CARDIOLOGY

Demonstrate procedure of manual blood pressure measurement to students, outlined below:

• Explain procedure and obtain consent. Wash hands.
• Ensure that the patient is comfortable and rested, with arm supported at heart level and the arm straight and sufficiently exposed.
• Ensure that the correct sized cuff is being used and apply it to the upper arm with the centre of the cuff over the brachial artery.
• Position fingers correctly to palpate the brachial pulse.
• Inflate the cuff until the pulse is impalpable, noting the pressure on the manometer.
• Deflate the cuff and allow the patient’s arm to recover.
• Re-inflate the cuff to a pressure 20mmHg higher than the blood pressure by palpation.
• Place the stethoscope on the brachial artery and auscultate.
• Deflate the cuff by 2-3mmHg per second.
• Listen to and note the point at which you hear the first heart sounds.
• Continue to deflate the cuff and record when the heart sounds disappear.
• Explain findings and their significance to patient.
• Record blood pressure correctly in notes or on NEWS chart accurately.
• Decide if further examination/action is necessary.

If necessary, briefly discuss the physiological mechanisms underpinning the Korsakoff sounds.

Allow students to practice on each other. Provide guidance or further support as necessary.

1. https://geekymedics.com/blood-pressure-measurement/