[color=sandybrown]i was expirementing with taking a bp reading and i have a quick question! we haven't touched on this in class yet (should be this week!!) but i wanted to try it and see if i could do it. (and i'm excited about my lab kit that i just got!! ) i used my textbook as a reference...anyway...i had no problem finding the pulse...i inflated the cuff to 200mm hg and opened the valve. the needle started to jump about 10mm hg before i was able to hear the first clear sound. was i doing it right or should i have heard the first sound at the same time as the needle started pulsing? thanks for your help!!
There are different procedures based on the school that you attend. But in the end you should always be close to the same reading. If you are seeing the needle bounce but not hearing anything you should try to move the stethoscope. Sometimes it just takes a little movement and you'll hear it. Good luck to you!!
My textbook says to wait 10-15 seconds, but I disagree with it. It's too soon to reinflate the cuff and will result in a high systolic reading.
I usually do the estimate first, do the rest of the vitals, then finish the BP last. This gives sufficient time between readings, usually around 2 minutes.
But think about it. You are deflating the cuff very quickly post palpation. It doesn't give a false high.
I have never really seen anyone with experience use the deflate-reinflate method. There is no reason, IMO, for someone who is quick enough to deflate the cuff after your arterial palpation reading. I've taken plenty of BPs this way and never had a problem with subsequent readings. Then again, I'm fast. FWIW, if you look at different books for medical students, they say to use either the brachial or radial pulse. Bates mentions using the deflation technique and waiting 15 to 30 seconds before reinflating the cuff. I imagine if Bates, a book designed for MDs/DOs, says that 15 to 30 seconds is okay before you reinflate, then it must be safe and reliable. I just don't think it's necessary if you're good/fast.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I have never really seen anyone with experience use the deflate-reinflate method. There is no reason, IMO, for someone who is quick enough to deflate the cuff after your arterial palpation reading. I've taken plenty of BPs this way and never had a problem with subsequent readings. Then again, I'm fast. FWIW, if you look at different books for medical students, they say to use either the brachial or radial pulse. Bates mentions using the deflation technique and waiting 15 to 30 seconds before reinflating the cuff. I imagine if Bates, a book designed for MDs/DOs, says that 15 to 30 seconds is okay before you reinflate, then it must be safe and reliable. I just don't think it's necessary if you're good/fast.
Thanks for your excellent posts on this subject! Since for most of my career we only took manual BPs, you do get fast at it, most of the time you know where to place the stethoscope. I thought it was normal to see the needle start to jump before you hear the sound. These methods described sound very time-consuming, and we heard from one new grad here complaining that her preceptor was on her case for taking too long to do the BP, a bit of an argument following.
I'd just add one thing which is probably obvious to everybody- that if you don't hear it the first time to not keep pumping the cuff up over and over- like the nurse who was admitting my 7 week old baby for his inguinal hernia repair. . .I glanced over to see my son's arm a dark purplish-black! and then she had nerve to give me attitude when I stopped her!
) i used my textbook as a reference...anyway...i had no problem finding the pulse...i inflated the cuff to 200mm hg and opened the valve. the needle started to jump about 10mm hg before i was able to hear the first clear sound. was i doing it right or should i have heard the first sound at the same time as the needle started pulsing? thanks for your help!! 
and then she had nerve to give me attitude when I stopped her!
emmie9905
13 Posts
There are different procedures based on the school that you attend. But in the end you should always be close to the same reading. If you are seeing the needle bounce but not hearing anything you should try to move the stethoscope. Sometimes it just takes a little movement and you'll hear it. Good luck to you!!