Blood Pressure Assessment
"I am not sure, I think I heard 160/80 or something like that," the new first responder said to me. When we got back to the station, I gave him these tips for blood pressure auscultation.
1. Check the patient's radial pulse so you know the rate and rhythm you will be hearing.
2. Bare the patient's arm.
3. Don the stethoscope with the ear pieces angled forward — the same direction as your ear canals.
4. Apply the BP cuff snuggly to the patient’s bare arm — over the bicep, not the antecubital space.
5. Straighten the patient's arm to bring the brachial artery closer to the surface of the skin.
6. Know the location of the brachial artery as it passes through the antecubital space (this pulse should be palpable at the anterior aspect of the elbow).
7. Place the stethoscope where you palpated the brachial artery.
8. Don't place the stethoscope under the cuff — this is not TV.
9. After inflating the cuff look away from the sphygmomanometer (the thing with the numbers).
10. Deflate the cuff slowly until you hear the pulse — then look for the systolic blood pressure number.
11. You know the rest …
If you can't hear anything, try the patient’s other arm. If that doesn't work, assess blood pressure by palpation. Share your blood pressure auscultation and palpation tips and tricks in the comments area.