What's the deal?

[dodgerla]

I'm a nursing student, just started this January. I am a little scared about the trouble I'm having with blood pressure. I can only hear it sometimes. Why? It's frusterating, is there something wrong with the way that I'm doing it? I practice on my husband and was trying earlier and couldn't hear it for the life of me and then when I finally did, it was really, really low. So we decided to give it a break for a while and try again later. It worries me because I have return demonstrations on Wed. and I'm afraid I won't be able to do it.... Is this a normal problem?

[Daytonite, BSN, RN]

Yes. You have to "train" your ears to pick out the sounds. Make sure you are not pressing down too hard over the artery with the bell of your stethoscope. You have to take many, many blood pressures and listen to many, many pulses before you "get the deal". Find patience. You'll get it.

[Lammmster]

Yes, be very patient. Do you palpate for an artery prior to taking the blood pressure? That will give you a good area to place the bell. Also many people make a mistake and place the bell over the anterior crevace of the elbow. You do not want to do that because most of the time you will not have the bell completely on the skin especially when the patient moves. It also could be the stethoscope your using as well. If you have the cheap ones they are not the greatest for listening and make it difficult.

[LaceyRN]

We just learned this skill but our instuctors told us to use the diaphram not the bell to ascultate the brachial artery. Which is correct?

[dodgerla]

Yes, they are having us use the diaphram also, and I've always seen others use the diaphram. I may be pressing too hard, and I have a littman stethoscope. I'll keep practicing, that makes perfect they say!

[meandragonbrett]

I am with daytonite on this one. It takes practice and lots of it. Sometimes there are some people's BP that you just can't hear (sometimes can't hear diastolic). Keep practicing and practice on different people.

[ChristineN, BSN, RN]

It took me forever to get BP's. You know why? my stethascope was broken, couldn't hear a thing through it (and it was a Littman), started using was of those disposable cheapies hospitals have for isolation rooms, now it hear it almost everytime. :)