Sometimes the noise level of your work area may make it very difficult to listen to the patient’s pulse with a stethoscope or you may not have a stethoscope available.

In such cases, use your fingertips (not your thumb) to feel the pulse instead of using a stethoscope to listen for the pulse.

The following steps summarize how this procedure is performed.

a. Position the Patient.

Position the patient so that you can easily take the patient’s pulse.

b. Locate Pulse.

Locate the patient’s pulse (inside elbow or knee).

c. Place and Inflate Bladder.

Wrap the bladder around the patient’s upper arm or thigh, as appropriate. (The bladder must be placed between the pulse site and the patient’s heart.)

d. Inflate Bladder to Starting Point.

Inflate the bladder while continuing to feel the patient’s pulse. Inflate the bladder until you feel the pulse stop; then inflate it another 10 mm Hg.

NOTE: Inflate the bladder to at least 140 mm Hg, but not more than 200 mm Hg.

e. Release the Air Slowly.

Turn the valve so that air escapes. Continue to feel for a pulse and continue to watch the gauge.

f. Determine Systolic.

The systolic is the pressure at which you feel the first pulse beat return.

g. Determine Diastolic.

The diastolic is the pressure at which the pulse changes to a less distinct (more normal) pulse. The diastolic measurement is only an approximation since it is usually difficult to determine the diastolic using this method.

h. Release Air.

Open the valve fully in order to relieve the pressure as quickly as possible.

i. Verify Readings, If Needed.

If you wish to check your results, squeeze the air out of the bladder, close the valve, and repeat the procedure.

j. Record Readings.

Write the patient’s readings (systolic/diastolic) on the form or paper. Remember that both readings are to be even whole numbers.

k. Remove Bladder.

Remove the bladder from the patient’s arm or thigh. Also assist the patient to adjust his clothing or position as needed.

l. Return Equipment.

If you are not going to take another patient’s blood pressure, return the sphygmomanometer to the proper storage area.