Taking BP: Can't hear systolic!

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We have gone over general CNA skills to make sure we have this knowledge base and for some reason I am having such a difficult time hearing the systolic sound when taking a BP.

A few things, please correct me if I'm wrong:

- The first sound I hear is the systolic number. (When I listen, it sounds awfully faint compared to diastolic number)

- The last sound I hear should be the diastolic number

- I'm placing the diaphragm of the stethoscope on the anticubital area.

- I inflate the cuff till it reaches 180mmHg (my friend's BP runs in the 120/80 range).

- I'm using a Littman Cardiology III

- I have no reported hearing issues and have gotten my ears tested. I can hear heart and lung sounds fine (if that helps).

- I am practicing taking BPs in a silent environment.

Any thoughts?

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

You are taught go pump to 180 in school, I know, as I was taught same thing. But if you know your friends sbp is 120, only pump to 130.

This is even more important if a persons bp runs high, like my exes. I took his while I was in Cna school. I could hear the sbp at 180, turns out he was running over 200 sbp. (Not med compliant)

Instead of listening at the genl antecubital area, you may want to first palpate a pulse, such as the brachial, and place your stethoscope there. This is the best site for listening. But once your ears are more trained for the sound, you'll likely be able to hear it anywhere in the genl antecubital area.

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Try holding the chestpiece between the distal phalanges of your index and middle finger in a 'V' shape for Victory.

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Hello,

I am in nursing school as well and have the same problem. Everyone keeps telling me to just practice..has yet to help tho. Good luck.

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Thank you everyone for the advice! Very much appreciated! I'll focus on continuing to practice on my live-in boyfriend this time (poor sucker, haha), try the "V"ictory method and try listening over the brachial artery. Thanks, guys. :)

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