Two step blood preasure????

[newway]

Ok I think I got the basic concept but I have a question. Where do you check for the intial pulse to stop at? The brachial or the radial artery? Our instructor tells us to do it at the brachial, but my wife who is also an instructor at a different school say's stopping the pulse is stopping the pulse so the radial is much easier to feel and is the best spot, and was the way she was checked off by the state.

Now the instructor I have says if you check it at the radial you will feel it longer and pump the cuff too high when you go 30 over. My wife does say to do it how the instructor says, because she will be the one checking me off. But I just wanted to know in the real world which way is correct. I do find the radial pulse much easier. Which do you do?

[meandragonbrett]

We don't actually do this in the real world unless if we are just trying to get the palpable systolic BP in an emergency. Use the radial or brachial. I don't think it really matters.

[sunnycalifRN]

For school, just do it like the instructor says so you can be checked off. In the "real world", you'll see that automated BP machines are used most of the time.

[newway]

So no one actualy does the two step???? maybe it is just me because i am leaning but i can always find the radial pulse but the brachial is hard to find and keep.

[dannyc12]

If they make you palpate the brachial in checkoff, make sure you know your victim's usual systolic and go from there if you lose it.

Get good at finding the brachial pulse in any case. I practiced it at work for a while while before going through that checkoff.

[morte, LPN, LVN]

So no one actualy does the two step???? maybe it is just me because i am leaning but i can always find the radial pulse but the brachial is hard to find and keep.

you need to have the elbow fully extended and supported....the patient's arm needs to be relaxed.

[cjcsoon2bnp, MSN, RN, NP]

Not that I ever do it in real life but I would use the radial artery for taking the pulse. That's just me.

!Chris

[HappydayRn]

Yeah no one does that in real life, I remember doing it in nursing school though I always did the radial pulse.

[aussiemom]

The two-step method is really nice in that it doesn't squeeze the heck out of the Pt's arm, like the machine does. We were given free rein to practice our manual BPs in the hospital during clinicals, though we also regularly used the machines. We were taught to check the radial pulse for the two-step manual BP, as it is fairly easy to find. Pts were receptive to the technique when it was explained, particularly due to the reduction in uncomfortable squeezing! I'd go with whatever you need to get checked off. Know how to take a manual BP, because it can be useful. However, the majority of clinical sites I was at used a machine that checked pulse, BP, and pulse oximetry. In the nursing home, however, BP machines were non-existent (and thermometers were few and far between). Bring your cuff! Best of luck on checkoffs.

[newway]

Thanks!

For check off I will have to do it at the brachial, but afterwards I think I will switch the radial. My instructor was very negative about the machines. She thinks they are inaccurate and not able to detect an irregular heart beat.

[CASTLEGATES]

They palpate on firing ranges and in combat and in noisy situations like combat (emergencies, etc). Otherwise, the rest is fun school stuff. One would likely get in hot water over fooling with alternative ways of taking a BP and spending time with nonstandard practice. Whatever your books say is what will most likely be on the test.