How to Measure Blood Pressure Using a Cuff and Stethescope

Normal blood pressure levels are essential to a person's overall health and wellness. Knowing how to use a a manual blood pressure cuff along with a stethoscope to measure one's levels is an important skill, in today's world of digital monitoring. A manual cuff allows for greater control and accuracy in readings and can be very useful for monitoring one's blood pressure at home. This guide will walk you through the process of taking an accurate blood pressure reading with manual tools step-by-step.

1. Blood pressure cuff with attached pump bulb and manometer
2. Stethoscope
3. Willing test subject (referred to as "patient" in instructions)
4. A chair and table for proper arm support

To ensure accurate results, have the patient sit in a chair with their feet flat on the floor, while they place their arm on a table at heart level, palm up. Then to prevent any interference roll up the patient’s sleeves if present.

Note: blood pressure is not limited to a specific arm, so whichever is most convenient for the patient is perfectly suitable for use.

Once the patient is situated, place two fingers together on the inside of the patient's elbow to feel for a pulse.

It should be located towards the inner elbow crease, but can sometimes be difficult to locate, and require moving around to identify the correct area.

Open the cuff completely and carefully wrap it around the patient's arm, ensuring that it sits about an inch above the crease of the elbow.

Depending on if you are using the right or left arm, align the correct arrow to the brachial artery on the inner elbow (where the brachial pulse was felt in Step 2).

The cuff should fit snuggly so it stays in place but loose enough that two fingertips can fit underneath.

Note: some cuffs will have a metal loop that holds it in a round shape, if it is present tuck the end of the cuff through the loop before sliding it on the arm.

The Manometer or gauge should come with a clip or attachment on the back that will fit into place just above the artery indicating label on the cuff.

Once clipped into the correct position it will allow for easy monitoring of the blood pressure

Note: on an average blood pressure cuff, the gauge should start at 20 mmHg (millimeters of mercury) and end at 300 mmHg.

Grab the stethoscope and place the ear tips inside your ears.

Then place the larger drum side of the stethoscope under the edge of the cuff, on top of the patient's brachial artery, and lightly hold it in place with one hand.

Using your other hand, locate the metal valve on the bulb and turn it clockwise until the airflow through the valve is closed.

Rapidly squeeze the pump bulb while watching the manometer gauge carefully, pumping until it reaches about 180 mmHg or 30 mmHg above your patient's usual systolic pressure.

Note: if the gauge moves and then falls back downward make sure the valve is closed completely to block any unwanted airflow, then retry.

Very slowly turn the valve counterclockwise until the gauge begins to fall at a rate of about 2 mmHg per second

Note: if the gauge falls too fast, the readings will no longer be accurate and the procedure will need to be started again from Step 6.

Using the stethoscope listen very carefully and note when you hear the first sound. This is your patient's pulse and should occur around 120 mmHg.

This is the patient's systolic pressure reading

The gauge will continue to fall and at about 80 mmHg the pulse sounds will fade out.

Take note of when the sound is no longer audible, this is the diastolic pressure reading

Once you have the diastolic reading, completely open the valve by continuing to turn counterclockwise and deflate the cuff quickly.

Once deflated, remove the cuff from the patient's arm, and write down the systolic and diastolic pressure in a fraction format.

Systolic/Diastolic (read systolic over diastolic)

Systolic is the force exerted on the artery walls by the blood as the heart pumps, and diastolic refers to the pressure of the blood in the arteries between heartbeats.

The normal rate of blood pressure for the average healthy human is 120/80 mmHg.

A patient with blood pressure frequently above the normal range should consult a doctor. (refer to the chart above to see what levels there are of high blood pressure and the severity of their diagnosis.