 Hi and welcome to Nursing School Explained. This video will go over how to take a patient's manual blood pressure. So we need some tools for that. We need a set of scope and a blood pressure cuff. Let's take a look at the different compartments or parts of the blood pressure cuff first. So it is very important that you actually have the correct size blood pressure cuff for your patient because if the blood pressure cuff is too big for the patient, the blood pressure reading may be too low. If the blood pressure cuff is too small the patient's blood pressure reading will be too high and neither of those will give us an accurate reading of what the patient's blood pressure actually is. Now if we take a look at this blood pressure cuff it'll tell us over here that it's an adult regular size and then over here it also has the range in centimeters which in this particular case is 25.4 to 40.6 centimeters. And then in order to make sure that we have the correct size of the cuff for our patient, we look on the inside of it and see that there is the velcro part and then right underneath here is the actual bladder which is the part that gets inflated around the patient's arm. And the length of the bladder is supposed to be 40 percent approximately 40 percent of the patient's upper arm circumference. So what we will do is we will put the blood pressure cuff on the patient and make sure that it covers less than half of the patient's arm circumference in order to be the right size. Now looking at the two other compartments or parts we have our bulk here the one that actually inflates the blood pressure cuff. So there is the dial and then here's the bulk that we will actually squeeze to inflate the cuff. Now this dial if you are right-handed I would recommend holding it in your right hand and then having the control of the dial with your index finger and thumb and then dial it up all the way until it comes to the stopping point. Once it comes to the stopping point that means that now it's ready to be inflated and you can squeeze the ball to inflate the cuff and then gently move it with the index finger and thumb to deflate the blood pressure cuff. And you really want to do this very slowly because if the dial releases too fast you won't be able to see the actual reading. Now if you are left-handed it helps to turn this bulb the other way and actually hold it with your left hand. Now in this case you will need to turn it towards you to lock it and then again you hold it with the index finger and the thumb and in this case you will move it away from you to deflate but see it's very small movements here to make sure that the needle actually deflates at a rate that we can see easily see the patient's blood pressure. The other part of the blood pressure cuff is the actual sphing momentometer so the actual device that will give us the reading. As you can see here it goes from zero all the way to 300. It is very important that we assess the patient and ask them what their normal blood pressure is and then inflate the blood pressure cuff to approximately 20 to 30 millimeters of mercury above the normal blood pressure. So for example if the normal blood pressure is 110 over 70 we would inflate the cuff to approximately 130 to 140 and then slowly dial it so that you can easily see their normal blood pressure. There is no reason to inflate the blood pressure cuff to higher than that because it exerts a lot of pressure on the patient's arm and actually causes some discomfort. Now take a look at the dials in between so for example from 60 to 80 there is a bigger line that says seven that would be 70 and then in between we have smaller lines and increments of two so that would be 60, 62, 64, 66, 68 and 70. So it is really difficult on a manual blood pressure cuff to get odd numbers because you really need Spiderman vision to be able to see those in between lines so make be aware of that and make sure that you get your accurate readings mostly with even numbers here. And then one more part we need to discuss is this little loop here so this is actually an empty little device because you can hook the Spidermanometer either from the bottom with the hook in here and hold it in place or if you prefer there are these two little prongs back there you can actually hook it this way and it'll sit right here. Now both of them are a little flimsy and remember it's going to be sitting on the patient's left or right brink of artery so it might be more on the inside of their upper arm so it might be a little bit difficult so sometimes what I do is I just unhook it and ask my patient to actually hold it to where I can easily see it. So now let's take our patient's blood pressure. Hi I'm going to take your blood pressure is that okay? Yes. Can you tell me what your normal blood pressure usually is? It's around 120 over 70 something. Okay thank you so then we'll roll the patient's sleeve up we want to make sure that we actually don't put the cuff over a piece of clothing because that again might alter the results. So I'll take my cuff and place it around the patient's upper arm in this case that it is left upper arm so I need to make sure I line the arrow up with his brachial artery so I will feel for his brachial artery right there and line my arrow up then I will close the cuff with the belt roll and make sure that it doesn't move. Now you want to make sure that it's nice and snug but not too tight and not too loose and again that just takes time and practice. Now we have the tubing right here that can kind of be a little bit disorienting at times so in this case I'm going to ask my patient can you please hold this for me thank you and because I'll be using my center scope there's going to be three tubings here now if I the stethoscope tubing rubs against one of these other two I'm going to have a difficult time actually hearing the blood pressure reading so I always recommend detangling the tubing first so in this case I bring this around here and then I place my stethoscope at the patient's brachial artery so right where I just palpated I will put my stethoscope. Now make sure that you're not putting the stethoscope underneath I'm really jamming it underneath because again I might cause some friction that you can hear and it'll be very distracting especially if you're just starting to do that. So I put my stethoscope right here and the best way to hold it is to secure it with your thumb of your non-dominant hand and then have the fingers of the same hand behind the patient's arm that way you can kind of squeeze it against here and it'll be pretty steady. Other techniques I've seen in the past is holding it with your index and middle finger but that kind of makes it a little bit too wobbly for me so I like the other burden where you're really able to really just hold it and press it against the patient's skin of course we're very gentle with that and then I can let this go now because I have my a good vision of my this big momentometer right here so I put my earpieces in and I will start to inflate the cuff thank you for that. My reading was 108 over 68 which is normal so I'll remove the blood pressure cuff from the patient I take care of my patient get them back in order and I will record my findings. Thank you so much for watching this video on nursing school explain on how to take a manual block pressure please also make sure that you watch the other videos that assess the the rest of the vital signs thanks for watching