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Measuring blood pressure part 2: procedure
(using a mercury sphygmomanometer)
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About this procedure:
This procedure describes how to recognise the Korotkoff sounds, and how to position the patient and the blood pressure cuff when measuring blood pressure. It describes how to estimate the systolic pressure, explains the auscultatory gap, and describes how to measure the diastolic pressures. The procedure explains how to document the readings, and discusses the pros and cons of K4 and K5 readings. (Note that an alternative version of this procedure is also available, showing use of an aneroid sphygmomanometer.)
Author:
Demonstrated by Richard Hatchett, Principal Lecturer Adult Nursing, London South Bank University.
Last updated:
April 2008; last reviewed May 2009
References:
Hjortskov N, Rissen D, Blangsted AK, et al. (2004) The effect of mental stress on heart rate variability and blood pressure during computer work. Eur J Applied Physiol 92(1-2): 84-89. www.springerlink.com/content/tawr8yuyqt0fk0kf/
O'Brien E, Asmar R, Beilin L. (2003) European Society of Hypertension
recommendations for conventional, ambulatory and home blood pressure
measurement. Journal of Hypertension 21: 821-848.
http://www.bhsoc.org/bp_monitors/ESH_BP_rec.pdf
Key Reading:
Beevers G, Gregory YHL, O’Brien E. (2001) Blood pressure measurement. Part II—Conventional sphygmomanometry: technique of auscultatory blood pressure measurement. Br Med J 322: 1043-1047. www.bmj.com/cgi/content/full/322/7293/1043
Bailey RH, Bauer JH. (1993) A review of common errors in indirect measurement of blood pressure. Arch Intern Med 153: 2741-2748. archinte.ama-assn.org/cgi/content/abstract/153/24/2741
British Hypertension Society website: www.bhsoc.org
Hatchett R, Curzio J, Stetson N. (2007) Clinical observation and monitoring devices. In: Hatchett R, Thompson DR (eds). Cardiac Nursing: A Comprehensive Guide, 2nd edn. Edinburgh: Churchill Livingstone, pp. 99-127.
Ljungvall P, Thorvinger B, Thulin T. (1989) The influence of a heart level pillow on the result of blood pressure measurement. J Hypertens 3: 471-474.
National Institute for Clinical Excellence. (2004) Hypertension: Management of Hypertension in Adults in Primary Care. London: NICE. Available at www.nice.org.uk/guidance/CG34/guidance/pdf/English.
Williams B, Poulter NR, Brown MJ, et al. (2004) The BHS Guidelines
Working Party Guidelines for Management of Hypertension: Report of the
Fourth Working Party of the British Hypertension Society, 2004 –
BHS IV. J Hum Hypertens 18: 139-185. www.bhsoc.org/Latest_BHS_management_Guidelines.stm
Related procedures:
Measuring
blood pressure part 1: equipment (featuring alternative sphygmomanometers
to mercury)
Measuring blood pressure part
2: procedure (featuring alternative sphygmomanometers to mercury)
Measuring blood pressure part
3: the patient (featuring alternative sphygmomanometers to mercury)
Measuring blood pressure
part 1: equipment (featuring mercury sphygmomanometers)
Measuring blood pressure
part 3: the patient (using a mercury sphygmomanometer)
Measuring blood
pressure lying/sitting and standing
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pdf of Procedure