Taking BP's - Use Diaphragm or Bell?

[j_tay1981]

I'm in nursing school and I have two textbooks - one says take a brachial BP using the bell because the Kortokof (sp?) sounds are a low sound. Another says to use the diaphragm. How do you all take a manual BP?

[EDRN-2010]

I've always used the diaphragm to take a BP. As long as you are hearing it, I do not think it matters which side you use.

[Aymese]

In nursing school, I was always taught to use the bell for BP's. I believe the rationale was that it better auscultates higher pitched sounds. I've tried both ways though and can always hear better using the bell.

[dscrn]

always used diaphraghm (sp) for bp. bell for chest ascultations...

[emt2rn82]

I always use the bell for blood pressures, for me any ways I can hear a faint blood pressure almost all of the time. the bell never failed me yet

[mamamerlee, LPN]

Many hundreds of years ago, back in the Jurassic Age, the stethoscopes that were issued to the nursing students had only a diaphragm......

More currently, the disposable 'scopes in the rooms where the pts have infectious processes also usually only have a diaphragm.

And my 58 year old ears can still hear a BP with a cheap scope that only has a diaphragm!

[CorpsmanRN, BSN, RN]

always used diaphraghm (sp) for bp. bell for chest ascultations...

Interesting...I was always under the impression that the bell was for low frequencies (like heart) & diaphragm for high freqs (lungs). I use a Littmann & so have become accustomed to adjusting the pressure of the diaphragm.

[CuriousMe]

Interesting...I was always under the impression that the bell was for low frequencies (like heart) & diaphragm for high freqs (lungs). I use a Littmann & so have become accustomed to adjusting the pressure of the diaphragm.

This is what I was taught as well.

[TCASII, ADN]

Yes, the bell is for low frequency sounds and the diaphragm is for high frequency sounds. If you reference a book like Bates Guide to Physical Examination (MD/DO book), it says to use the bell because Korotkoff sounds are low-pitch. For cardiology, both the bell and diaphragm have their applications. Pulmonology mostly applies the diaphragm. DeGowin's Diagnostic Examination text also mentions using using the bell for brachial BPs. Despite this, some MDs and DOs prefer to use the diaphragm (or diaphragm mode on a tunable Littmann). If you own a tunable Littmann, light skin contact equals the traditional bell mode, whereas pushing firmly against the skin "activates" the diaphragm mode.

It's all about personal preference and how you hear it best with your ears. The quality of the stethoscope is important as is the length of the "tube"/binaurals. Shorter tubing is best.

[jlcole45]

diaphragm because these are usually higher pitched sounds.

[Chris NS]

diaphragm because these are usually higher pitched sounds.

arnt the krokoff sounds low picthed

[ICU, RN, BSN, B.S.]

Diaphragm. (spelling)!