How to Appropriately Measure Blood Pressure in a Practice Setting

The OhioAFP, in partnership with the Ohio Department of Health, Dr. Ryan Kauffman and staff at Oakhill Medical Associates, and with the creative talents of Dr. Benjamin Romney, has created a video on how to appropriately measure blood pressure in a practice setting.
We encourage you to use this video to train office staff, students, residents, and physicians new to the practice so that the entire team may learn a similar technique.
This video was supported by Grant Number 2B01OT009042, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

[@mohamedfarag9037]

Best "complete" educational video, particularly the part of placing the cuff.

[@ahmedahm1]

Excellent training video ! Thank you Ohio Academy for FP

[@nathankillian3622]

This video is probably one of the best I have ever seen for the proper technique in measuring blood pressure. One factor that makes it outstanding is the addition of the Korotkoff sounds. I assume the sounds were dubbed in to correspond with the patient, Erin's, blood pressure of 106/78. Thanks to Erin for agreeing to participate in the making of this video. It would have been nice to hear her heart sounds also.

[@iMaGiNaTiOnWpAsSiOn]

Except the fact he used his thumb 🤷🏻‍♀️ You can hear your own pulse through the stethoscope when your thumb is on it. Not supposed to use the thumb.

[@rwakram]

Beautifully explained. Thanks a lot.

[@emonvirtud1084]

The most accurate. Thank you for making this video

[@iMaGiNaTiOnWpAsSiOn]

Except the fact he used his thumb 🤷🏻‍♀️ You can hear your own pulse through the stethoscope when your thumb is on it. Not supposed to use the thumb.

[@zarirmarawala1938]

Great job! I have to make my future RN and PA students "unlearn" the bad habit of pushing occlusive pressure to 200 and learn the radial artery technique. I'm requiring this video for all my students! Thank you Ohio Academy. Regards, DrZ

[@soonsuicidal]

Omg that is also what is taught to us. Even the nurses I knew taught the same thing. Just pump it to 200 mm/hg. 🤦🏻‍♀️ i'm just wondering is it normal to get results as is like for example 127/76, 115/91. Or do I still need to round it off? Coz I always see the results divisible by ten like 110/90, 120/80, 140/100 etc.

[@justjordan8018]

Best tutorial for this 10x.

[@michaelreyes1129]

Here's a great method that I used to lower my blood pressure: MaxHeart. xyz

[@1Brain4Wheels]

Thank you for including the sounds, this is very useful! :)

[@tomkpaik]

Finally the video provides actual sound!!

[@asim_a_m_alaraby]

Great information 🤍🌸. Thanks so much sir ☺️💗

[@nwadikefabian4481]

Thanks very much

[@bigpun1427]

Lovely patient

[@nguladan1062]

I want to see exactly to take the systole and diastole readings, but thanks for the nice video I will continue watching until I understand

[@joeritadayot2279]

Thank you

[@satriamandala6180]

Thanks

[@Robert-lo6uf]

This was the best blood pressure video by far! Thank You for sharing

[@faizaanaslifestyle375]

Thanks it was alot helpfull of all the videos❤️

[@BirdyOfficial]

Thanks for the great video.

[@catalindots9378]

Cheers for this, I've been looking for "what causes a chirping sound in my ear?" for a while now, and I think this has helped. Ever heard of - Meniley Deyilliam Method - (search on google )? It is a good exclusive product for discovering the real root cause of Tinnitus without the headache. Ive heard some great things about it and my work buddy after a lifetime of fighting got amazing results with it.

[@drnighatbukhari7]

Great information

[@bloodpressurecures344]

Great video. Keep up the great work!

[@medtricks7440]

I also explained it , but it's nyc too

[@bobbymike]

8 years old b4 I got to it but gotta be the best on you tube 8 yrs later 😊

[@renepage7072]

Hi there, I want to know if Hybetez Remedy, will work for me? I notice a lot of people keep on talking about this high blood pressure treatment.

[@drnighatbukhari7]

I can understand

[@amgluk]

The stethoscope sensor should not touch the cuff, but manufacturers produce kits where the sensor IS mounted on the cuff. In my experience, placing the transducer under the cuff only adds some noise, but does not greatly affect the intelligibility of the Korotkoff sounds.

[@mmmm5201]

good

[@ahmadkhan5395]

Thanks for the video

[@viswanathancr2801]

good video

[@adobemastr]

I believe this diastolic reading of 78 is incorrect. At 5:29 she says, "“The diastolic blood pressure is measured at the start of phase 5.” She describes Phase 5 at 5:23: "Phase 5 sound is not a sound, but rather is the level at which the sounds disappear.” Listening very closely with quality headphones on, there is a discernible thud exactly at 78, meaning, according to her, this is NOT the diastolic reading. I would humbly state the more accurate reading would be no greater than 76.

[@100PercentOS2]

I have a fat arm and your method does not work for me because the cuff doesn't completely close off the artery, so I inflate my cuff until it just begin to hurt a little. And my cuff is an adult large so the bladder is a sufficient size after doing some measuring of the bladder itself. So really, you need to consider how much fatty tissue is on the arm. While you have the stethoscope over the brachial artery which goes to the top of forearm, the artery marker on the cuff is not on the brachial artery running up the inside of upper arm in the middle of your bicep and tricep. The instructions on some of these sphygmomanometers will tell us to put the artery marker there. And it sure makes a lot of sense.

[@707SonomaComa]

My girlfriend works at a skilled nursing facility. Most of her patients are elderly and rather frail. What would be the best stethoscope for taking blood pressure manually? I am going to get her a Littmann Cardiology stethoscope. Would the Master Cardiology Stethoscope with a single sided 2 inch, 3.2 Ounce chestpiece work better than a Littmann Cardiology IV with a double sided 1.3 & 1.7 inch, 3.1 Ounce chestpiece.

[@olimphus26]

How many patients does she have? I heard "skilled nursing facilities" have outrageously high nurse to patient ratios.

[@BronsonWally]

What happens if you put the chesst piece under the cuff to hold it in place like i see some people do ?

[@100PercentOS2]

If I can't hear the korotkoff sounds while the stethoscope (no double head) is under the band on my arm than I'm forced to put it under the cuff where the marker is making sure it is over the brachial artery in the inside of arm. I get about the same readings using both methods. I don't know why that happens but it does and I've had an issue with it for several years now though most of the time the stethoscope is under the band.

[@ashifmahmud9244]

mesurement nice system....thanks

[@Prusi1995]

What is Hybetez Remedy? I've noticed several amazing things about this high blood pressure treatment.

[@Rajesh.j]

Sir which arm is preferred by health care professionals to measure BP and why

[@alexmurphy5289]

Neither one is preferred.

[@bradleyellis8376]

Do natural high blood pressure remedy like Hybetez Remedy really work and if so, how effective are they? I have heard several awesome things about this high blood pressure treatment.

[@laurenmatthews7418]

My friend asked my lookup CureBloodPressure6.blogspot.in the blood pressure level solution on Google. Before, his blood pressure was at 158/120. The end result of this program can be seen right away particularly if you eat the correct food items. Immediately after 2 weeks, he has noticed a progressive decline in his blood pressure level to 128/84. .

[@wendyklang683]

Corrected spelling: "disappeared"

[@nayanmipun6784]

Some say the last sound is diastolic and some say the no sound (phase 5) is diastolic

[@tommy-tungdoan3182]

Hmm....he shouldn't hold the stethoscope by his thumb because he could mis-hear his own pulse.

[@abdurrazzakkhan4487]

Sphygmomanometer how many price

[@aparnawarrier6085]

You're also supposed to use the diaphragm of the stethoscope, not the bell right?

[@iMaGiNaTiOnWpAsSiOn]

You can use the bell if you can’t hear with the diaphragm.

[@joeritadayot2279]

Permit to use this in my class

[@shadrackkwakye7049]

108/78

[@stevebh9846]

And here we have another case of the Emperor's new clothes. You can see the needle begin to move in time with the heart rate in this very video, starting a bit below 130 Torr. Yes, you can! It goes down, stops, goes down, stops. It is not smooth. It's the same rate as the heart rate, and it's caused by the BP. Yet it's high above the systolic BP, which is marked by the Korotkoff sound I, at 106 Torr here. So what IS this prescient predictive needle-bounce? What does it MEAN? Generations of nursing, paramedic, and medical students have asked this. Should they pay attention to it? Students fear that onset of this non-smooth pressure-reduction behavior in the cuff is really the systolic BP and their ears are so bad they can't hear the K I sound that should be going with it, and by the time they really hear it, they are listening to Korotkoff III, and have totally missed the systolic blood pressure. A few people actually convince themselves they DO hear a sound when they first see the needle start to bounce in time with HR, and these people then get a bad (artificially high) systolic BP reading. These people cause a lot of chaos. It does not help that many students are abused by their instructors by being told that the silent needle bounce isn't really happening, since it would be happening far above the systolic BP, so nothing can be causing this. So ignore what is not there, (students are told) and listen for the first sound, which is Korotkoff I. So students learn to notice see the silent bounce, learn that it means the K1 sound is "coming up soon" but to otherwise ignore it, except as herald. From the instructor side I think this is a fine demonstration of the art of "ignore what you can't explain." Okay, so here's the explanation for what you really see (and if you deny you see it, watch this video till you do): Far above the systolic BP pressure, while the cuff has still completely closed the arteries, the rate at which the BP cuff air pressure drops, is STILL influenced by blood pressure pulses, as you get close to arterial pressure. How could it NOT be? They expand the arm just at the cuff top. They put differential pressure on air in the cuff. They influence the rate at which air LEAVES the cuff. If you watch pressure in any air filled cuff, long before systolic BP is reached, you can see signs of the heart working, in the air-emptying behavior OF the cuff. In systolic phase, the cuff empties a bit faster. In diastolic phase, not as fast. But the needle stops falling perfectly smoothly, and starts to "jiggle" in time with the pulse. This is not the pressure of systolic phase. But it does exist in what you see on your gauge, and it tells you that your systolic BP pressure is approaching. I think this phase should have a name, something like "Korotkoff Phase Zero". It's silent, but so is Korotkoff Phase V. And by the way, you can see the needle "bounce" in the silent Korotkoff V region, too, if you look carefully. But people don't, because they don't want to see what they can't explain easily there, either. But the explanation in both cases, is the same. Artery pulsations influence manometer readings, even in pressure regions where the arteries are always open through the entire heart cycle. Live with it. Enjoy the complexity of nature. Don't ignore it and pretend it's not there. That's dishonest. Steven B. Harris, M.D.

[@100PercentOS2]

I'm very award off the bouncing needle before the Korotkoff sound and after the Korotkoff sound. I've been taking my own blood pressure for 20 years and have honed my skill taking note of many things. When a bouncing needle is seen before and after, the korotkoff sounds seems to me that the artery is not compressed enough at least in my case. And since I've been inflating my cuff to where it just begins to hurt a little I know then that the artery is completely compressed and I don't have that bouncing of the needle before and after. Only during the korotkoff sounds. Try it making sure the marker is on the brachial artery on the inside of the arm between the bicep and tricep.

[@cuffinkillian]

Erin does have her feet flat on the floor but only because she is wearing flat shoes. Should a woman remove her high heels before getting her pressure checked?

[@Zorro00444]

Such a long intro.

[@SaltySirenFloriduh]

I wish my doctors would actually use this technique. The digital cuffs always give me a wrong reading and they’re too lazy to pull out the manual cuff.

[@lelrica6883]

I'm sure you could request it if you wanted :)

[@candylara5771]

Ummm Is it just me or is he holding the stethoscope wrong??

[@hananu2853]

There s 2 sides of the stethoscope the smaller part usually gives a better sound maybe thats why

[@NickyEmpress123]

I think so too

[@iMaGiNaTiOnWpAsSiOn]

He’s holding it wrong- not supposed to use your thumb.

[@haunteddanelle5515]

Who has time for that

[@iMaGiNaTiOnWpAsSiOn]

Yeah, no one hardly does that in the real world. Lol.

[@mdsuneta6939]

.see.see

[@ralden2691]

Basically stole the script from the NEJM video from Dec 2014

[@marleneoliveira13]

did you really just use the bell of the stethoscope to take this BP? Horribly wrong.

[@dudemone]

aside from the fact that the stethoscope was turned towards the diaphragm.... 5:44

[@marleneoliveira13]

what do u mean by this? you use diaphragm to measure brachial a. bp.....bell is used for bruits.

[@marleneoliveira13]

Hi Johannes. This is just one study. Just because you read a few articles here and there doesn't prove this is the correct technique of taking a brachial blood pressure. Protocol for hospitals in NY, USA is to use the diaphragm. If different health professionals measured the BP with bell or diaphragm whenever they fancy, you can see different BP recordings, which is why its not recommended. Goodbye.

[@dudemone]

This may be just one study, but I wouldn't pontificate. Consider, how many guidelines and pieces of medical "evidence" are disseminated with an equally small amount of evidence, yet we take them for granted. Have you gone through the source reference for any given guideline and followed it to it's inception? You will find that much of our medical "knowledge" is based on equally small studies performed decades ago, in addition to a dose of the anecdotal. We are narrow as healthcare professionals when it comes to epistemology, holding things to be true whether or not we know any evidence exists. At least Johannes questioned the assumption, that is the first and most important step in evaluating evidence, had you been able to provide a valid alternate study, or even a theory as to why a diaphragm works and not the bell, your refutation would have been fairer.

[@Lillybellll]

Actually, it is correct because the bell of the stethoscope is more sensitive to those sounds. It helps you to hear the sounds better and get a more accurate reading. I know most will be trained to use the diaphragm, but the bell is better.

[@mahmoudsolimanphysicalther8141]

مش مترجم ارجع تانى 😂

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[@sayantikaghosh5876]

Use 3 fingers instead of 2 to feel the radial pulse in palpatory method.Your method was wrong

[@olimphus26]

Use 2,3, 10 fingers. . . No difference.

[@stuartbaker1181]

The method used was just as acceptable as your method. It makes no difference whatsoever. Are you incapable of palpating a pulse with less than three fingers?

[@akrambegum1313]

Postcolonial