How to Take a Blood Pressure Manually



0:00 everyone, it’s Sarah with registered nurse RN. com and today I’m going to go
0:03 over with you how to take blood pressure manually in the hospital
0:07 settings we are blessed because we have automatic blood pressure monitors that
0:11 take her blood pressure is constantly for patients but there are times in the
0:15 settings where we’ll have to take them manually
0:18 especially if we don’t trust the monitor or you can sometimes the monitor won’t
0:22 read a patient’s blood pressure because of their blood pressures too low so you
0:26 have to know how to take blood pressure manually so in this video I’m
0:29 going to go over how to take blood pressure manually I’m actually going to
0:33 perform the skill and you’ll get to watch me do it and see how I do it and I
0:36 want to give you some quick tips that I’ve just learned over the years with
0:40 taking blood pressure is manually so first to let’s go over equipment
0:44 ok this is a manual blood pressure cuff you can get these anywhere Walmart off
0:49 the internet anything
0:51 typically you have it comes with a cuff make it comes and make sure because
0:56 sometimes people buy these and they don’t come with this big monitor big
0:59 moment ometer and always make sure that whenever you’re buying it says with this
1:04 big manometer because sometimes you just get the cuff and the rubber bowl but
1:10 you won’t get that you have to buy that extra this is the big thing about it so
1:13 make sure that it comes with this and you have your rubber bulb that blows up
1:18 with an open and closed valve and a lot of times they come with little neat
1:23 carrying bag so if your home health nurse you have to travel a lot or you
1:28 just want to take your own blood pressure it will need to have your own
1:30 cup
1:31 and also you need a stethoscope many times if you’re just learning to take
1:36 your own blood pressure that’s why you’re watching this video
1:39 this can actually come with the stethoscope but I like my own set the
1:42 scope but a lot of times they come with the set up so you’ll need your cuff your
1:46 but your speedometer and a play and scope so let’s go over exactly the steps
1:53 of how to take blood pressure and the end we will talk then you’ll actually
1:56 see me perform the skill
1:58 okay whenever you’re taking blood pressure in the clinical setting
2:01 anywhere you want to have the patience set down
2:04 have them be calm for about three to five minutes
2:08 if they’re anxious the real nervous or they’re crying or something like that
2:12 have them set sail for three to five minutes set in a chair with her legs
2:15 on the cross and they’ve armed at a heart level the end what you will do you’ll
2:22 get your cuff and you need to make sure that you have the right size cup if you
2:26 have too large of a calf or too small of a cuff you will get an inaccurate
2:29 reading which is not good
2:31 so whenever you put your cuff on the patient take a look at the patient’s arm
2:34 and you can tell the patient is really little in this area probably need a
2:39 smaller adult or if they have a larger arm you might need a large cup how you
2:44 tell is that you put the cuffs on the arm which I’ll show you with my patient
2:48 that will be doing here in a second and you stick two fingers underneath the
2:51 cuff and if they fit just right
2:54 you have the right size cup if not if it’s too tight to lose you need to get
2:58 another size cuff
3:00 next you’re going to ask your patient what are you can take their blood
3:04 pressure in some people have preferences and make sure the patient has not had an
3:08 AV shunt place in their arm or they have an IV in their arm or a PICC line
3:13 they’ve had a mastectomy or history of blood cost anything
3:17 never want to take blood pressure in that type of arm so put your cup on the
3:21 patient
3:22 you’re going to feel for the brachial artery and I want you to practice this
3:25 with me
3:26 your right heel artery is found on your elbow and it’s the distal part closest
3:30 to your body and the best thing is to extend your arm out as much as you can
3:34 and feel that bounding and I can feel mine right now and that is your brachial
3:40 artery that is the artery that we are going to be feeling and listening for
3:44 so you pick your cuff on the patient and on your cuff you will notice these
3:49 little arrows you have a narrow down little say left arm you have a narrow
3:53 down that his right arm
3:54 so if you’re using the left arm you’re going to make sure that that arrow is
3:57 literally right on or slightly above that brachial artery
4:01 so you’ll put that on there and then you’ll take your stethoscope and
4:07 and your stethoscope has two sides to it it has a diaphragm and a bill
4:12 studies have shown that it’s really personal preference on what side you
4:16 want to listen to
4:17 I like to listen with my diaphragm so you’re going to take your self scope put
4:21 it put it in your ears and you’re going to take the side frame and you’re going
4:25 to put it over that brachial artery then you are going and when you hear it
4:29 you’re going to inflate the cuff with the rubber bulb and typically you and
4:35 flight until you cannot hear the brachial artery anymore
4:38 this is generally on your little spigot moment odometer you will imply all the way
4:43 up 280
4:44 – 200 – 200 millimeters of mercury hundred and eighty is usually sufficient
4:49 enough
4:50 another how you can know how much the employee is asking the patient
4:54 what their top number which is your systolic normally runs and if they say
4:58 it runs a hundred you would inflate 230 240 millimeters of mercury so the role
5:05 is usually to in-flight 30 to 40-millimeter meet millimeters of mercury
5:09 more than what they say that their blood pressure is but I like to stick with the
5:14 hundred and eighty so you inflate their once you inflate you start you take your
5:21 rubber valve and you start letting out air slowly very slowly if you do it too
5:26 fast you’re going to inaccurate reading you do it slow
5:30 where you’re seeing that needle drop down to 23 millimeters of mercury and
5:35 let me show you what I’m talking about
5:37 behind me I have I’ve drawn it’s not the best drawing but I’ve drawn a little
5:42 speaking of all manometer that you would see and your needle typically
5:48 starts right here at the end and as you inflate it goes up
5:53 so where you would always already in flight to the 180 marks than when you’re
5:58 letting out the heir to a hundred and two to three millimeters of mercury
6:03 you’re going to do it slowly so it would do something like this
6:08 you’ll see this little needle and
6:09 we’ll just start going slowly and then all of a sudden you hear buh
6:14 ok so we’ll leave sp_lbl we hear the booth at the 120 marks over systolic is a hundred
6:19 and twenty the annual keep hearing the noise will keep hearing boo
6:23 boof boof boof boof boof boof and all of a sudden it will stop and you make know
6:29 where it stopped that and we’ll say it stopped right here which is the 70 mark
6:32 and that is our diastolic so the patient’s blood pressure is 120 over 70
6:38 then after you get that what you’re going to do is you’re going to open the
6:42 valve all the way let all that air come out until the patient what their blood
6:46 pressure always tells the patient with their blood pressure is a lot of
6:50 patients want to know and some people may not ask you because I feel like it
6:53 might be rude to ask
6:54 so just let them know and explain what that really means a lot of people like
6:57 was a higher is that love and explain to them what that is a normal blood
7:01 pressure reading is usually 120 over 80 but we’re not all perfect and
7:06 we all can’t have that great blood pressure
7:09 typically the golden rule you want that top number to be at least a hundred and
7:14 if the top at which is on the little bit little over the side but if that top number
7:19 starts going to 150 is 161 a tease
7:22 hi that’s not good that’s hypertension you’ll need to let the doctor know
7:25 now that’s how you talk about pressure so let’s go over some quick tips and
7:29 then we’ll do our skill you want to use that correct size remember the
7:34 two-finger rule fit underneath the cuff make sure it doesn’t get too snug to tie
7:39 just right and if the patient has smoked so always ask them if they’ve smoked at
7:45 the 8th or they just got done exercising its best to wait about 30 minutes before
7:49 you take that blood pressure because you can get an inaccurate reading and again
7:54 no blood pressures in patients whose hat who had a baby shirts mastectomies blood
7:59 clots anything like that
8:01 so now let’s do our skill of recording we are getting a blood pressure here we
8:06 have our patient
8:07 it is my awesome husband Ben and he is here to be my test at me for doing our
8:13 blood pressures so the very first thing you want to do is you want to have your
8:16 patients set down and if they’ve been
8:19 running around or really anxious or talking you want them to be calm for at
8:24 least three to five minutes before you take their blood pressure because of you
8:26 want to get the most accurate response the end you will have them have their
8:31 legs uncrossed and have their arms down by their side and you want to ask them
8:37 what are you can take their blood pressure and because of a lot of patients
8:40 are had preferences on what blood pro
8:42 what are you can use especially if they’ve had a navy shot or a blood clot
8:46 in the armoire mastectomy you would never want to take blood pressure on
8:50 that arm
8:50 so I’m going to use bands left arm you want to get your manual blood pressure
8:55 cuff and your stethoscope and what we’re going to do is we’re gonna put on our
9:01 left arm and on your blood pressure cuff you have little arrows
9:05 that’s a left and right these arrows are meant to go over the brachial artery
9:10 so we’re going to slaughter come up through the brachial artery and I’m
9:14 going to just feel on his brachial artery where his artery is and it’s
9:18 always on the inside of the elbow and always have them in that arm up really
9:23 good because it pushes the pulse up and he has a really nice one right there
9:28 so what I want to do is I’m going to take where it says that left arm arrow
9:33 and I’m going to put it right about two inches above that order e that’s where
9:39 you want the cuff to rest above the elbow about one and a half to two inches
9:42 and you always want to make sure that your cuff it’s the patient
9:49 you have really small patients and then you have some obese patients who need
9:53 larger or smaller cups and to check your cup size used two of your fingers and
9:57 just slide it underneath the cup
9:59 make sure it fits good not too snug not too loose because if you have a blood
10:03 pressure cuff that does not fit you will get an inaccurate reading and this cuff
10:07 it’s him great so we have that now what we’re going to do is we’re going to get
10:13 our speedometer and we’re going to just clip it here you can do whatever you
10:17 want with it as long as you can see it because this is going to tell us
10:21 everything that we need to know for his blood pressure
10:23 now what I want to do with myself the script is I’m just going to listen to
10:27 that artery
10:29 and a lot of people it really doesn’t matter you can listen with the diaphragm
10:34 or the bell of your stethoscope studies have shown it does not matter I like to
10:40 use my diaphragm
10:41 so I’m going to place it over his brachial artery
10:45 when we fill it again fill it right there and now I’m going to close the
10:52 valve on the blood pressure cuff and I’m going to pump it up
10:57 you pump it up at least 30 to 40 millimeters of mercury of what they say
11:03 that their blood pressure is a lot of patients don’t know what their blood
11:06 pressure normally runs so it’s always safe to say to blow the cuff up to a
11:11 hundred 80 to 200 millimeters of mercury that’s usually sufficient enough in a
11:15 patient
11:16 so what we’re going to do is we’re going to inflate are tough to that amount or
11:20 until we do not hear the break your artery anymore
11:25 like I said we’re going to in plate to about a hundred and twenty I mean a
11:29 hundred and eighty millimeters of mercury then we are there and I want to
11:34 slowly release open my valve where it goes down at least two to three
11:39 millimeters of mercury
11:42 just slowly and what I’m doing is I’m listening for that first beat that first
11:48 beat will be our top number which will be our systolic and I’ll tell you when
11:52 I’ve heard it
11:53 we’re passing 130 passing 120 and I just heard it just now at the 110 marks and
12:07 still hearing it so hearing it and notice how it sticking
12:13 see that little moving up and down ok and then it has stopped it stopped at 62
12:21 so 110 over 60 2 is his blood pressure and slowly let the air out blood
12:26 pressure was 110 over 60 – and always tell the patient what their blood
12:30 pressure is because a lot of people like to know I know i’ve been in hospital
12:33 settings and no one told me what my blood pressure was and I would love to
12:37 know
12:37 and then, of course, take the cap off of them and if you have to repeat the blood
12:42 pressure
12:43 you can do it in about five minutes and it’s good to switch arms
12:47 so thank you so much being for being my test dummy
12:50 and that’s how you take a blood pressure okay I hope I helped you learn how to
12:54 take blood pressure manually
12:56 thank you so much for watching and be sure to check out my other nursing
12:59 clinical skill videos we have a lot of those and also teaching series and be
13:03 sure to visit my website
13:05 registered nurse RN. com for all your nursing student needs and be sure to
13:09 subscribe to this channel thank you so much for watching
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Arm with blood pressure cuff|How to take a blood pressure manually


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