taking BP

mysterl33

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Hey,

So yesterday we learned how to take blood pressure but my instructor went through it kindof fast. So can anybody help me understand what exactly I should be looking for?
 

firecoins

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you inflate up the cuff and place the scope on the artery. You listen for the beat to start. Thats the systolic pressure. When the beat stops again. Its the diastolic pressure.
 

HorseHauler

Forum Lieutenant
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or you put the cuff on and hit the button and watch the numbers pop up... those are my favorite :lol:
 

firecoins

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yeah electric cuffs are easier. If you could only do those on the exams
 

BossyCow

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Make sure you have good contact with the scope on the artery.

Also, make sure your knee isn't resting on the railing on the gurney... lol the road vibration can drown out the pulse.

I recommend for all my students to just practice on everyone they know. Not just over and over on the same person but fat arms, skinny arms, old arms, muscular arms, kids arms.

A lot of the problems that new EMT's have are based on them expecting everyone to be the way they are in the book. People's anatomy is very different and getting used to finding pulses in odd little nooks and crannies is part of learning the craft.
 

Ridryder911

EMS Guru
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Ask and you shall receive!.. Seriously, most EMT's do not really know the steps of taking a blood pressure, which can be very important !


BPInfo2.gif
 

BossyCow

Forum Deputy Chief
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Great visual aid Rid. Do you have a link to it so I can print out a nice clean copy?
 

Ridryder911

EMS Guru
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A very good site, with insight of how and why you are hearing what you are hearing, much more than diastole and systole as well as how to correct pittfalls of taking a BP.

http://www.steeles.com/catalog/takingBP.html
 
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Ridryder911

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I m sure you heard accurate blood pressures. However you actually never understood and really performed an accurate auscultated BP. Even though one could hear the "lubb dubb" at 140, one should be able to understand Korotkoff sounds. The same analogy of CPR could be made. Someone performing compressions correctly would be performing accurate CPR; however not knowing the steps and rational values is what separates us from common laymen and being a health care professional.

Majority of EMT's are not trained and educated even in the simplicity of taking blood pressures because we continue to water down the EMT course to a first aid level, with the reasoning "they don't need to know this, because they won't understand"... which is nonsense.


All these steps should be well understood to have an understanding of the steps of blood pressure. This is the correct way to perform taking a blood pressure... knowing the accurate and proper steps only demonstrates one understanding of assessment techniques.

R/r 911
 
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Trumajunkie

Forum Ride Along
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The thing that really helped me is palpating the brachial artery. Do it every time before you inflate the cuff. It makes things alot eaiser, especially when going 55 with sirens blarring.
 
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mysterl33

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so just to clarify

  • Put the BP Cuff on so that it inflates over the artery
  • Palpate the pulse on the wrist
  • Place the stethoscope near the artery and begin to pump the BP Cuff
  • Listen for the artery to stop beating and take the number which because the systolic pressure
  • Start releasing the pressure slowly and listen for the artery to beat again this number is the diastolic pressure
  • Release the pressure all the way, take the cuff off, record the numbers.

is that about right?
 

Ridryder911

EMS Guru
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In summary yes.. remember auscultated BP are only an approximation. Each persons hearing varies. It takes a lot of practice.

Palpation is an alternative way; whenever there is too much ambient noise and unable to auscultate a BP. Remember, you are only getting am approximate systolic reading.

Good luck in school!

R/r 911
 

Alexakat

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...and don't be shy to pump up the cuff again if you're not sure.

When I first started, I thought I had to be all fast about it...but it's ok to take your time & get it right. You will be in situations where it's loud & difficult. Practice until it's 2nd nature (like everyone said, practice on your family, friends, etc...)

The basic skills are REALLY important (getting pulses, B/Ps, respirations, checking pupils, etc.). If your instructor glosses over anything, ask questions...lots of them! If you're shy in class, make sure you ask after class or during your instructor's office hours.
 

Alexakat

Forum Lieutenant
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so just to clarify

  • Put the BP Cuff on so that it inflates over the artery
  • Palpate the pulse on the wrist
  • Place the stethoscope near the artery and begin to pump the BP Cuff
  • Listen for the artery to stop beating and take the number which because the systolic pressure
  • Start releasing the pressure slowly and listen for the artery to beat again this number is the diastolic pressure
  • Release the pressure all the way, take the cuff off, record the numbers.

is that about right?

Clarification:
The pulse on the wrist (radial) is to be used when you're getting a palpated pressure. You wouldn't use your scope for that...

The pulse on the inside of the arm (brachial) is to be used when you're obtaining a B/P by auscultation (with your scope). Even though you're going to listen, palpating the brachial pulse before pumping up the cuff helps you get oriented with the whole area.
 

fm_emt

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Palpation is an alternative way; whenever there is too much ambient noise and unable to auscultate a BP. Remember, you are only getting am approximate systolic reading.

Palpation is also a great tool for lazy firefighters. If they hand you a sheet with vitals and the BP says "120/P" - take your own set of vitals. :)
 

Recycled Words

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When I first started, I had a lot of difficulty getting it on my first shot. If you don't get it the first try, feel free to try a second time. If you think the BP you got was a bit off, try again.

The worst thing you could possibly do is make up the numbers. If you can't get it, ask your partner for a hand.
 

Emtgirl21

Forum Lieutenant
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so ridryder911 do you enjoy working with an EMT partener or you prefer a paramedic?
 

FF/EMT Sam

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The worst thing you could possibly do is make up the numbers. If you can't get it, ask your partner for a hand.

^^^^One of the smartest things ever said on this forum.

Also, you can hear most people's BP by listening in the center of the interior elbow. However, some people's arteries are off to one side. If I'm having trouble getting a BP, I release the cuff completely and feel the joint with two fingers. Often, I can feel it elsewhere (usually closer to the patient's body), and I put the stephoscope there and try again.

Getting a BP usually isn't that hard, but it takes some practice. Good luck!
 
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