3. Locate the Radial Pulse
- On the same arm, feel the inside of the wrist, above the thumb with your index and middle fingers until you feel the pulse.
- Hold your fingers on the pulse.
4. Inflate the Cuff
- Close the needle valve (air lock) counterclockwise attached to the hand control bulb firmly, but so it may be released readily.
- Pump to inflate the cuff until the radial pulse stops. Note the mercury level at which the pulse disappears.
- Look at the dial, and pump to 20 or 30mm Hg beyond where the radial pulse was no longer felt. This is the maximum inflation level (MIL). It means that the pressure of the cuff collapses the brachial artery and no blood is flowing through the artery.
5. Position the Stethoscope End Piece
- Place the end piece over the palpated brachial artery, in the one inch space above the antecubital fossa, and slightly toward the inner side of the arm. Hold tightly in place.
6. Deflate the Cuff Gradually
- Release the air lock slowly (2 to 3mm per second) so that the dial drops very gradually and steadily.
- Listen for the first sound: systole (“tap, tap”). Note the number on the dial, which is the systolic pressure. This is the beginning of the flow of blood past the cuff.
- Continue to release the pressure slowly. The sound will continue, first becoming louder, then diminishing and becoming muffled, until finally disappearing. Note the number on the dial where the last distinct tap was heard (not the muffled sound). This number is the diastolic pressure.
- Let the rest of the air out rapidly.
7. Repeat for Confirmation When There is a Question About a Reading
- Wait 30 seconds before inflating the cuff region again. More than one reading is needed within a few minutes to determine an average and ensure a correct reading.
- Write the date and arm used.
- Record blood pressure as a fraction. Example: R Arm, Nov. 3, 20XX 120/80.