Measuring Blood Pressure?

Question

I am in school to become a medical assistant. I can draw blood, give injections, check pulses and am over all getting straight A's in all my courses. The trouble I am having is messuring blood pressure. I can't hear the heart beat. Does anyone have any suggestions on what I am doing wrong? I have the sphygmomenometer placed on the upper arm and the stethescope is place on the inner side of the arm where the elbow bends but I am still not hearing anything.

Answer 1

Before anything else,you need to familiarize yourself of the pounding sound of the pulse. Practice it constantly by listening to the sound of brachial artery.The pulse of the brachial artery is palpable on the anterior aspect of the elbow. Once you know well how it sounds then you are ready to listen to the sound you are after for when checking the blood pressure. Be sure to correctly place your sphygmo cuff and be sure that your stethoscope diaphragm are perfectly alright and on. Press the steth diaphragm on the brachial part where you could palpate the pulse gently and not press it hard. Inflate the sphyg cuff and release the pressure in the cuff very slowly while you are not yet so good in catching the sound . When blood just starts to flow in the artery, the turbulent flow creates a "whooshing" sound and be attentive as in a moment a pounding sound could be audible which will be the marked as the systolic and the last distinct sound as the diastolic. Last distinct sound will be followed by the usual sound of pounding of the pulse. Constant practice is all you need. Goodluck.

Answer 2

There are a few things to rule out.
1. Are you listening to the correct side of the Bell/diaphram? It should rotate, which alternates the side you can hear through the stethoscope. The diaphram is most commonly used for BP measurements
2. Do you have the earpieces pointed outward (towards your face)? Otherwise it would be hard to hear
3. Have you located the brachial artery? Placing the diaphram near the elbow is not specific enough. Although the location you describe is where the brachial artery is usually located, there are interindividual variations in location.
4. Is the cuff inflated? You won't hear a heartbeat when the cuff is inflated at a pressure greater than the patient's actual blood pressure.
I apologize if some of these are simplistic - just trying to rule out everything i can think of.

Once you can hear it (and you will eventually), the most common mistake that is made is letting the pressure drop too fast. I think that this because more common with more experience. The pressure should drop 2-3mmHg/sec. Any faster and you lose accuracy very quickly. Rarely do I ever see anyone do this properly

Answer 3

Find the pulse in the upper arm.
Place the cuff 2-3" above the bend in the elbow.
Place the scope on the pulse site without touching the cuff.
Ask your patient, if possible, what their pressure normally runs.
Pump appx. 50 mm/Hg above that.
Release the pressure smoothly, and LOOK and LISTEN for the first beat (you should see the needle jump at the same time you hear the beat).
Keep going until you hear second beat.
If you get a crazy reading, Look at your patient.....
It just takes practice....Soon you'll be doing it without a second thought.....

Answer 4

Feel for pulse (thumb side of elbow area= brachial artery, using index and middle finger) and place the stethoscope exactly there. Pump the cuff up to 200 and slowly release the pressure... if you still don't hear the beats, try it again. It does take some practice.
You can also move the stethoscope around alittle while the pressure is around 100 & you will eventually find it.

Answer 5

3 years ago, I was diagnosed - hypertension with a reading of 160/100. I used to feel dizzy a lot, my legs had awful cramps, and levels were very low in my potassium, causing my fingers and toes to always cramp together. One day I started to feel really faint while I was driving with my daughter in the back seat and I passed out, hitting 3 cars and ending up in a ditch. That moment,I knew I had to do something because my meds weren't working. I heard about this diet from a friend and thought I'd give it a shot. The results have been remarkable. In just 21 days, I honestly can't remember feeling this good, my blood pressure went from 175/110 to 125/70.

Answer 6

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Answer 7

There's some trial and error involved, but first things first. I bet you're using one of those cheapo stethoscopes with the single skinny tube and poor ear-pieces. Listen to something else, like your heartbeat, to make sure the ear-pieces are adjusted to where you can hear.

Answer 8

Are you sure you want to take someone`s blood pressure?
Surely, we all need our blood pressure, we cannot live without it, so leave it alone.
Besides, taking what does not belong to you is classed in this country as theft.
Be careful!

Answer 9

How well are you aligning the arrow on the cuff to the major artery on the underarm? Also, when was the last time that you had an audiogram?

Answer 10

First of all check to see if you have any hearing problem.

Second of all, talk to your instructor, he might be able to trouble shoot what you are doing wrong