Hudson River Healthcare Competency Checklist For Blood Pressure Measurement Page 2
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2Position the diaphragm of the stethoscope over the brachial pulse site.
Check stethoscope amplification for sound.
Position the diaphragm of the stethoscope over the brachial pulse site.
Close the valve on the bulb and inflate the cuff to the appropriate # mmHg.
Deflate at 2mmHg/ heartbeat (SLOW DOWN!).
When you hear the first sound, note the reading on the manometer. This is
the systolic pressure. Continue to allow air to escape and watch the
manometer/ needle gauge.
At the absence of any more sounds, note the reading on the manometer.
This is the diastolic pressure.
Release the remaining air in the cuff by opening the valve completely and
remove the cuff.
If need to reinflate to check for accuracy completely deflate, wait, 1-2
minutes and then reinflate.
Document in pt. record, pt. position, arm used, cuff size, blood pressure
measurement to the nearest 2mmHg, and any deviations from measurement
protocol that were unavoidable.
Competency Achieved MET NOT MET
Corrective action plan (if not met):
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Staff Member Signature
Date
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Reviewer Signature
Date
* Determine if the patient has any special conditions that limit which arm you use for taking the blood
Pressure: Is there an intravenous line in the patient’s arm? Are there wounds, an AV shunt, swelling, pain, or
deformities in either arm? Do not take the bp in an arm with any of these conditions. If the patient has had a
recent mastectomy, do not take the blood pressure on the side of the surgery.
• Neither pt nor clinician should talk.
• * One step-method: observer will inflate cuff to 30 mmHg above pt. usual systolic pressure as
starting point for BP measurement.
Classification of Blood Pressure level in Adults
Systolic mm Hg Diastolic mm Hg
Normal
<120
<80
Pre-hypertension
120-139
80-89
Stage 1 Hypertension
140–159
90–99
Stage 2 Hypertension
160
>100
*AHA and NHLBI categories
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