What is the correct technique to measure blood pressure using a manual cuff?

• A. Arm supported at heart level, cuff snugly, locate brachial pulse, inflate above systolic, deflate slowly, read systolic/diastolic.
• B. Arm raised above head, cuff loose, inflate to 60, read only systolic.
• C. Use thigh cuff with leg extended; measure diastolic only.
• D. Ask patient to estimate blood pressure by symptoms.

Answer: (A)

Measuring blood pressure with a manual cuff relies on doing it with the arm at the correct level and using the cuff properly to hear the real arterial sounds. Position the arm supported at heart level so the reading isn’t skewed by gravity. Make sure the cuff fits snugly around the upper arm and that you can feel the brachial pulse under the cuff so you know you’re listening in the right spot. Inflate the cuff to a level above the estimated systolic pressure so the artery is fully occluded, then slowly deflate while listening with a stethoscope placed over the brachial artery. The systolic pressure is read when you first hear the sounds (Korotkoff phase I) and the diastolic pressure when the sounds disappear (phase V). This combination of position, snug cuff, accurate palpation site, and deliberate deflation is what yields a reliable manual reading.

Other options don’t fit because they violate one or more of these principles: raising the arm changes the reading due to hydrostatic effects; a loose cuff or inflating to a fixed number without occluding the artery leads to inaccurate results; using a thigh cuff on the leg is not the standard method for a typical upper-arm measurement; and asking the patient to estimate blood pressure by symptoms is not a valid measurement.