Tik & Dug Sounds: Need Help In Taking A Blood Pressure

Nursing Students Student Assist

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NEED HELP IN TAKING A BLOOD PRESSURE! I'm getting a bit confused about which sound I should note as the systolic blood pressure. The book says that in taking a blood pressure using an aneroid type BP apparatus, the first sound that you here after you release the cuff pressure is the systolic BP and so I used that principle during our exposure in the clinical area. But there was an instance when I took a patient's BP and I heard this "TIK"sound at 170mmHg followed by the same "TIK-TIK-TIK" sound until the sound changed to a "DUG" sound at 150. Since I heard the first sound at 170, I told the nurse who was supervising me at that time that the systolic BP was at 170. She then took the patient's BP herself and told me that the patients systolic BP was at 150. She told me that the ticking sounds were extraneous sounds and that I should always consider where I heard the first "DUG"sound as the systolic BP. And then one time I encountered the same situation again (the ticking sounds first then a "dug" sound). I heard the ticking sound at around 160 then a dug sound at around 140. I was using an aneroid type BP apparatus then, but when I heard this ticking sounds again I decided to try using the automatic type of BP apparatus. The automatic BP monitor registered at 164 (so its around the level at which I heard the ticking sounds). PLEASE I REALLY NEED HELP WITH what I should follow...THANKS SO MUCH!

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Specializes in Adolescent Psych, PICU.

Maybe it would be easier for you to find the systolic palpating the brachial pulse instead of just listening? I usually palpate for systolic and listen for diastolic by pumping the cuff up about 20-33mm over what the systolic was and let it down, it takes longer though but I am able to be accurate each time. I am still just learning myself though but that is how I do it for now.

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Specializes in Neuro ICU, Neuro/Trauma stepdown.

170 and 160 are high systolic numbers, not that that doesn't happen, but i'm thinking you should listen to it all the way down, chances are you will realize you were just fidgiting around too much when you hear tiking or duging that sounds rythmic--like a heart beat. practice on your loved ones,or other girls in your class...they may not let you when it comes to iv sticks or urinary caths, but most people don't mind having a bp taken. my problem when i started was not having the ear pieces in my ears good, now i know i need to turn them outward to fit me good, everyone's different.

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i think maybe you are deflating too fast. i use to defate too fast and i heard the same thing. if you deflate a little slower you should hear a whossing sound

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Hey ya guys! Thank you! Thank you so much for replying to my query!

I hope you wouldn't mind me venting here but you know, because most of the time I get it wrong, I don't have much confidence in myself anymore with what I get when I take somebody's BP. I'll try the technique marilynmom, thanks!

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Specializes in med/surg, telemetry, IV therapy, mgmt.

i resurrected this thread because someone posted a link to a physical exam site that included an interactive blood pressure cuff that you can play around with for practice. here is the link:

http://medicine.osu.edu/exam/ - from ohio state university college of medicine, an interactive guide to physical examination for 8 body systems and includes sounds. has an interactive blood pressure cuff (the link is toward the bottom of the page, "take a blood pressure") where you click on a blood pressure bulb to start the inflation of the cuff. you will then hear and watch the manometer and tell the program what the final blood pressure is. it re-cycles to give you lots of practice!

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Specializes in Emergency & Trauma.

That is a fantastic site for practice. Thanks so much!

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Specializes in L&D, QI, Public Health.

Ok, stupid question.

When you release the gauge, should you be continually releasing it, or just release once and enough for it to go down by itself?

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Specializes in L&D, QI, Public Health.
Maybe it would be easier for you to find the systolic palpating the brachial pulse instead of just listening? I usually palpate for systolic and listen for diastolic by pumping the cuff up about 20-33mm over what the systolic was and let it down, it takes longer though but I am able to be accurate each time. I am still just learning myself though but that is how I do it for now.

Can you give me an example of how you do this and how the number you get from the brachial corresponds to the systolic

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Specializes in med/surg, telemetry, IV therapy, mgmt.

here are sites on how to take a blood pressure you might like to review:

http://www.ktl.fi/publications/ehrm/product2/part_iii3.htm - blood pressure measurement

http://homepage.smc.edu/wissmann_paul/anatomy1/1bloodpressure.html - how to take a blood pressure

http://nursing.about.com/od/assessmentskills/ht/bloodpressure.htm - how to take a blood pressure

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