Systolic Blood Pressure

  1. Which sound do you record as the systolic blood pressure? The first sound or the loud sound?
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  2. 6 Comments

  3. by   moonshadeau
    Generally, when I take a blood pressure I listen and watch the mercury at the same time. I generally record the number in which I see the mercury start to "bounce" and know that is the systolic blood pressure. This should be the top number of you B/P reading. Then keep listening and watching for the sounds and mercury to stop and this is the diastolic pressure.
  4. by   Sharon
    I record all sounds heard. Additional sounds are frequently associated with a disease process. When auscultating B/P's with multiple sounds and titrating medication, I always use the first sound for systolic.

    I have worked a couple of codes in which the first responder or nurse did not use the first sound heard and the patient proceeded into full arrest.


    [This message has been edited by Sharon (edited October 20, 2000).]
  5. by   JillR
    The first sound you hear,not the first bounce you see, is the true systolic BP. If you do it any other way, the BP may not be accurate and treatments that correspond to BP measurements may be either given needlessly or not be given when needed.

    [This message has been edited by JillR (edited October 21, 2000).]
  6. by   Overland1
    Originally posted by JillR:
    The first sound you hear,not the first bounce you see, is the true systolic BP. If you do it any other way, the BP may not be accurate and treatments that correspond to BP measurements may be either given needlessly or not be given when needed.
    Jill,

    Thank you for helping to dispel the myth that the "bounce method" is OK to use; I have had a few (EMT) students try to tell me that this is what they would do. That is when we have a little conversation.

    Jerry
  7. by   ceworden
    Another tip for finding the Systolic BP....

    Feel the bracial pulse in the wrist as you inflate the cuff. When you no longer can feel the bracial pulse, the go up apox 20, then begin to listen. I was taught this when I went through EMT training especially when we all we could get was a Systolic Pressure.
    I am surprised the EMT students have not been taught this. It was the first thing we had to learn to do because in the back of an Ambulance you can not depend on the "bounce of the needle".

    MNM--A Step for Our Future,2001

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    CEWorden, LPN
    Proud to be a Nurse
  8. by   JillR
    Actually, I was taught as an EMT to do BP by palpation, I do use it often in the back of the Ambulance but rarely need to resort to using it as a RN on the floor. There are all sorts of little tricks we learned as EMT's that have served me well in nursing too.

    There is a theory that goes if you can get a radial pulse the systolic BP is 90 or above. If you can't get a radial but can get a femoral, then the systolic is 80 or above and if you can't get either of them but do feel a carotid pulse then the systolic is around 60. God I hope I got this right. I am doing this by memory, so if I didn't get the numbers exactly right please don't get too offended. It is a great tool when you need to know fast where your pt is at.

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