Learning Target

By the end of this station, the student should be able to:

1. Measure blood pressure correctly using palpatory and auscultatory methods.
2. Identify systolic and diastolic blood pressure and explain their physiological significance.

Required Material

• Sphygmomanometer
• Stethoscope
• Chair / examination couch
• Table or arm support
• Simulated patient / peer model
• Station instruction card

Student Task / Procedure

1. Explain the procedure to the patient and ensure the patient is relaxed.
2. Seat the patient comfortably with the arm supported at heart level.
3. Wrap the cuff around the upper arm, about 2–3 cm above the cubital fossa.
4. Ensure the cuff bladder is placed over the brachial artery.
5. Palpate the brachial artery in the cubital fossa.
6. Use the palpatory method to estimate systolic blood pressure.
7. Place the stethoscope over the brachial artery.
8. Inflate the cuff above the estimated systolic pressure.
9. Deflate slowly and listen for Korotkoff sounds.
10. Record:

• Systolic BP: First clear Korotkoff sound
• Diastolic BP: Disappearance of Korotkoff sounds

11. State the BP reading in mmHg.

Observation / Identification Points

The student should correctly demonstrate:

• Correct patient position: seated, relaxed, arm supported
• Correct cuff placement on upper arm
• Cuff lower edge 2–3 cm above cubital fossa
• Cuff bladder aligned over brachial artery
• Palpatory estimation of systolic BP before auscultation
• Stethoscope placed over brachial artery, not under cuff
• Slow cuff deflation during auscultatory method
• Correct identification of systolic and diastolic BP

Result / Interpretation

• Systolic blood pressure is the pressure in arteries during ventricular systole.
• Diastolic blood pressure is the pressure in arteries during ventricular diastole.
• In auscultatory BP measurement:
  • First Korotkoff sound indicates systolic BP.
  • Disappearance of Korotkoff sounds indicates diastolic BP.
• Correct BP measurement is important for screening and monitoring hypertension, hypotension, shock, and cardiovascular risk.

Viva Questions

1. Which artery is used for routine blood pressure measurement?
Answer: Brachial artery.

2. Why is the palpatory method performed before auscultatory measurement?
Answer: To estimate systolic BP and avoid missing the auscultatory gap.

3. What indicates systolic blood pressure during auscultation?
Answer: The first clear Korotkoff sound.

4. What indicates diastolic blood pressure during auscultation?
Answer: Disappearance of Korotkoff sounds.

5. At what level should the arm be supported during BP measurement?
Answer: At the level of the heart.

Marking Scheme

Total Marks: 5

Common Student Mistakes

• Placing the cuff too low or too loose.
• Putting the stethoscope under the cuff.
• Deflating the cuff too quickly.
• Skipping the palpatory method.
• Not supporting the arm at heart level.

AIM Feedback

To improve, revise the correct sequence of BP measurement: position patient → apply cuff → palpate brachial artery → estimate systolic BP by palpatory method → auscultate Korotkoff sounds. Always remember that the first Korotkoff sound is systolic BP, and the disappearance of sound is diastolic BP. Accurate technique prevents false BP readings.

Short Caption:
Watch this short procedure video to revise correct cuff placement, palpatory estimation, auscultatory method, and identification of systolic and diastolic blood pressure.