Welch Allyn Vital Signs Monitor - User Manual - Manual (Page 53)

Vital Signs Monitor 47
Quick Guide to Taking a Manual (Auscultatory) Blood Pressure
Action Explanation
1 Collect appropriate equipment.
• Use a certified accurate sphygmomanometer
and quality stethoscope.
• Select a blood pressure cuff of a suitable size.
Use a blood pressure cuff of the largest appro-
priate size for patient (see markings on inside of
cuff).
Many sphygmomanometers are inaccurate. Low
quality stethoscopes do not transmit sound well
enough for blood pressure sounds to be heard
accurately. A cuff that is either too large or too
small will produce an inaccurate reading.
2 Have the patient assume a comfortable position
with the upper arm relaxed at heart level and
the lower arm passively supported. If the arm is not at the proper level, inaccurate
readings will result.
3 Expose the area of the brachial artery by remov-
ing clothing, or move a sleeve, if not too tight,
above the area where the cuff will be placed. Clothing over the artery hinders the ability to hear
and may cause inaccurate readings. Tight cloth-
ing may cause vessel congestion and inaccurate
readings.
4 Center the cuff bladder so that the lower edge
is at least 1 inch (2.5cm) above the bend of
inner arm of the elbow. This places the cuff in the best position for
occluding the blood flow through the brachial
artery.
5 Palpate the brachial or radial pulse. Determines the most accurate location for
assessment and approximation of systolic pres-
sure.
6 Inflate the cuff until the pulsation disappears.
Then continue to inflate until the pressure reads
30 mmHg above the point where the pulse dis-
appeared. Facilitates identification of Phase One of Korot-
koff sounds.
7 Listen carefully with stethoscope over brachial
artery while controlling the release of air at a
rate of 3 mmHg per second. One of the major sources of error in auscultatory
blood pressure measurement is deflating the cuff
too quickly. It is a normal operation of the Welch
Allyn Vital Signs Monitor to deflate at the Ameri-
can Heart Association recommended 3 mmHg
per second.
8 Systolic is determined by reading the manome-
ter gauge when the first faint but clear tapping
sound is heard with the stethoscope. Follows AHA recommended standards.
9 Diastole, in adults, is determined by reading the
manometer gauge to the closest even number
when the last sound is heard. Follows AHA recommended standards.
Diastolic blood pressure in children is the point at
which the sound becomes muffled.
10 Release the air quickly after at least 10 to 20
mmHg of silence.