Procedure for Determining Blood Pressure with a Manual Device

1. Prepare the Patient

  1. Explain to your patient that you will be taking their blood pressure.
  2. Seat the patient comfortably, with the arm slightly flexed, palm up and the entire forearm supported on a level surface even with the heart. Ensure the legs aren’t crossed.
  3. Use either arm unless otherwise indicated. For example, a person who is physically disabled. Repeat blood pressure readings should be completed on the same arm as differences in each arm can be as much as 10mm Hg.
  4. Take pressure on bare arm, not over clothing.

2. Apply the Cuff

  1. Apply the completely deflated cuff to the patient’s arm, supported at the level of the heart.
  2. Place the portion of the cuff that contains the inflatable bladder directly over the brachial artery. The cuff may have an arrow to show the point that should be placed over the artery (Figure 4). The lower edge of the cuff is placed one inch above the antecubital fossa (inside crease of the elbow). The key is to fasten the cuff evenly and snugly (Figure 5).
  3. Adjust the position of the gauge for convenient reading.
  4. Palpate the area between the antecubital fossa and cuff to locate the brachial artery pulse found on the inside of the forearm. The stethoscope end piece is placed over the spot where the brachial pulse is felt (Figure 5).
  5. Position the stethoscope earpieces in the ears, with the tips directed forward.