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Need help taking blood pressure

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I need some advice on taking blood pressure. I am having a very hard time hearing the systolic number. I am not sure what I am listening for. I would love to know if anyone else had this problem and how they overcame it, any advice would be greatly appreciated.:(

when you pump the cuff up and let it down slowly you should hear nothing then a noise comes in like a beat/throb and is louder at the start then it phases out until you can no longer hear it. It takes a lot of practice, ther should be guidelines in most your nursing books for step by step guide i had a book the royal marsden i think its called. Dont buy it but try get it from the library instead. has lots of other clincial skills in it too. Dont let it phase you practice on everyone you know theyll all sound slightly diff. Make sure the stet it the right way around too!

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

there is an online virtual blood pressure cuff that you can play around with and take practice blood pressures. make sure your computer's sound is turned on:

  • http://medicine.osu.edu/exam/ - to access the blood pressure cuff, scroll down to "objective iv" and click the link that says "take a blood pressure". when the player comes up, you can re-cycle the player over and over to hear and input blood pressure readings that it quizzes you on.

lainith

Specializes in HCA, Physch, WC, Management. Has 6 years experience.

That link really helped me a lot! I listened to it during my first module of nursing classes! The "ah ha!" moment for me though was when I tried to take my OWN BP myself and finally was like "Ohhhhhh I get it now." :) Good luck! I love that website.

Thanks everyone for all of your advice. Keep your fingers crossed that I pass my Practical this week :uhoh21:

We had a BP lab today, and I was flying through it with no trouble, heard everything perfectly on the manikin, but then I couldn't hear ANYTHING on any of my classmates! NOTHING! It was like my stethoscope was off or something, but it was on! I tried person after person and couldn't hear anything... I was getting so frustrated I almost cried... finally, I heard it! It's so sad too, such a basic, easy skill, and I was stressing like crazy over it because I couldn't HEAR it! Good luck, don't beat yourself up over it! Good luck to both of us on our pass-off! Yikes!

LovingNurse, BSN, RN

Specializes in Oncology, Triage, Tele, Med-Surg.

Although it's the first clear SOUND you're waiting for, sometimes you'll notice the gauge 'bounce' about the same time the systolic is being detected.

It also takes practice releasing the cuff at the right speed - not too fast or too slow. You might want to purchase a cuff for home use - the more you practice, the more comfortable you will be.

Good luck with your practical.

These sounds are pointless (well, not pointless, but you don't need them to interpret the the BP when using the manual cuff). By the way, you'll almost never use a manual cuff in the hospital setting. AT ANY RATE, here is the "cheater's" way of doing it, which a couple of instructors have shown me: put the BP cuff on like usual, inflate the cuff to about 180 or so... slowly release the valve so that the needle slowly drops. It should drop smoothly. As soon as you see it bounce/bob up and down/etc, then that is your SYSTOLIC (top) number. As it is falling and bouncing up and down at the same time, you'll notice when it STOPs bouncing. That is your DIASTOLIC (bottom) number. After that the needle will fall smoothly once again until it has reached 0. While you're doing this, pretend to be listening for the sounds with your stethescope, but really, all you need to do is look at the measurement meter and go off of that. Good luck to you! Oh... also, for testing purposes, just know what the sounds mean. That was on our test a few times.

LovingNurse, BSN, RN

Specializes in Oncology, Triage, Tele, Med-Surg.

pretend to be listening for the sounds with your stethescope, but really, all you need to do is look at the measurement meter and go off of that.
The bounce might help as a guide but it's not a replacement ... Please learn & do it the right way. Who would want a nurse who "pretends?" :no:

it's a replacement when you can not hear the sounds, which is more often than not. the only time that i have had to use a manual cuff was when I was in nursing school during the 1st semester. Haven't seen or touched one since.

I've yet to use a machine for BP in clinicals and we were taught that they are not nearly as accurate as a manual. You should always know how to get a good manual read.

I also struggled when first learning, but for me the key was having a good steth! Once I got a good one, I still was having trouble, but I found when I replaced the ear peices it was like someone cranked the volume way up! Now I can hear a BP like a really loud "thud" and then the thumping sounds start. It will come with practice and a good stethescope, but please don't think it's a nursing skill you won't need.

One Flew Over

Specializes in CV Surgical, ICU.

I've yet to use a machine for BP in clinicals and we were taught that they are not nearly as accurate as a manual. You should always know how to get a good manual read..

True! And a lot of times they don't even work, and you waste so much time waiting for them, only to have them give you error messages. They can be pretty frustrating! :eek:

melmarie23, MSN, RN

Specializes in L&D/Maternity nursing.

In every hospital I have been in thus far, we have electronic cuffs (usually a dinamap). However, in the community setting? Its just your steth and a cuff. You NEED to know how to do a good reading. Or what about in an emergency? Or if you work in a Dr.'s office? Or what if you are employed at a hospital that rural and doesn't have the money for the newest technology?

I've done them on short, tall, fat, thin, young, and old and it just really does take some practice. But you'll learn, I promise.

And sure, the "bobbing" can be used as a guide, but its never a replacement. You should be listening and yes, you will be able to auscultate the sounds. You just have to have your steth placed correctly.

You need to have a good stethescope. There is no way around it. I have to shell out the dough before I could hear the thump.

I had the same problem! LOL I realized after many attempts, that I was only able to hear it when I placed the chest piece beneath the cuff right on top of the brachial artery haha (I got this idea because my mom purchased a stethascope/sphygmomanometer and they were fused together as such) . But we're not supposed to do that XD - THOUGH I made very accurate readings! (Or so I was told.. and I was so sad when I found out I couldn't do it that way haha)

I don't know, it took me a lot of practice before I could hear the systolic with the chest piece outside the cuff. LOTS of practice. What also helped was looking at the dial! Because sometimes you can tell about when the sounds are supposed to occur... so I guess by knowing when to expect sounds helped me distinguish them. haha.

Best of luck with all your endeavors :) keep trying! YOU CAN DO IT!

I had the same problem! LOL I realized after many attempts, that I was only able to hear it when I placed the chest piece beneath the cuff right on top of the brachial artery haha (I got this idea because my mom purchased a stethascope/sphygmomanometer and they were fused together as such) . But we're not supposed to do that XD - THOUGH I made very accurate readings! (Or so I was told.. and I was so sad when I found out I couldn't do it that way haha)

I don't know, it took me a lot of practice before I could hear the systolic with the chest piece outside the cuff. LOTS of practice. What also helped was looking at the dial! Because sometimes you can tell about when the sounds are supposed to occur... so I guess by knowing when to expect sounds helped me distinguish them. haha.

Best of luck with all your endeavors :) keep trying! YOU CAN DO IT!

You're not allowed to put the steth on the brachial artery UNDER the cuff (chances are high you'd get artifact--noise from the cuff rubbing the steth)....but you should be putting it on the brachial artery just under the cuff.

there is an online virtual blood pressure cuff that you can play around with and take practice blood pressures. make sure your computer's sound is turned on:

  • http://medicine.osu.edu/exam/ - to access the blood pressure cuff, scroll down to "objective iv" and click the link that says "take a blood pressure". when the player comes up, you can re-cycle the player over and over to hear and input blood pressure readings that it quizzes you on.

:up:

i cant begin to tell you how much i am grateful for all your posts. i went to the website and will share it will all my fellow students to help them practise as well.

but its true you have to have a good stethoscope, no double tubing you can hear the rubbing if you are moving, as one person said and place it in the antecubital fossa away ( far away) from the bp cuff because you can hear the rubbing of the cuff not the korotoff sounds and keep the hands very still and not move, you really have to concentrate and not move at all! when we were performing this skill in class it was very nerve wracking because it wasnt silent and any little movement, by patient or nurse, can alter what you are hearing. but its true you can have the needle jump make you a little more aware of the sound, and if performing it first using that and then do it again aware of where the jumps were you can try to listen a little harder at those points, but as others said be careful using that as a crutch.

but thanks this is awesome to have this website, i especially like hearing the breathe sounds that are also located on this site. thanks again daytonite:yeah: you are making us better nursing students one post at a time!!!:nurse::rolleyes:

Nepenthe Sea

Specializes in PICU/Pedi. Has 5 years experience.

FWIW, do learn how to read a manual BP the correct way. It's true that you hardly ever use those in the hospital setting, but last semester the CI made one of my classmates read a guy's BP with the cuff - on his leg! It's rare, but it does happen. I just pray that if I ever have to do it, I will remember the right way. Plus, I like to occasionally take a BP at home on a family member, just to keep an eye on their health. I never seem to have one of those "nurse-on-a-stick" things around the house when I need it, oddly enough! :lol2:

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