New to taking BP

EMT-B Trainee

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I just started an emt-b course. We have just covered vital signs and assessment. Due to the lack of time in class I still have no real idea on how to take a BP. My biggest problem is trying to find the area to put the stethoscope at to listen for a pulse. I can find the pulse on the wrist and do a reading that way but not the other way. If any one can help I would be very thankful. Any online pictures or videos would be great.
 

rescuecpt

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I dont have any pictures or videos, but here are some pointers:

Make sure to straighten the arm, I like to have it palm up as well. The arm should be level with the heart.

Put the cuff about 1 inch above the elbow. Make sure the cuff is tight around the arm and properly sized, otherwise the reading may be off.

When you put the earpieces in your ears, make sure they point forward towards your nose, not back.

Use your pointer and middle finger to feel for a pulse in the bend of the elbow. You should be able to find the brachial artery and feel the pulse. This is where you want to put your stethoscope. Listen to the beat with your steth - you are now in the right place.

As you inflate, keep listening to the heartbeat on the brachial artery. When you don't hear it anymore, give another good pump or two, then slowly loosen the screw to let air escape from the cuff.

The number of the first sound is the systolic (top number) pressure.

The second number is the diastolic (bottom number) pressure.

If you can't get a pressure, try again, but not more than 2x per arm because you will actually cause their pressure to spike a little in the arm that you keep pumping up. If you can't after two tries, let the patient relax for 5 minutes and try again.

If there is an IV in, never take the pressure in that arm. Also, if the patient has pain, or has had a mastectomy, don't take a pressure in that arm.

The best way to learn? PRACTICE PRACTICE PRACTICE!!! Find a buddy from class or your family members and check them.

Good luck!
 

ResTech

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Could'nt have explained it better myself... Taking a blood pressure is one of those skills that when you first have to learn it it seem's sort of difficult but after you get the hang of it and do them alot it will be very easy for you. Take Rescuelt's advice and it should come to ya.
 

Chimpie

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Yep, rescuelt did a great job explaining it.

Oh, and WELCOME TO EMTLife.com!!

Chimp
 

ffemt8978

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Great explanation, RescueLt.

Not to confuse our new member, but how many of you use the visual indications when taking a BP to back up your auscultation BP?
 

rescuecpt

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Originally posted by ffemt8978@Jul 18 2004, 12:34 AM
Not to confuse our new member, but how many of you use the visual indications when taking a BP to back up your auscultation BP?
Do you mean looking for the bounce? I try not to, but sometimes I use it when I'm hearing lots of different things or having a hard time hearing.
 

SafetyPro2

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Originally posted by rescuelt+Jul 17 2004, 11:27 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (rescuelt @ Jul 17 2004, 11:27 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-ffemt8978@Jul 18 2004, 12:34 AM
Not to confuse our new member, but how many of you use the visual indications when taking a BP to back up your auscultation BP?
Do you mean looking for the bounce? I try not to, but sometimes I use it when I'm hearing lots of different things or having a hard time hearing. [/b][/quote]
Same here.
 

Firechic

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What about palpating the BP if you can't hear? (and if the situation warrants it)
 

rescuecpt

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If I resort to "looking for the bounce" or palpating, I usually throw on the automatic cuff too to see what that reads - if it's similar to what I get by palp or by observation.
 

MMiz

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I dont know how others feel about it, but I dont use the bounce as a reading. If it comes down to it, I'll just get the BP by palpation.
 

ffemt8978

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I don't use it for a reading either, but I do use it as a back up to listening for the pulse.

What I mean is when I start to see the bounce, I know that I SHOULD hear the pulse pretty soon. If I don't, then something is wrong and I have to figure out what it is.
 

MMiz

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Originally posted by ffemt8978@Jul 20 2004, 11:20 PM
I don't use it for a reading either, but I do use it as a back up to listening for the pulse.

What I mean is when I start to see the bounce, I know that I SHOULD hear the pulse pretty soon. If I don't, then something is wrong and I have to figure out what it is.
Exactly. I know if I see it start to bounce, and don't hear a BP soon, I usually try to take it again.

It's another piece of great information, but I don't take it as a value.
 

emeraldjay

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I dont know how others feel about it, but I dont use the bounce as a reading. If it comes down to it, I'll just get the BP by palpation.
My experience when doing vitals, as a nurse aide rather than in the field, has shown me that the numbers can be nearly 20 off with both numbers. I agree that if you can't hear it, do it by palpation.

Anyone have suggestions on what brand/model stethoscope to use for getting a bp?
 

MMiz

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Originally posted by emeraldjay@Jul 28 2004, 08:19 AM
I dont know how others feel about it, but I dont use the bounce as a reading. If it comes down to it, I'll just get the BP by palpation.
My experience when doing vitals, as a nurse aide rather than in the field, has shown me that the numbers can be nearly 20 off with both numbers. I agree that if you can't hear it, do it by palpation.

Anyone have suggestions on what brand/model stethoscope to use for getting a bp?
Welcome to the forum!

In this post I talk about my stethoscope experiences. If you're in a clinical setting, there is no doubt, you need a Littman. If you're working in the ambulance, I'd get something for around $20 or so.

I've learned to really like my Littman. As much as I don't want to believe it, I really think people respect me more when I walk into a facility with it around my neck. It's sad, but I think when the ER doesn't have much to judge us on, they look at our stethoscope.

Still, I like it a lot, and I've been keeping an eye on it. The Littmans have a special way of being misplaced or stolen.

It's good to see you on the forum, I hope you decide to stick around.
 
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