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Blood Pressure Measurement: Sphygmomanometer Technique Step-by-Step

Accurate BP measurement requires standardized technique (AHA/ESH guidelines).

Equipment

  • Validated upper-arm cuff device (automated oscillometric preferred for routine).
  • Manual: Aneroid sphygmomanometer + stethoscope (auscultatory – gold standard).

Patient Preparation

  • Rest 5 min, seated, back supported, feet flat, legs uncrossed.
  • No caffeine, exercise, smoking 30 min prior.
  • Arm bare, supported at heart level.

Cuff Placement

  • Correct size: Bladder encircles 80% arm, width 40% circumference.
  • Lower edge 2–3 cm above antecubital fossa.

Manual Auscultatory Method

  1. Inflate to 20–30 mmHg above radial pulse disappearance.
  2. Deflate 2–3 mmHg/sec.
  3. Korotkoff Phase I (first tap) = Systolic.
  4. Phase V (disappearance) = Diastolic.
  5. Record to nearest 2 mmHg.

Automated Devices

Follow manufacturer; validate annually. Take 2–3 readings 1 min apart; average.

Common Errors

  • Wrong cuff size (too small → falsely high).
  • Arm below heart level.
  • Talking/moving during measurement.
  • Terminal digit preference (rounding to 0/5).

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