Taking Manual Blood Pressure: A Step-by-Step Guide

Electronic (automated) blood pressure (BP) monitors have become more common in health care settings.

But as a nurse, knowing how to take manual BP readings is still essential. In this guide, we’ll walk you through the steps of taking manual blood pressure in nursing.

Why is This an Important Skill for Nurses and Nursing Students?

Taking manual blood pressure is a fundamental skill for nurses and nursing students.

It helps assess a client’s heart health and detect potential issues early. Mastering this skill ensures accurate readings, which is vital for making informed clinical decisions.

Nursing schools often test students on manual blood pressure measurement proficiency, which is a requirement for many certifications.

What Do Nurses Use to Take Manual Blood Pressure

To take manual blood pressure, nurses use a sphygmomanometer and a stethoscope.

The sphygmomanometer consists of:

• An inflatable cuff
• A measuring unit (the aneroid manometer gauge)
• A bulb with a valve for inflating the cuff

Nurses use the stethoscope to listen to the arterial blood flow sounds (a loud swooshing sound that should sound like a pulse). These are Korotkoff sounds, which help determine the systolic and diastolic pressures.

Steps on How to Take Manual Blood Pressure

Taking manual blood pressure requires a systematic approach.

Follow these 10 steps for an accurate reading:

1. Wash hands and prepare the equipment. Ensure the sphygmomanometer and stethoscope are in good working condition. Select the right cuff size for the client’s arm.

2. Position the client. Have the client sit comfortably with their arm supported at heart level. Encourage them to relax their arms. Make sure their feet are flat on the ground and the legs uncrossed. Remind the client not to talk while you measure their blood pressure.

3. Locate the brachial artery. Palpate the brachial artery just above the elbow to find its pulse.

4. Apply the cuff. Snugly wrap the cuff around the upper arm, with the lower edge about an inch above the elbow. Align the cuff with the brachial artery.

5. Place the stethoscope. Position the stethoscope’s diaphragm over the brachial artery, just below the cuff’s edge.

6. Inflate the cuff to constrict the artery until the radial pulse is no longer palpable. Close the valve on the bulb. Inflate the cuff by squeezing the bulb. Continue inflating until the manometer reads at least 30 millimeters of mercury (mmHg) above the expected systolic pressure.

7. Deflate the cuff slowly. Open the valve slightly to deflate the cuff at 2 to 3 mmHg per second. Listen for the first Korotkoff sound (systolic pressure) and note the reading on the manometer.

8. Continue deflating. Keep deflating the cuff and listen for the point where the Korotkoff sounds disappear (diastolic pressure). Note this reading as well.

9. Record the readings. Document the systolic and diastolic pressures accurately. Looking closely at the BP device, you can see the needle jump at both points. For example, a blood pressure of 120/80 mmHg would mean that the systolic and diastolic pressures are 120 and 80 mmHg, respectively. Repeat the measurement if necessary to confirm accuracy.

10. Remove the cuff. Once the measurement is complete, fully deflate and remove the cuff from the client’s arm.

By following these steps, nurses can ensure they obtain accurate, reliable BP readings, which are vital for client care and management.

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