Funny - Tech Broken, Use "Old School" Sphygmomanometer

CT Pixie, BSN, RN · Sep 16, 2014

If it isn't required, it should be. Often the automatic ones aren't working, are giving wonky numbers or needs charging and you have to use the manual one.

When I trained as a CNA back when dinosaurs roamed (1984 haha) there were no automatic cuffs. We did it with the manual ones. Most of the LTCF we had LPN clinicals in didn't have the automatic ones either. it wasn't until my RN program that I noticed the automatics ones were more readily available.

Personally I would take the old school BP cuff all day any day over an automatic one. I find they are more reliable and often much quicker to do than waiting for the cuff to inflate, then start to deflate, then reinflate again..over and over and then coming up with an error or some off the wall reading.

elkpark · Sep 16, 2014

I've worked in facilities where there was a Dynamap for each unit, but all but one of them would be not working on any given day. You really need to know how to use a traditional sphygmomanometer. I also trust them more than the fancy machines, which aren't accurate unless they are calibrated periodically, which most places don't do.

funtimes · Sep 16, 2014

Yes taking a manual BP was part of the state CNA test, and its also the thing most people fail on. We also practiced taking BP frequently on each other in class. Buy a bp cuff/gauge and a steth and practice if you plan on becoming a Nurse or ever working in a hospital(nobody calls it a sphygmowhatever.) The more you practice the better you become.

As for coaching you through it on here I suggest youtube, or better yet having someone who knows how to do it demonstrate it to you in person.

It really is an important skill and any CNA that doesn't know how to do it is a FAIL. Sorry not your fault your school didn't do their job, and at least your new. Some CNAs whove been doing it a while still probably cant take an accurate BP.

lilmissetter · Sep 16, 2014

I agree that taking blood pressures with manual cuffs should be a required skill and instructors should spend more time teaching this skill. Readings are far more accurate and although machines are great, they do malfunction. The instructor in my CNA class also worked as a nurse in the ICU and she spent quite a bit of time teaching us to do manual readings. She preferred doing blood pressures manually. We were able to take home stethoscopes and cuffs to practice with and one of our assignments over the course of the class was to get vitals on 20 people and record them. It's an important skill to know and is quite easy once you practice and get the hang of it. As a working CNA, the first time the nurse asked me to get a blood pressure, I think she was quite impressed when I asked her for a cuff and stethoscope. I guess I'm old school because I have never actually used an automatic cuff.

hookyarnandblanket · Sep 16, 2014

There are times you are going to see orders directly stating that BP must be done manually. I also agree it should be a mandatory skill in CNA training, and honestly, once you learn it and get skilled at it, manual BPs can be attained much faster than a machine.

MidLifeChg2Nursing · Sep 16, 2014

Wow Funtimes, it's a good thing I am thick skinned...what you say bounces off me and sticks to you :).

I will be in a nursing program Aug 2015, so I will buy a BP cuff and steth, practice on the wife and kids and any guests, then take it to work and use it in place of the electronic/automatic cuff.

psu_213, BSN, RN · Sep 16, 2014

Wow Funtimes, it's a good thing I am thick skinned...what you say bounces off me and sticks to you :).
I will be in a nursing program Aug 2015, so I will buy a BP cuff and steth, practice on the wife and kids and any guests, then take it to work and use it in place of the electronic/automatic cuff.

So I had to reread funtimes' post again…still not sure what was offensive about it. Anyway, if an RN tells the doc "Mr. G had a pressure of 78/40" the doc will almost always come back with "was that a manual BP?" Yes, the machines have to be calibrated regularly, but they are not always correct--for example, if the pt. keeps moving their arm during the measurement. Being able to take a BP on your own is a skill you must have in order to be a nurse. Shame on your school for not teaching how to take a BP and shame on your state for not requiring that skill to become a CNA.

SeattleJess · Sep 16, 2014

So I had to reread funtimes' post again…still not sure what was offensive about it. Anyway, if an RN tells the doc "Mr. G had a pressure of 78/40" the doc will almost always come back with "was that a manual BP?" Yes, the machines have to be calibrated regularly, but they are not always correct--for example, if the pt. keeps moving their arm during the measurement. Being able to take a BP on your own is a skill you must have in order to be a nurse. Shame on your school for not teaching how to take a BP and shame on your state for not requiring that skill to become a CNA.

I had to reread funtime's post to get this, too! Midlife, maybe you have thick skin but bat ears? Truly wouldn't have heard the post that way without a prompt. I believe the point is that your school let you down. I second the sentiment: shame on your school!

Washington requires manual BP; in fact, it was the measuring skill I drew when I passed my test. The only reason I struggled with BP was that I had some hearing loss of which I was unaware - not enough to show up anywhere else in my life. If you have adequate hearing, it's not a difficult skill. Much easier than making an occupied bed! Just practice, practice, practice.

We're going to need to hone our listening skills for heart and bowels come nursing school anyway.

One of the units where I now work float does not use a "nurse on wheels" so all vitals are done old school. I like manual BPs because the patients are quiet; with the machine, patients tend to yammer on throughout the process, making it tough to get respirations. (Apparently, these have not yet been automated.)

OrganizedChaos, LVN · Sep 16, 2014

Wow Funtimes, it's a good thing I am thick skinned...what you say bounces off me and sticks to you :).
I will be in a nursing program Aug 2015, so I will buy a BP cuff and steth, practice on the wife and kids and any guests, then take it to work and use it in place of the electronic/automatic cuff.

Wow, did you just say I'm rubber you're glue whatever you say bounces off of me & sticks to you? ?

You asked for advice on a public forum & nothing funtimes said was offensive. Since you plan on applying to nursing school you must know how to use a manual cuff. Start using it at work.

funtimes · Sep 17, 2014

I wasn't intending to insult you, just point out that I don't understand why a CNA school would just barely touch on something that a CNA likely would have to do regularly and could cause a patient serious problems if not done right.

I guess its the EMT in me that thinks this is important as manual BPs were all we ever did unless I was working ALS and we had an automatic cuff on the lifepack monitor(some paramedics still insisted on manual BPs for the first set of vitals).

Even in LTC some elderly people that bruise easily wont tolerate an automatic cuff since they will sometimes inflate really high.

Also a few things to know. Never put a BP cuff over a dialysis fistula, if they have one use the other arm. Never use a cuff on an arm they have a picc line in(something you probably wont see often in LTC), and if they have ever had a mastectomy try not to use the arm on the side they had it on as they already have impaired lymphatic circulation and it can cause them problems.

MidLifeChg2Nursing · Sep 17, 2014

I guess my wife was correct, my sense of humor has a lot to be desired - I was trying to joke with Funtimes, hence the smiley face, was refering to his/her reference of saying I was a FAIL for not knowing how to manually take BP.

I was not offended.

I 100% agree with everything everybody has said - manual BP should have been taught (I thought I made that clear in my original post), and I'm surprised it's no longer a required skill in CT. I plan on learning and using my own manual BP cuff to do vitals at work.

Thanks everyone for your input.