Blood Pressure Palpatory Method

The palpatory method of taking blood pressure is performed by using only a blood pressure cuff. It reads the systolic measurement, or the measurement of the heart at work. The palpatory method is useful in instances when a traditional blood pressure measurement, using a stethoscope and blood pressure cuff, cannot be done due to noise interference or other situations. The palpatory method is straightforward and takes minimal practice to master.

Preparation

• You will need a blood pressure cuff with attached manometer, the measurement dial. It is important that you use the correct size blood pressure cuff for your patient, as a cuff too large or too small for your patient's arm will cause an incorrect reading. Your patient should be sitting or lying with a relaxed, outstretched arm at heart level. Some patients become tense or nervous about having blood pressure taken, especially if they have had trouble with high blood pressure in the past, so try and assist your patient with relaxation as needed.

  Using two fingers, feel the radial pulse, the pulse at the wrist, of your patient's outstretched arm and count the beats for 60 seconds. This ensures that a patent radial pulse is present and gives a baseline pulse rate.

Method

• Place the blood pressure cuff just above your patient's elbow, wrap the cuff snugly around the patient's arm and secure with the Velcro closure. The cuff should be prepared for inflation by turning the valve on the inflation bulb fully clockwise in order to close the port.

  Palpating the radial pulse before and during cuff inflation is necessary in order to read the systolic pressure, so place two fingers over the patient's wrist until the pulse is felt. Leave your fingers there throughout the blood pressure reading.

  Pump the inflation bulb about 10 mm Hg/second until the radial pulse is no longer felt. This signals constriction of the brachial artery. However, to ensure the artery is completely constricted and able to provide an accurate pressure reading, pump the inflation bulb an additional 20 mm Hg after you no longer feel a pulse.

  With your fingers still on your patient's wrist, slowly open the valve on the inflation bulb clockwise and allow air out at about 5 mm Hg/second. As the brachial artery becomes less constricted, blood will begin to flow through, so feel carefully with your fingers at the patient's wrist for a pulse to return. The first beat you feel at the radius is the systolic blood pressure.

  The manometer needle may jump as the pulse returns, indicating the systolic pressure at the same time you feel the pulse beneath your fingertips. Be sure to record the number noted on the manometer as the radial pulse returned. Blood pressure readings are written as the systolic reading over palpation, for example: 110/P.

  Once you've obtained the systolic reading, quickly allow the blood pressure cuff to deflate as not to cause your patient any undue discomfort.