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Technician in Rescue and Pre-Hospital Emergencies Course

Institution: Venezuelan Red Cross
Topic: Blood pressure measurement procedure
Study guide and class notes

Table of contents

General concept of blood pressure ......................................................................... 2

Normal blood pressure values ................................................................................. 3
Types of blood pressure meters .............................................................................. 4
Blood pressure measurement procedure with manual meter .................................. 5
Manual blood pressure meter .................................................................................. 7
Digital blood pressure meter (Monitor) .................................................................... 7
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General concept of blood pressure

In general, blood pressure refers to the pressure the blood makes on the walls

of the arteries when it’s pumped out by the heart. Besides this basic and

straightforward definition, we must consider additional concepts in order to have a

broader comprehension of the measuring procedure and its importance in the pre

hospital scenarios where paramedics and technicians in rescue work.

It is convenient to differentiate between two terms that are commonly

confused and therefore, used as synonyms. Such terms are pressure and tension.

The pressure refers to the force the blood makes on the walls of the arteries when

it’s pumped out by the heart. In other words, how hard the heart pumps the blood

out. The term tension refers to force the arteries make on the blood as it circulates

and it depends on the elasticity of the blood vessels. By knowing this difference, it is

understood that the correct term to use is pressure instead of tension. We measure

the blood pressure.

When we measure the blood pressure, we get two readings. The systolic and

diastolic pressures. The systolic pressure indicates the maximum force or pressure

applied against the walls of the arteries when the heart contracts to pump out the

blood through the circulatory system. The diastolic pressure indicates the minimum

force or pressure applied by the blood when the heart relaxes (This happens

between two heartbeats). The blood pressure is measured in millimeters of

mercury (mmHg) and denoted in the following format:

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(Systolic pressure over diastolic pressure / 120 over 80).

Normal blood pressure values

Globally speaking, there is a consensus about the average blood pressure,

which is 120/80 mmHg. This pressure is a standardized reading based on an

average healthy individual. However, normal blood pressure varies according to age

and gender.

Standardized normal blood pressure for systolic and diastolic pressures

(Maximum and minimum pressures):

▪ Systolic: it ranges from 100 to 139 mmHg.

▪ Diastolic: it ranges from 60 to 89 mmHg.

Blood pressure disorders:

▪ High blood pressure (Hypertension): Reading over 140/90 mmHg.

▪ Low blood pressure (Hypotension): Reading below 90/60 mmHg.

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Types of blood pressure meters

There are two basic types of blood pressure meters. Digital meters and

manual meters. Below, we can see some of the main characteristics of these

equipment.

Digital meters

▪ These meters don’t require any training, other than following the owner’s

manual, which make them ideal for domestic use.

▪ They are programmed to execute the blood reading automatically.

▪ As no auscultation with a stethoscope is required, they can be used in noisy

environments.

▪ Their measurements may not be as accurate as those obtained with manual

meters because they operate with electronic components and batteries that

are affected by environmental conditions such as temperature.

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▪ Digital meters are not recommended to be used with certain patients, such as

those with preeclampsia, arrhythmia, and other conditions. This is because

digital meters cannot accurately read these conditions.

Manual meters

▪ In comparison with digital meters, manual ones are more accurate, but

training is needed.

▪ It is necessary to use a stethoscope for auscultation.

▪ Manual meters require calibration checks in order to maintain accurate

readings.

Digital meter Manual meter

Blood pressure measurement procedure with manual meter

Patient’s position

▪ The patient should be seated and have his/her arm supported.

▪ It is advisable that the patient has rested for at least five minutes prior to the

blood pressure measurement.

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▪ In case of a pre hospital emergency where the patient is wounded, he/she

should be laid down on his/her back.

Measurement procedure

▪ Place the cuff around the upper arm in a snugly way. Not too tight and not too

loose.

▪ Place the cuff at the same height of the patient’s heart.

▪ Place the diaphragm of the stethoscope under the cuff on the brachial artery.

▪ Inflate the cuff until the needle reaches 200 mmHg, then slowly release the

pressure at a 2 to 3 mmHg rate.

▪ Observe the manometer. As the pressure falls, a series of pounding sounds

can be heard through the stethoscope. The first sound heard indicates the

systolic pressure.

▪ Continue hearing until the last pounding sound is heard. This last sound

indicates the diastolic pressure. Notice that the pounding sound fades as the

pressure in the cuff falls and the needle of the manometer jumps at the same

time you hear the sound.

Note: it is important that the size of the cuff is correct based on the patient

as an incorrect cuff size will result in a wrong reading.

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Manual blood pressure meter

Storage bag

Stethoscope

Cuff

Manometer

Diaphragm

Digital blood pressure meter (Monitor)

Cuff

Monitor