Blood Pressure

Blood pressure (BP) is the force of the blood against the wall of any blood vessel. The systolic BP is the pressure of the blood against the artery walls when the heart contracts (beats). The diastolic BP is the pressure of the blood against the artery walls between heartbeats, when the heart relaxes.

Tips to Ensure Accurate Measurement:

Delay BP reading if patient has smoked (transient increase in BP), consumed caffeine (increase BP), or exercised (lower BP) within the past 30 minutes.

• • Make sure arm is free of clothing (rolling up the sleeve can cause a tourniquet around the upper arm).

  • Do not place the cuff on a limb being used for intravenous or intra-arterial infusions, any area where circulation is potentially compromised, has an arteriovenous fistulas, where lymphedema exists, the risk for lymphedema exists (e.g. lymph node dissection for treatment of breast cancer), or nonintact or injured skin.

  • If the above conditions exists bilaterally, use lower extremities to obtain a measurement.

  • Palpate the brachial artery to ensure it has a viable pulse.

  • Position the arm so that the brachial artery is at heart level (if below the reading will be higher, if above the reading will be lower).

  • While obtaining the blood pressure, neither the patient nor the person obtaining the blood pressure should talk

  • Avoid repetitive inflations of the cuff (produces venous congestion which can falsify readings); try on other arm or wait 2 minutes in between readings.

Interpretation / Clearance

Our client's safety is paramount. Blood pressure which exceeds 160 systolic and/or100 diastolic should be sent off for clearance. Therapist discretion can be utilized if sitting very near this level.

• Additional readings are required if blood pressure is > 140/90.

• Multiple readings should not be done on the same arm consecutively.

• An arm to arm difference > 15-20mmHg could be indicative of peripheral vascular disease and a letter to the GP should be sent for additional review.

• If reading remains high, at least one reading should be performed in supine.

• Client with elevated blood pressure should be provided with blood pressure letter for either clearance or review, our reception team should also be advised so that the booking agent/employer is made aware.

• Please note if the blood pressure is high, low intensity medical testing (do not do spirometry) and low intensity musculoskeletal testing (do not do fitness testing, manual handling, abdominal/core tests) can be performed prior to sending for clearance.