BP

HouTx, BSN, MSN, EdD · Sep 2, 2016

It's a learned skill - you'll get better with practice. Make sure that you're using quality equipment. Have you ever had a formal hearing test to determine if you have any problems with specific sound ranges? Finally - double-check your placement. I'm sometimes amazed by the sloppy manual technique in my physician's office... honestly, I don't know what sounds they can detect with placement of the bell on the wrong danged side of my arm - LOL.

When it comes to the importance of BP - or any hemodynamic measurement - it't the "Big Picture" that matters most. A single reading is pretty much meaningless without context. It needs to be evaluated in terms of the patient's normal reading & overall physiological issues. If you're working with really sick patients, they'll probably have technology-based monitoring (e.g., automatic cuff, peripheral oxygenation, etc.).

jj224 · Sep 2, 2016

I'd recommend a quiet room and possibly a better stethoscope.

SapphireKitten, CNA · Sep 2, 2016

This may sound silly and basic, but when you put the earpieces in your ears, make sure they're pointing forward into your ears, not backward into your ears. It would seem logically like you'd point backward, but it's actually the opposite.

I was taught how to take manual blood pressure for the first time at my job (I'm a tech, nothing fancy). Several people showed me how, and for a while I couldn't understand why I couldn't hear the dang beats. Or the times I did hear them, it was veeery faint. It was so frustrating because I was doing everything else correctly, and I'd almost always have to grab a co-worker to help. Those several people didn't think to include the direction you put it on your ears!! I figured it out after trying online tutorials. I always get it now haha. You'd be surprised how big of a difference that makes.

smf0903 · Sep 3, 2016

Also make sure your bell/diaphragm is on the side you want to listen from. When I learned how to take a BP I literally could not hear anything...at all. That day I learned that the bell/diaphragm turns so that you hear out of one or the other--you can't hear out of both unless that entire piece is turned (not sure how to explain it here!). Otherwise, just keep practicing. You'll get it!

alissa8168 · Sep 3, 2016

Just posting to say you're not alone. We tried in lab then I went home and tried again. Finally after trying on different family members, checking my notes, watching videos and hearing samples, I think I'm beginning to get it

NICUismylife, ADN, BSN, RN · Sep 3, 2016

Are you palpating brachial pulse before placing the stethoscope bell? It needs to be right over the brachial pulse, and like others have mentioned, use a quality stethoscope.

neogirl · Sep 3, 2016

I have an Adscope Clinicial stethoscope given by the school. Is that good or should I get a different one?

pmabraham, BSN, RN · Sep 3, 2016

Neogirl, try to see if there are uniform shops in your area that carry stethoscopes you could try out while you were shopping. See if your school bookstore has any you can try.

Banana nut, BSN, RN, EMT-B · Sep 3, 2016

To take a BP manually requires as little as a plastic disposable steth. You should not need anything fancy. You do need to make sure you are aware of the anatomy and the artery location. If your steth is not on the artery it will be hard to hear the beat. Just keep practicing and if you can't hear the beat while inflating the cuff then dint expect to heat it when you deflate.

Zooey72 · Sep 3, 2016

I am having a problem with this as well. I blew 250 bucks on my stethoscope, so I don't think that is it. I can hear it, but it just seems like it should be louder than what it is (I have no hearing issues). When I was a child and had a kid/toy stethoscope I was able to hear more clearly with it more than the one that I have now.

I haven't had my prof look at it yet, and maybe that is the issue. If I was shipped a bad one that could explain it.

Kuriin, BSN, RN · Sep 4, 2016

Are you palpating brachial pulse before placing the stethoscope bell? It needs to be right over the brachial pulse, and like others have mentioned, use a quality stethoscope.

I feel like you only do this in the skills lab to get checked off. For me, it is simply too annoying to find the brachial pulse due to either fat or muscle.

TL;DR: You don't need to palpate for brachial pulse first.