What is essential when measuring blood pressure with a sphygmomanometer?

• A. Inflate cuff to a high pressure quickly
• B. Sit the resident with arm supported at heart level
• C. Place the stethoscope over the wrist
• D. Record measurements without noting systolic/diastolic

Answer: (B)

Getting an accurate blood pressure reading hinges on proper positioning and technique. The arm must be supported at heart level so the hydrostatic pressure matches the arterial pressure you’re trying to measure; if the arm is below heart level, readings tend to be higher, and if it’s above heart level, readings tend to be lower. That’s why seating the resident with the arm supported at heart level is essential. Place the cuff on a bare arm with the bladder centered over the brachial artery, not over the wrist, and position the stethoscope over the brachial artery to hear the Korotkoff sounds clearly. Inflating the cuff to a very high pressure quickly can cause discomfort and may not give you an accurate reading, so inflate to about 20–30 mmHg above the palpated systolic value and release slowly to detect the sounds accurately. Finally, record both systolic and diastolic values rather than just one number, ensuring a complete, accurate measurement.