How to take blood pressure – Clinical skills for student nurses



okay safely so we're going to go through taking a manual blood pressure measurement today okay and we have done some about something around blood pressure in our theory before so I'm just but I'm just going to go through the practical steps now that we need to take in order to take up manual blood pressure we need a plan okay can you remember what we're measuring when we're measuring blood pressure so we're measuring the pressure of the blood through the arteries that's right yeah so we measure the blood as it pumps around the body as it goes through the arteries yeah it's a really important measurements in clinical practice just to it's a good measure of how healthy somebody is or if they're ill or whatever so we we do take this measurement quite a lot you may see a hospital as well they use the map the automated a well on that movie so lies and they are very useful but they do have the limitations and sometimes they're not accurate for all sorts of patients it's really importantly you maintain your technique with an ugly so that's what we're going to do today Marie is our patient hello ladies only and so what we're going to do I'm going to demonstrate this skill I'm ray so before we undertake the procedure we'd obviously wash our hands and and obviously make sure we gain consent from the patient before we hand take the tarts okay so in order to in for the technique what we need to do first of all we need to be able to locate where the brachial artery because we're going to take the blood pressure on the arm so if you look around myself and this air of the arm is called the antecubital fossa and at the inside of the elbow and that says an artery and main article the brachial artery that runs down the arm so if you could just if you try and palpate your own brachial artery yeah sometimes if it's difficult can be difficult to feel on some patients so if you extend the Arbor a little bit more sometimes that helps to to take find the pulse okay okay all right so I'm going to do the same on Maria now thank you you're on I can find a nice strong brachial pulse there so what I'm going to do now is make a note of where roughly where I I found the pulse because that's the area where I'm going to be putting the diaphragm this Desco when I listen a little bit later okay so what going to do now is we need to place the cuff and on the arm I need to make sure that the cuffs an appropriate size for the patient and and what I'm going to do because I've noted where the brachial artery is I'm now going to place the cuff a few centimeters above for that because that's where I'm going to need to put my stethoscope if you notice on the curve there's a little arrow seeing artery yeah that's where the that's where you say so you just need to wrap it around snugly you need to make sure there's no tight clothing or anything because that couldn't obviously affect the measurement does that feel a right flank yeah and what I'm going to do is well I'm going to get a pillow and I'm going to support Maria's arm like so if the arms either too high or too low it can really affect the the measurement so it's important the arm supported the patient's relaxed and in a sort of relaxed state because that can affect the reading as well okay so we've got us fig here and we also need a stethoscope as well for this but the first step is what we're going to do is going to need to close off the valve here and what I'm going to do is I'm going to palpate the brachial artery like we did before and what I'm going to do my speaker if you can see is I'm going to pump up the cuff until I can no longer feel the pulse any longer and when I can no longer feel the pull so I'm going to make a rough estimate of the reading at that point and I'm going to let the cuss all the way down so that's not my estimated systolic reading because if you remember but pressures got the two measurements systolic and the diastolic that's the estimated systolic reading so now for the next step what I'm going to do is I'm going to get my stethoscope I've used s Clips a lot for listening to it sounds and patients some different parts of the body but for this particular one we tend to use the diaphragm the status gogo so I'm going to paste the diaphragm of the stress go over there with a brachial artery okay and this time when I pump it up I'm going to pump it up to about twenty to thirty millimeters of mercury above the estimated systolic reading and then I'm going to let the cuff down very very gradually to try and actually take the measurements and if you remember there's two sounds we listen for the first sound is when we put the first tapping sound is the first crop-top sound and that's the dead systolic reading the when the sound disappears that's the fifth crop-top sound and that's when we take the diastolic reading okay you okay yeah crying thank you this is the hard bit to let it down very gradually there we are CEO and you're left there let the cuff down and see then I could hear the first typing sound around 120 and and the sound disappeared at 78 so that would be 120 over 78 the blocking and so after the reading and then I've see it's important to document it very carefully in the notes and one thing to say about this procedure is something that you need to practice a lot you'll find when you go on your clinical placement now it's really important you practice a lot of patience because it can at first it's because skill it needs to be mastered it can be difficult to hear and if you don't get a first time it's okay to let the patient at rest for a few minutes and then try together and different patients will be you know some are clearer than others to here so and that's something that the nice guidelines even say it's important for qualified practitioners to practice this technique regularly to maintain that okay there

9 comments

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  4. Very helpful, well explained. I use the automatic machines all the time and had quite a hard time understanding this drawn out procedure from the book, but your demonstration really helped.

  5. when are you so called professionals going to learn, the way you took her pressure was so bad. her arm was not supported at heart level, she was leaning strongly to one side, her back was in no way supported, her feet where not firm to the floor! how could you possibly get an accurate reading? do it correctly.

  6. Very useful videos about blood pressure measurement,execellent tools for teaching.,,self explanatory.

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