Take a Blood Pressure

Blood pressure can be an important vital sign, both in military and humanitarian settings.

In military tactical settings (in the middle of a battle), BP measurements are nearly impossible to take (noise of battle), but are also not of much use.

Once the battle is over and the victim moved to a protected setting, the BP may be more important. In contemplating MEDEVAC, one of the considerations may be the patient's blood pressure.

To take a blood pressure using the cuff:

• Feel for a pulse from the artery coursing through the inside of the elbow (antecubital fossa). This will be your landmark.
• Wrap the cuff around the bare arm (push the sleeve up or you may get a false recording).
• Line up the "Artery" lable on the cuff with the arterial pulse you felt in the antecubital fossa.
• Make sure the "Index Line" falls between the "Need Smaller Cuff" line and "Need Larger Cuff: lines.
• Place the stethoscope head directly over the artery you found. Press in firmly enough to make a good connection with the skin, but not so hard that you block the artery with pressure from your stethoscope.
• Close the thumb-screw next to the squeeze bulb.
• Pump the squeeze bulb several times, until the blood pressure gauge rises to 180 or 200.
• Open the thumb-screw to slowly release the pressure.
• As the pressure is slowly falling, listen with the stethoscope for the steady "bump, bump, bump" of the pulse. 
• Systolic blood pressure (the first of the two numbers) is the pressure at which you can first hear the pulse.
• Keep listening as the pressure continues to slowly drop. Below a certain pressure, you will no longer be able to hear the "bump, bump, bump" of the pulse.
• Diastolic blood pressure is the last pressure at which you can still hear the pulse.
• Record the blood pressure as "XXX/YYY" (Systolic pressure / Diastolic pressure.)

Sometimes, blood pressure must  be estimated rather than directly measured. If you are in a noisy environment and cannot hear with the stethoscope, or if the equipment is not available, then estimation may be necessary.

The presence of a pulse in certain body areas correlates reasonably well with the following blood pressures:

Feel for a pulse

Align the "Artery" lable on the cuff with the pulse you felt.

Make sure the "Index Line" is within the normal range.

Close the valve and pump up the cuff.
Slowly release the pressure.
Listen for the steady "bump, bump, bump" of the pulse.
Note the pressure when you first hear it, and when you can no longer hear it.

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*This web version is provided by The Brookside Associates, LLC.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. The medical information presented was reviewed and felt to be accurate in 2001. Medical knowledge and practice methods may have changed since that time. Some links may no longer be active. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

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