leading from the bulb to the cuff). Pressing the stethoscope firmly into the brachial artery with one hand, quickly inflate the cuff to 80mmHg with the other hand. Listen carefully every 10mmHg while adding pressure in increments until the pulse disappears. Keep going for another 30mmHg just to make sure that the pulse is gone. Record this number as the maximum pressure level.
5. Repeat the procedure but do not go the 30mmHg above the place where the heartbeat stopped at the maximum pressure level. Slowly (by 2mmHg/second) decrease the pressure by opening the thumb valve the appropriate amount with the same hand that was used to inflate the cuff by squeezing the bulb. Listen carefully for the pulse to start making noises again as the cuff deflates and record the reading in mmHg (on the dial) as the systolic pressure level. Keep listening for the point at which the last heartbeat is heard for the diastolic pressure measurement. Continue listening for 20mmHg more to make sure that it was the last heat beat heard. Record these two numbers in a notebook or on a piece of paper. Do these measurements three times using this step.
Tags: blood pressure, blood pressure, brachial pulse, sure that, adult cuff