Presented by Umna Naveed.

1. Blood Pressure
and Pulses

2. Measuring
Blood Pressure

3. Task
Estimate systolic blood pressure by
palpation. Measure systolic and diastolic
blood pressure by auscultation
 Preparation – 4 marks
 Palpation – 2 marks
 Auscultation – 4 marks

4. Setting up
 Alcohol Gel
 Clean your hands
 Make it visible to the examiner
 Introduce yourself
 “Hello. Good morning. My name is YOUR NAME. I’m a first year
medical student from University of Manchester”
 Confirm
 “May I please confirm your name?”
 “How would you like me to call you today?”

5. Setting up (cont’d)
 Informed Consent – explain what is involved
 EXPLAIN
 “Alright PATIENT NAME. I have been asked to check your blood
pressure. This will involve me putting this cuff around your arm
and inflating it”
 “This might feel a bit tight but it shouldn’t hurt”
 “I will inflate the cuff twice, or more if needed”
 “If at anytime you feel uncomfortable please let me know”
 CONSENT
 “Is that okay with you?”
 “Do you have a preference as to which arm I use?
Check :
IV lines / cannulas
Female pt. ask for birth control implants

6. Preparation
 “ Could you please roll up your sleeves to about here” (show
the patient how up you’d like them)
 “would you like any help with that?”
 Check Equipment
 Sphygmomanometer
 Cuff is fully deflated
 Dial is at zero
 Stethoscope
 Put the stethoscope on with the earpieces pointing forwards
 Gently tap the diaphragm and make sure you can hear a sound, if
you can’t then turn the tap on

7. Preparation (Cont’d)
 Make sure the Sphygmomanometer is away from patient’s
view
 Look for brachial artery
 Rest Pt. arm on the bench
 Ask them to bend their elbow
 Feel for the Biceps tendon
 Brachial artery medial to tendon
 Deflate the cuff and wrap it around pt. arm (according to the
arrow)

8. Estimating Systolic BP
 To examiner: “ I will first get an estimate for the Pt. systolic
blood pressure by palpating for their radial pulse”
 Find Pt. radial pulse
 Located lateral of forearm
 Inflate the cuff
 Up to 200mmHg
 Usually, up to this point the pulse is no longer palpable
 Deflate the cuff slowly
 To the point where the pulse becomes palpable again
 This is your estimated systolic blood pressure

9. Estimating Systolic BP
Report: “The patient’s systolic blood pressure is ______
mmHg.

10. Systolic & Diastolic BP
 Make the sure the sphygmomanometer is at 0.
 Put the stethoscope on
 Place the diaphragm on patients brachial artery
 located on the upper arm medial to the humerus
 Inflate the cuff 30mmHg above your estimated systolic
pressure value
 Deflate the cuff slowly
 First sound you hear = systolic pressure
 When this sound disappears = diastolic pressure

11. Systolic & Diastolic BP
Report:
“The patient’s systolic blood pressure is ______ mmHg
and diastolic pressure is ______ mmHg, accurate up to 2
mmHg”

12. Pulses
Examination

13. Task
 Should be able to locate and count any two of the
following pulses:
 carotid
 temporal
 facial
 brachial
 radial
 ulnar
 posterior tibial
 dorsalis pedis
Location and accurate measurement of each pulse – 4 marks

14. Carotid Pulse
Image 1: How to feel for the pulse Image 2: Anatomy of carotid artery
 Located in the Neck
 medial to sternocleidomastoid muscle
 Carotid artery
 Feel for it on one side only!

15. Temporal Pulse
Image 1: How to feel for the pulse Image 2: Anatomy of temporal artery
 Located on the temple bone
 Directly infront of the ear
 Superficial Temporal Artery
 Feel for it on one side only!

16. Facial Pulse
Image 1: How to feel for the pulse Image 2: Anatomy of facial artery
 Located on the Mandible (lower jawbone) on a line with the
corners of the mouth
 Facial artery
 Feel for it on one side only!

17. Brachial Pulse
Image 1: How to feel for the pulse Image 2: Anatomy of brachial artery
 Located on upper arm
 Medial to humerus
 Brachial Artery

18. Radial Pulse
Image 1: How to feel for the pulse Image 2: Anatomy of radial artery
 Located on the lateral of the wrist
 Radial Artery

19. Ulnar Pulse
Image 1: How to feel for the pulse Image 2: Anatomy of ulnar artery
 Located on the medial of the wrist
 Ulnar Artery

20. Posterior Tibial Pulse
Image 1: How to feel for the pulse Image 2: Anatomy of posterior tibial artery
 Located on the medial side of ankle
 2cm inferior and 2cm posterior to the medial malleolus
 Posterior Tibial Artery

21. Dorsalis Pedis Pulse
Image 1: How to feel for the pulse Image 2: Anatomy of dorsal pedis artery
 Located on the top of the foot
 Immediately lateral to the extensor hallucis longus
 Dorsal Pedis Artey

22. Thank you
Questions?