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Blood Pressure

How to Take a Blood Pressure Manually

junio 5, 2018

[VidSitePro id=6 ]hey everyone it’s sarah with registered nurse RN comm and today i want to go over with you how to take a blood pressure manually in the hospital settings we’re blessed because we have automatic blood pressure monitors that take our blood pressures constantly for our patients but there are times in the settings where we’ll have to take them manually especially if we don’t trust the monitor or you can’t sometimes the monitor won’t read a patient’s blood pressure because their blood pressures too low so you have to know how to take a blood pressure manually so in this video I’m going to go over how to take a blood pressure manually I’m actually going to perform the skill and you’ll get to watch me do it and see how I do it and I want to give you some quick tips that I’ve just learned over the years with taking blood pressures manually so first let’s go over equipment okay this is a manual blood pressure cuff you can get these anywhere Walmart off the internet anything typically you have it comes with a cuff it comes and make sure because sometimes people buy these and they don’t come with this big mama tur spigot mol manometer and always make sure that whenever you’re buying it says with this big moment ometer because sometimes you’ll just get the cuff and the the rubber bulb but you won’t get that and you’d have to buy that extra this is the big thing of it so make sure that it comes with this and you have your rubber bulb that blows up with an open and closed valve and a lot of times they come with little neat carrying bag so if you’re a home health nurse you have to travel a lot or you’re just wanting to take your own blood pressure it’s real neat to have your own cup um also you need a stethoscope many times if you’re just learning to take your own blood pressure that’s why you’re watching this video this Cup actually came with the stethoscope but I like my own set the scope but a lot of times they come with a set scope so you’ll need your cuff your big Amal manometer and a but M sub scope so let’s go over exactly the steps of how to take a blood pressure and then we will talk then you’ll actually see me perform the skill okay whenever you’re taking a blood pressure in the clinical setting anywhere you want to have the patient set down have them be calm for about three to five minutes if they’re anxious the real nervous or crying or something like that have them set sail for three to five minutes setting in a chair with their legs uncross and their arm at heart level then what you will do you’ll get your cuff and you need to make sure that you have the right size cup if you have too large of a cup or too small of a cup you will get an inaccurate reading which is not good so whenever you put your cuff on the patient take a look at the patient’s arm and you can tell if the patient is really little in this area you probably need a smaller adult or if they have a larger arm you might need a large cup how you tell is that you put the cuff on the arm which I’ll show you with my patient that we’ll be doing here in a second and you stick two fingers underneath the cuff and if they fit just right you have the right sized cup if not if it’s too tight to loose you need to get another size cuff next you’re going to ask your patient what arm you can take their blood pressure in some people have preferences and make sure the patient has not had an AV shunt placed in their arm or they have an IV in their arm or a PICC line they’ve had a mastectomy or history of blood loss anything never want to take a blood pressure in that type of arm so put your cup on the patient you’re going to feel for the brachial artery and I want you to pack this this with me your brachial artery is found on your elbow and it’s the distal part closest to your body and the best thing is to extend your arm out as much as you can and feel that bounding and I can feel mine right now and that is your brachial artery that is the artery that we’re going to be feeling and listening for so you’ll put your cuff on the patient and on your cuff you will notice these little arrows and you’ll have an arrow down that’ll say left arm you have an arrow down that says right arm so if you’re using the left arm you’re going to make sure that that arrow is literally right on or slightly above that brachial artery so you’ll put that on there and then you’ll take your set the scope and your stethoscope has two sides to it it has a diaphragm and a bail studies have shown that it’s really personal preference on what side you want to listen to I like to listen with my diaphragm so you’re going to take your sub scope put it put it in your ears and you’re to take the Steyr frame and you’re going to put it over that brachial artery then you are going and when you hear it you’re going to inflate the cuff with the rubber bulb and typically you inflate until you cannot hear the brachial artery anymore this is generally on your little spigot momen ometer you will inflate all the way up to 180 to 200 to 200 millimeters of mercury 180 is usually sufficient enough another how you can know how much to inflate is ask the patient what their top number which is their systolic normally runs and if they say it runs a hundred you would inflate to 130 240 millimeters of mercury so the rule is usually to inflate 30 to 40 millimeter millimeters of mercury more than what they say that their blood pressure is but I like to stick with 180 so you inflate there once you inflate you start you take your rubber bow and you start letting out air slowly very slowly if you do it too fast you’ll get an inaccurate reading you do it slow where you’re seeing that needle drop down two to three millimeters of mercury and let me show you what I’m talking about behind me I have I’ve drawn it’s not the best drawing but I’ve drawn a little speaking spin Amal manometer that you would see and your needle typically starts right here at the end and as you inflate it goes up so where you would all want already inflate to the 180 mark then when you’re letting out the air to a hundred and two to three millimeters of mercury you’re going to do it slowly so it’ll do something like this you’ll see this little needle and it’ll just start going slowly and then all of a sudden you’ll hear both okay so we’ll pretend we heard the boof at the 120 mark so we’re systolic is 120 then you’ll keep hearing the noise you’ll keep hearing boo boo boo boo boo boo boo boo boo boo boo boo boo boo and then all of a sudden it’ll stop and you make know where it stopped that and we’ll say it stopped right here which is the 70 mark and that is our diastolic so the patient’s blood pressure is 120 over 70 then after you get that what you’re going to do is you’re going to open the valve all the way let all that air come out and tell the patient what their blood pressure is always tell the patient what their blood pressure is a lot of patients want to know and some people may not ask you because I feel like it might be rude to ask so just let them know and explain what that reading means a lot of people’s like well as I higher is that love and explain to them what that is a normal blood pressure reading is usually 120 over 80 but we’re not we’re not all perfect and we all can’t have that great blood pressure typically the golden rule you want that top number to be at least 100 and if the top which is on a little bit of a lower side but if that top number starts going the 150s 160s 180s high that’s not good that’s hypertension you’ll need to let the doctor know now that’s how you take a blood pressure so let’s go over some quick tips and then we’ll do our skill you want to use that correct size remember the two finger rule fit it underneath the cuff make sure it doesn’t fit too snug too tight just right and if the patient has smoked so always ask them if they’ve smoked if they ate or they just got done exercising it’s best to wait about thirty minutes before you take that blood pressure because you can get an inaccurate reading and again no blood pressures in patients whose hat who’ve had a V Shutts mastectomies blood clots anything like that so now let’s do our skill of recording or getting a blood pressure here we have our patient it is my awesome husband Ben and he is here to be my test dummy for doing our blood pressures so the very first thing you want to do is you want to have your patient sat down and if they’ve been running around or really anxious or talking you want them to be calm for at least three to five minutes before you take their blood pressure because you want to get the most accurate response then you will have them have their legs uncrossed and have their arms down by their side and you want to ask them what arm you can take their blood pressure in because a lot of patients are have preferences on what blood what arm you can use especially if they’ve had an AV shunt or a blood clot in the arm or mastectomy you would never want to take a blood pressure in that arm so I’m going to use bins left arm you want to get your manual blood pressure cuff and your stethoscope and what we’re going to do is we’re going to put on our left arm and on your blood pressure cuff you have little arrows that say left and right these arrows are meant to go over the brachial artery so we’re going to slider cuff up through the brachial artery and I’m going to just feel on his brachial artery where his artery is and it’s always on the inside of the elbow and always have them Bend that arm up really good because it pushes the pulse up and he has a really nice one right there so what I want to do is I’m going to take where it says that left arm arrow and I’m going to put it right about two inches above that artery that’s where you want the cuff to rest above the elbow about one and a half to two inches and you always want to make sure that your cuff fits the patient you have really small patients and then you have some obese patients who would need larger or smaller cups and to check your cuff size use two of your fingers and just slide it underneath the cup make sure it fits good not too snug not too loose because if you have a blood pressure cuff that does not fit you will get an inaccurate reading and this cuff fits him great so we have that now what we’re going to do so we’re going to get our Spig monitor and we’re going to just clip it here you can do whatever you want with it as long as you can see it because this is going to tell us everything that we need to know for his blood pressure now what I want to do with my stethoscope is I’m just going to listen at that artery and a lot of people and it really doesn’t matter you can listen with the diaphragm or the Bell of your stethoscope studies have shown it does not matter I like to use my diaphragm so I’m going to place it over his brachial artery let me fill it again fill it right there and now I’m going to close the valve on the blood pressure cuff and I’m going to pump it up you pump it up at least 30 to 40 millimeters of mercury of what they say that their blood pressure is a lot of patients don’t know what their blood pressure normally runs so it’s always safe to say to blow the cuff up to 180 to 200 millimeters of mercury that’s usually sufficient enough in a patient so what we’re going to do is we’re going to inflate our cuff to that amount or until we do not hear the brachial artery anymore like I said we’re going to inflate to about 120 I mean 180 millimeters of mercury then we’re there and I’m going to slowly release open my valve where it goes down at least two to three millimeters of mercury just slowly and what I’m doing is I’m listening for that first beat that first beat will be our top number which will be our systolic and I’ll tell you when I’ve heard it we’re passing 130 passing 120 and I just heard it just now at the 110 mark I’m still hearing it still hearing it and notice how it’s ticking see a little moving up and down okay and then it has stalled it’s stopped at 62 so 110 over 62 is his blood pressure and I’ve slowly let the air out flood pressure was 110 over 62 and always tell the patient what their blood pressure is because a lot of people like to know I know I’ve been in hospital settings and no one told me what my blood pressure was and I would have loved to know and then of course take the cuff off of them and if you have to repeat the blood pressure you can do it in about five minutes and it’s good to switch arms so thank you so much Ben for being my test dummy and that’s how you take a blood pressure okay I hope I helped you learn how to take a blood pressure manually thank you so much for watching and be sure to check out my other nursing clinical skill videos we have a lot of those in also teaching series and be sure to visit my website registered nurse Orion comm for all your nursing student needs and be sure to subscribe to this channel thank you so much for watching

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