How to Take Blood Pressure Manually

How to Take Blood Pressure Manually at Home

Do you have concerns about the accuracy of your blood presssure readings from popular electric monitors?

If so, you are not alone and you might want to consider taking your readings manually to ensure you are getting the most accurate numbers.  For that, you need to know how to properly check for your blood pressure at home with a manual cuff.

You’ll need a few pieces of equipment to help you get started:

  • Stethoscope
  • Blood pressure cuff
  • BP measurement instrument

The BP measurement instrument is going to be called a sphygmomanometer, and it will have three main types of readings that it can take:

  • Aneroid
  • Digital
  • Mercury

Preparing the Subject

If you want to know how to get an accurate reading with a manual blood pressure cuff, you first need to know how to position the patient properly. All patients will need proper positioning, and this means:

  • Seated or standing

Seated tends to be the best position, and when in this position, it’s important that the subject’s arm be flexed during the reading. Flexion of the elbow should be at heart level. This will allow for the best reading and is the same routine that most doctor’s offices will follow.

It’s important that the subject does not have anxiety when the testing is taking place.

If a person is anxious, it will cause their heart rate to fluctuate. Instead, if a person is anxious, it’s important that he or she waits a few minutes before the blood pressure is checked. An anxious person will have a reading that is inaccurate.   You may have heard this referred to as ‘white coat syndrome’ when your anxiety leads to abnormally high readings at the Dr.’s office.

Patients must be relaxed fully, and this often means waiting five minutes before taking the blood pressure reading. Ensure that the person’s feet are flat on the floor, and remove any excess clothing that may interfere with the reading.

When the reading is taking place, it’s also important that the person not speak.

Note: The blood pressure cuff must fit properly.

An improper fit will lead to the cuff not fitting accurately, and this will skew the blood pressure reading significantly. If the cuff is not the proper size, choose one that is smaller or larger as needed.

Once you have all of the necessary equipment, you’ll be ready to move to the next step of checking your blood pressure.

1. Position the Cuff on the Patient’s Arm

You’ll need to position the cuff on the arm, and this requires finding the location of the brachial artery. The brachial artery is the main upper arm artery, located above the elbow, and this is why you’ll see most cuffs secured around the upper arm.

Wrap the cuff snug around the arm and prepare to move on to step two.

2. Palpate the Arm and Position the Stethoscope

Doctors will often tap the arm along the crease to find a person’s strongest pulse reading, and this is to find the antecubital fossa. Tapping allows the person to find the strongest pulse, or where they will want to place the stethoscope’s bell over.

You’ll be aiming to find that brachial artery so that you can find the strongest pulse reading.

3. Begin Inflating the Cuff

When you reach this point, it’s time to begin inflating the cuff. You’ll be listening for pulse sounds the entire time you’re inflating the cuff. The goal is to continue to inflate the BP cuff to the point where blood flow has stopped.

How do you know when you reach this point?

You’ll hear no more sounds through the stethoscope. Glance over at the gauge and make note of the mmHg levels.

These levels will typically be 30 – 40 mmHg above the person’s normal readings. But what happens if you don’t know the person’s normal readings? In this case, you’ll want to inflate the bulb to 160 – 180 mmHg.

The only time that you’ll want to inflate to a higher pressure than this is if you hear pulse sounds quickly.

4. Start Deflating the Cuff Slowly

You’ll want to follow the guidelines laid out by the American Heart Association which state that the deflation process should result in blood pressure levels falling at a rate of 2 – 3 mmHg per second.

It’s important to follow these recommendations.

Any levels that exceed 2 – 3 mmHg per second are simply too fast. And when the deflation occurs too quickly, this will lead to inaccurate readings – not what you want when checking blood pressure.

5. Listen for the Systolic Reading

Systolic readings are when the blood begins to flow through the artery after being cut off. Oftentimes, the sound that will be made will be similar to a tapping sound. These are rhythmic sounds that will be heard during the reading.

6. Listen for Diastolic Sounds

Diastolic readings are determined as the cuff’s pressure drops. These readings are when the sound begins to fade. An easier way to find this reading is to wait for the systolic sounds to stop. When these sounds stop, the reading will be what the gauge reads at this time.

What’s the best time to check blood pressure?

It depends.

The AHA claims that readings are higher in the morning and lower in the evening. Accuracy should be determined by double checking the results, once in each arm, and then finding the average of the two readings.

When double checking a reading, it’s important to wait five minutes or more between each reading.

Practice makes perfect when developing your blood pressure taking skills. Spend time on each reading, listening for the right systolic sounds and when the diastolic sound is reached. Over time, you’ll be able to read a person’s blood pressure faster and more efficiently.