Issues taking manual blood pressure Watch

Happy_Holidays
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#21
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#21
(Original post by anna_spanner89)
thats really helpful, how do you release the air in the cuff gradually? I'm finding it tough getting it slow and steady as it can be so stiff!


how would you take blood pressure as whole then?
I find the radial pulse, inflate the cuff till i can't feel the pulse...and take that as my systolic but im not 100% sure if thats right
Yeah you want to release the air gradually, about 2 per second.
To take a blood pressure as I whole I would stick the cuff on, put my steth on the brachial (I don't tend to feel for it as I'm pretty good at sticking it on about the right place), I would then inflate the cuff whilst listening for the dystolic then systolic, having heard the systolic I'd got 20 over that and start deflating at about 2 per second recording systolic and dystolic. If I needed to then I'd inflate it again slightly if I wasn't sure of the reading.

Although I was taught the radial pulse way as well I have found that steth on brachial is usually easy as you know the approx dystolic and systolic not just the systolic. It also reduces the time the patient has the inflated cuff on as you don't have to mess about putting it on their brachial whilst they have to cuff inflated.

You can get just the systolic without a steth doing it the way you discribed.

Its always very exact and most the time as long as you not too far out it doesn't really matter.
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Asclepius
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#22
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#22
(Original post by anna_spanner89)
thats really helpful, how do you release the air in the cuff gradually? I'm finding it tough getting it slow and steady as it can be so stiff!


how would you take blood pressure as whole then?
I find the radial pulse, inflate the cuff till i can't feel the pulse...and take that as my systolic but im not 100% sure if thats right
If you can manage it then its better to be using the brachial pulse. Can you find your own consistently? Find the biceps tendon and try palpating just medial to that.

Once you have the pulse, inflate the cuff until you can no longer feel it, and this is around the systolic pressure. We're then taught to add 20mmHg to this (but this most likely varies from place to place) and then inflate to the final pressure (pressure by palpation + 20) when auscultating.
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TommyWannabe
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#23
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#23
(Original post by anna_spanner89)
I own my own stethoscope luckily, as it was given to me by the rcn for joining them- plus its needed!


i try and find where the pulse is first, and then use the stethoscope- i can hear nothing at all in a stethocope though, can never hear a thing and its getting on my nerves a bit- even apex beats, etc...and its turned on! (first few times it wasn't lol)
Umm well you won't be able to hear anything when the cuff isn't inflated (or it'll be very quiet), it's only when the cuff is inflated to a certain extent and the blood has to be forced through the narrowing of the vessel, you can hear the beat.

As for the radial, I've never done it that way but it works fine.

Instead of pumping until you can't feel anything and recording that measurement, pump until you can't feel anything, then gently release the cuff until you CAN feel something. That is your diastolic.

Already been answered better though lol.
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anna_spanner89
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#24
(Original post by TommyWannabe)
Umm well you won't be able to hear anything when the cuff isn't inflated (or it'll be very quiet), it's only when the cuff is inflated to a certain extent and the blood has to be forced through the narrowing of the vessel, you can hear the beat.

As for the radial, I've never done it that way but it works fine.

Instead of pumping until you can't feel anything and recording that measurement, pump until you can't feel anything, then gently release the cuff until you CAN feel something. That is your diastolic.

Already been answered better though lol.

i'll try inflating the cuff a bit then finding the brachial and see if that works...

are people with 'larger frames' aka fat people harder to take a blood pressure reading from?
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TommyWannabe
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#25
(Original post by anna_spanner89)
i'll try inflating the cuff a bit then finding the brachial and see if that works...

are people with 'larger frames' aka fat people harder to take a blood pressure reading from?
I always found them a bit more difficult but only because it's more difficult to get the cuff on and hold everything in place lol. Nothing better than a lovely skinny person.
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Asclepius
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(Original post by TommyWannabe)
Umm well you won't be able to hear anything when the cuff isn't inflated (or it'll be very quiet), it's only when the cuff is inflated to a certain extent and the blood has to be forced through the narrowing of the vessel, you can hear the beat.

As for the radial, I've never done it that way but it works fine.

Instead of pumping until you can't feel anything and recording that measurement, pump until you can't feel anything, then gently release the cuff until you CAN feel something. That is your diastolic.

Already been answered better though lol.
Are you talking about going beyond the point that a pulse can no longer be palpated, and then releasing pressure until it can be palpated again? Because that would still be systolic
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anna_spanner89
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#27
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(Original post by Alex L)
If you can manage it then its better to be using the brachial pulse. Can you find your own consistently? Find the biceps tendon and try palpating just medial to that.

Once you have the pulse, inflate the cuff until you can no longer feel it, and this is around the systolic pressure. We're then taught to add 20mmHg to this (but this most likely varies from place to place) and then inflate to the final pressure (pressure by palpation + 20) when auscultating.

i've been told to add 30...so does the marsden, its hard to get it exact though i guess

just found my brachial for the first time lol hmm maybe its worth investing in my own kit, for pratice.
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TommyWannabe
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#28
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(Original post by Alex L)
Are you talking about going beyond the point that a pulse can no longer be palpated, and then releasing pressure until it can be palpated again? Because that would still be systolic
Yes sorry I meant systolic.
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anna_spanner89
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#29
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(Original post by TommyWannabe)
I always found them a bit more difficult but only because it's more difficult to get the cuff on and hold everything in place lol. Nothing better than a lovely skinny person.

i like it when im a bit drunk and bp is rather high, if i stretch my arm out you can see the pulse on my wrist lol
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Asclepius
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#30
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#30
(Original post by anna_spanner89)
i'll try inflating the cuff a bit then finding the brachial and see if that works...

are people with 'larger frames' aka fat people harder to take a blood pressure reading from?
You're better off finding the brachial before inflating at all, else you'll end up with a pt in some discomfort whilst you're trying to find their pulse. Get the pulse then inflate
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Happy_Holidays
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(Original post by TommyWannabe)
Umm well you won't be able to hear anything when the cuff isn't inflated (or it'll be very quiet), it's only when the cuff is inflated to a certain extent and the blood has to be forced through the narrowing of the vessel, you can hear the beat.

As for the radial, I've never done it that way but it works fine.

Instead of pumping until you can't feel anything and recording that measurement, pump until you can't feel anything, then gently release the cuff until you CAN feel something. That is your diastolic.

Already been answered better though lol.
Systolic

(Original post by anna_spanner89)
are people with 'larger frames' aka fat people harder to take a blood pressure reading from?
They can be but unless they are seriously overweight its usually not too bad. Might just be a bit quiter and a bit harder to find the brachial.
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TommyWannabe
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#32
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(Original post by Happy_Holidays)
Systolic
Yes sorry, I'm just tired.
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Asclepius
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#33
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#33
(Original post by anna_spanner89)
i've been told to add 30...so does the marsden, its hard to get it exact though i guess

just found my brachial for the first time lol hmm maybe its worth investing in my own kit, for pratice.
There is no right or wrong answer tbh, just an adequate margin.

Just keep practising getting it on yourself until you can get it without fail, just cause sick people tend to be awkward with difficult to palpate pulses :tongue:
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Asclepius
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#34
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(Original post by TommyWannabe)
Yes sorry I meant systolic.
I was wondering if I was really tired and hence confused
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TommyWannabe
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Anna we're all giving you different ways of doing it!

I wouldn't listen to us, find a really experienced nurse (i.e who did it before machuines were invented) and get them to show you properly.

We're all giving you different methods.
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Happy_Holidays
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(Original post by Alex L)
There is no right or wrong answer tbh, just an adequate margin.

Just keep practising getting it on yourself until you can get it without fail, just cause sick people tend to be awkward with difficult to palpate pulses :tongue:
Or stupidly high / low BPs so you think you haven't got it when in reality you haven't gone high / low enough.
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anna_spanner89
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#37
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nah i like being told different methods, when im in the skills lab tomorrow i'll pratice them and try what works for me!
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Happy_Holidays
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(Original post by TommyWannabe)
Anna we're all giving you different ways of doing it!

I wouldn't listen to us, find a really experienced nurse (i.e who did it before machuines were invented) and get them to show you properly.

We're all giving you different methods.
Or a Paramedic
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anna_spanner89
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#39
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#39
(Original post by Happy_Holidays)
Or stupidly high / low BPs so you think you haven't got it when in reality you haven't gone high / low enough.

is it normal to constantly have a low bp? im worried about it, as mine constantly seems to be 102/60...and im not ill or anything, i was expecting it to be high tbh...
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Asclepius
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(Original post by Happy_Holidays)
Or stupidly high / low BPs so you think you haven't got it when in reality you haven't gone high / low enough.
Hence the reason for palpating to start with, means that you inflate to an adequate pressure
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