BLOOD PRESSURE MONITORING – Palpatory Method and Auscultatory Method (MATERNAL AND CHILD HEALTH NURSING)
Palpatory Method
This method is useful for measuring the systolic BP only. This is used in the absence of a stethoscope
- Ask the woman to sit or lie down comfortably and relax. If the woman has come walking, let her rest for 5-10 minutes before measuring her BP
- The woman should be titled to her left side using a cushion placed behind her back
- Place the sphygmomanometer on a flat surface, level with the woman’s heart
- Ensure that the pointer on the dial is at zero. If not, adjust it by rotating the knob attached to the dial
- Fix the inflatable cuff on the upper part of either arm, after removing all clothing from that arm. The lower border of the cuff should not be more than 2.5 cm from the cubital fossa (elbow)
- The dial/manometer is placed at the same level as your eye
- Feel for the brachial artery over the cubital fossa, just medial to the biceps tendon, or alternatively feel for the pulse at the wrist of the arm, to which the cuff is tied, with your left hand
- Tighten the screw of the rubber bulb and inflate the cuff by repeatedly squeezing the bulb with your right hand
- The pointer of the dial will show increasing deflections above zero as the pressure increases within the cuff
- Keep on inflating the cuff and increasing the pressure by squeezing the rubber bulb till you do not feel the pulse
- Note the manometer reading. Increase the pressure by 10 mm Hg above the level at which the pulse disappeared
- Deflate the cuff gradually till you feel the pulse appear again. The level at which the pulse reappears gives the systolic BP
- Deflate the cuff by loosening the screw of the rubber bulb, and remove the cuff from the woman’s arm
AUSCULTATORY METHOD
This method is used if a stethoscope is available. It measures both the systolic and the diastolic BP levels
- Follow the same initial steps as mentioned in the palpatory method, and note them the woman’s systolic BP
- Now raise the pressure of the cuff to 30 mm Hg above the level at which the radial pulse was no longer palpable
- Place the stethoscope on the cubital fossa, ensuring that the diaphragm is in contact with the fossa. Ideally, you should not hear any sounds. Ensure that you are using the stethoscope correctly, with the ear pieces facing forwards when placed in the ears
- Lower the pressure of the cuff slowly, about 2 mm Hg at a time, till you start hearing repetitive thumbing sounds. The reading at which the sound first starts is the systolic BP
- Continue lowering the pressure until the sound first muffles and finally disappears. The reading at which the sound finally disappears is the diastolic BP of the woman
- The blood pressure is noted down on paper as “systolic BP/diastolic BP”
