HOW TO MEASURE BLOOD PRESSURE?
Accurate measurement and recording of blood pressure are essential to categorize levels of BP, ascertain BP-related cardiovascular risk, and guide management of high blood pressure. Most systematic errors in blood pressure measurement can be avoided by following the suggestions provided below:
Step 1: Properly prepare yourself
1. Have yourself relax, sitting in a chair (feet on floor, back supported) for >5 minutes.
2. You should avoid caffeine, exercise, and smoking for at least 30 minutes before measurement.
3. Ensure that you have emptied their bladder.
4. Neither the patient nor the observer should talk during the rest period or during the measurement.
5. Remove all clothing covering the location of cuff placement.
Step 2: Use proper technique for BP measurements
1. Use a BP measurement device that has been validated, and ensure that the device is calibrated periodically.
2. Support your arm (eg, resting on a desk).
3. Position the middle of the cuff on your upper arm at the level of the right atrium (the midpoint of the sternum).
4. Use the correct cuff size*, such that the bladder encircles 80% of the arm, and note if a larger- or smaller-than-normal cuff size is used.
5. Either the stethoscope diaphragm or bell may be used for auscultatory readings.
Step 3: Take the proper measurements needed for diagnosis and treatment of elevated BP/hypertension
1. You have to record BP in both arms. Use the arm that gives the higher reading for subsequent readings.
2. Separate repeated measurements by 1 to 2 minutes.
3. For auscultatory determinations, use a palpated estimate of radial pulse obliteration pressure to estimate SBP. Inflate the cuff 20 to 30 mmHg above this level for an auscultatory determination of the BP level.
4. For auscultatory readings, deflate the cuff pressure 2 mmHg per second, and listen for Korotkoff sounds.
Step 4: Properly document accurate BP readings
1. Record SBP and DBP. If using the auscultatory technique, record SBP and DBP as onset of the first Korotkoff sound and disappearance of all Korotkoff sounds, respectively, using the nearest even number.
2. Note the time of most recent BP medication taken before measurements.Step 4: Properly document accurate BP readings
Step 5: Average the readings
1. Use an average of ≥2 readings obtained on ≥2 occasions to estimate your level of BP.
*Selection Criteria for BP Cuff Size for Measurement of BP in Adults:
