Taking BP Question?

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That1Guy

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Hey everybody, I'm new to the forum and am currently in my 3rd week of my EMT-B program. I had a pretty simple question that I forgot to ask in class about taking a patient's blood pressure so I figured I'd ask you guys :D After securing the BP cuff on the patient, do you generally palpate the brachial pulse to find the exact location before placing the stethoscope over it? Or do you just place the stethoscope in the lateral antecubital space without palpating since that is where the artery is located? I have a skills test on blood pressure next class so I'm trying to get really solid on it! Thanks a ton.
 
I don't think I've ever needed to palpate in order to locate the brachial artery. I've only seen a handful of people do it, and they were all students.
But if your instructors told you to do it, just humor them ;)
 
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Underoath87 said:
I don't think I've ever needed to palpate in order to locate the brachial artery. I've only seen a handful of people do it, and they were all students.
But if your instructors told you to do it, just humor them ;)
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Pretty much that. You may need to do it during school but it is not done in the field (at least I have never seen it done).
 
So forgive me if I'm wrong, because I've had quite a bit of bourbon tonight :unsure: ... but what are you looking for in the lateral AC?

And no, I've never palpated to find the brachial. I've got a pretty good idea of the anatomy and where it should be.

Don't stress too much over it. It's just a blood pressure. There are plenty of other things to focus your time on. (Honestly, when I started teaching, I forgot that I once had to learn how to take a blood pressure :lol: )
 
Thanks for the quick responses guys! I don't see much of a need to palpate as well.

STXmedic said:
So forgive me if I'm wrong, because I've had quite a bit of bourbon tonight :unsure: ... but what are you looking for in the lateral AC?
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Hey forgive ME if I am wrong! That's roughly where I've been placing the stethoscope while listening, but perhaps my terminology or target area is off. I completely welcome constructive criticism if so! ^_^
 
That1Guy said:
Thanks for the quick responses guys! I don't see much of a need to palpate as well.



Hey forgive ME if I am wrong! That's roughly where I've been placing the stethoscope while listening, but perhaps my terminology or target area is off. I completely welcome constructive criticism if so! ^_^
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Remember that lateral means away from the midline of the body. Medial is towards the midline. Your artery runs on the medial aspect
 
Yep, you're completely right. And now I retreat back to my studying :blush:
 
I guess Im the only one who does this. I don't do it all of the time, only on people I suspect will be a bit difficult to hear, and I don't spend a lot of time doing it, but Ill sometimes palpate real quick so I can put the steth right over the brachial, especially if its someone who has large or flabby arms. It just makes my job easier as I have less than perfect hearing, and the location of the brachial can vary a little bit between people.

It doesn't hurt to do it, especially if you are starting out so you can get an idea where exactly the brachial is located in different people.

I think this habit started when I was a CNA. For our state test we had to first palpate a brachial pulse, get a BP by palp using the brachial, then do it auscultation(we were supposed to announce what we got by palp and then pump the cuff 30mms over), so I practiced it a lot before taking the test and just got in the habit. Things aren't as nitpicky in the EMS world though.
 
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I started out doing it, but soon realized if you have a general idea of where you're supposed to be and your cuff is pressurized enough, you can just firmly push the chest piece and hear a pulse. It may be a little faint, but you should still be able to get what you need with that.
 
I don't usually palpate prior, but I have....I don' t think it'll matter either way as long as you're comfortable and can obtain an accurate reading. But on the flip side, if that's what the instructor wants then do it...you'll find things are much different once you're in the field.... don't sweat the small stuff... good luck in your class!
 
I don't palpate either.

Don't put the edge of your stethoscope under the P cuff, it adds noise and can cause inaccurate readings. One of my pet peeves, I've had more than a few students who were very intent on making sure the stethoscope was under the cuff. That to me shows a fault on the instructor.
 
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