1. Relocate brachial pulse. Palpate the artery distal to the cuff with fingertips of nondominant hand while inflating cuff rapidly to pressure 30 mm Hg above point at which pulse disappears. Slowly deflate cuff and note point when pulse reappears. Deflate cuff fully and wait 30 sec.
(Perry, Anne Griffin. Fundamentals of Nursing, 6th Edition. C.V. Mosby, 2004. 22.214.171.124.1).
1. Place stethoscope earpieces in ears and be sure sounds are clear, not muffled.
2. Relocate brachial or popliteal artery and place bell or diaphragm chestpiece of stethoscope over it. Do not allow chestpiece to touch cuff or clothing.
3. Close valve of pressure bulb clockwise until tight. Quickly inflate cuff to 30 mm Hg above palpated systolic pressure.
ETC.... I didnt copy the whole thing, but I cannot see the difference between the two.
the two step method is when you actually take the bp twice. the first time you take the bp only to determine what the upper number is going to be and you don't really worry about the lower number. then, after waiting about 30 seconds you reinflate the cuff to only about 30 points more than what you determined the upper number (systolic reading) to have been the first time and do the complete measurement. i'm not sure what the purpose is of doing that, maybe because they think the patient might be a little freaked out, but i have a web link that describes this procedure. it was specifically written out for people who were doing bp measurements for data collection for some research study and they wanted all the data collectors to be doing the bps the exact same way.
confusion over the right way to take blood pressure comes up as a topic on the forums at the beginning of every school term. you'll see that the new allnurses software now lists some of the older threads on blood pressure at the very bottom of each page when this thread is pulled up. you might want to explore them to see if there is something helpful in them. however, i've kept a list of some of the blood pressure web links as they've been posted over the past couple of years. yours happens to be the first post i've seen on this recently, but i'm sure others will soon follow in the next couple of weeks. you might want to check some of these web sites out. one has a virtual bp cuff you can play around with.
http://www.ktl.fi/publications/ehrm/.../part_iii3.htm - blood pressure measurement where peak inflation level is determined first by palpating a radial pulse, inflating cuff and then determining the point at which the pulse is obliterated. [i think this might be the two-step method you are talking about.]
http://medicine.osu.edu/exam/ - from ohio state university college of medicine, an interactive guide to physical examination for 8 body systems and includes sounds. has an interactive blood pressure cuff (the link is toward the bottom of the page, "take a blood pressure") where you click on a blood pressure bulb to start the inflation of the cuff. you will then hear and watch the manometer and tell the program what the final blood pressure is. it re-cycles to give you lots of practice!
What is the difference between the Two-step and One-step method? I am not getting it. Is the difference just inflating the cuff to 30 mmhg and you dont do that with the one step method?
I perform the 2-step method by applying the cuff and inflating it until I feel the radial pulse disappear. This gives you a baseline for initiating the blood pressure reading. Add 30 mmhg to this baseline, and this is the number you should pump the cuff up to. So, if you lost the pulse at 120 mmhg, pump the cuff to 150 mmhg when evaluating their bp.
Hope this helps!
In our program the difference is, the one step you inflate 20-30 mmhg above what the patients normal bp is (what they state their bp is normally) and the 2 step method is you inflate the cuff with your fingers palpating the brach. artery until you no longer feel a pulse, then deflate until you feel the systolic and diastolic pressure. You then wait 2-3 minutes and inflate 20 mmhg over the number you felt the systolic pressure and use your stethoscope to take the accurate reading.
We were told to use the 2 step method on a patient where they are a new patient and you do not have a baseline.
we were also told that we will probably very rarely ever use manual blood pressure, but we have to know how to do it.