Blood Pressure Problems

[ExplorerShane]

I have been practicing BPs on my family members recently to improve my skills, but have run into a little problem. I have difficulty finding the Brachial artery to place my stethoscope on to find how far I need to inflate the cuff. Anyone have any tips to improve in finding it?

[Timmy]

http://youtube.com/watch?v=wZ1zk5z-RZ0

[ccmedoc]

Put the cuff on the patient, find the brachial pulse by palpation. After you are sure you have the pulse, inflate the cuff to obliterate the pulse and take notice of the number. Deflate the cuff. Place your stethoscope, inflate the cuff to about 10-15 mm/hg over the number you noted earlier, and slowly deflate the cuff. You should hear light taps getting louder. The first taps will be your systolic, and so on....Try not to use the needle fluctuations as these are rarely accurate enough to record for a BP.

Hope this helps...I didnt watch the vid so if it repeats I apologize

[mobey]

Ya what they said and...

Have your Pt. straighten thier arm. Even palpate your own brachial right now with your arm slightle bent. Now straighten your arm right out and palpate it again....much easier hey!!

I always tell my patients the straighter they have thier arm the better I can hear. I find this proves true with the NIBP on our Lifepak, we get less false readings with a straight arm.

[WestSideBorderPatrol]

Ya what they said and...

Have your Pt. straighten thier arm. Even palpate your own brachial right now with your arm slightle bent. Now straighten your arm right out and palpate it again....much easier hey!!

I always tell my patients the straighter they have thier arm the better I can hear. I find this proves true with the NIBP on our Lifepak, we get less false readings with a straight arm.

We've had so many problems with the NIBP on the Lifepak, I just don't even use it anymore.

[mobey]

Ya I always get a baseline manually then if Pt is stable I will use the Lifepak.

[fiznat]

I don't always palpate for the artery before I listen to a blood pressure. It is helpful sometimes, but in general I know about the area that it will be in and the bell of the stethoscope is big enough to assure that I'll be in the vicinity. My advice would be to not get caught up trying to palpate. Work on tuning your ears instead.

[Nurseman]

The way I have been taught (student nurse)

- Attach cuff, Pt relaxes arm

- Palpate radial pulse, inflate cuff until pulse not felt. Note number

- Deflate cuff

- Palpate brachial pulse, place stethoscope on

- Inflate cuff to 30mmhg above reading when radial pulse was occluded

- Deflate 2-3mmhg per second

- Auscultate first sound, note systolic

- Auscultate last soud, note diastolic

[Nurseman]

Another thing, try getting the Pt. to flex their arm, put your fingers on the inner elbow as if to palpate the brachial pulse then get the Pt. to straighten their arm. Keep pressing, you should find it quite easily.

[Dustdevil]

Another thing, try getting the Pt. to flex their arm, put your fingers on the inner elbow as if to palpate the brachial pulse then get the Pt. to straighten their arm. Keep pressing, you should find it quite easily.

Good point. Flexion pushes the artery closer to the surface, making it much easier to palpate.

And always remember that all common pulses on the body will be found in a groove. If your fingertips are not pushing into a groove, you're in the wrong place. On the arm, that groove is in between the biceps muscle and the humerus. Find the biceps muscle, then slide your fingertips down until it slides into that groove, and you can't miss it.