Hello, I am currently doing my internship,and I am having some trouble with my blood pressures. The problem is that I am having trouble hearing the sounds, especially if the pt is talking, moving around,or if they have on long sleeves. I was wondering if there was anything that I could do that would help me be able to hear the sounds better. Any advice would be appreciated.
Thanks,
TML

Are You Still In School? Yes

Are You Working? Yes

Are you feeling for the brachial artery? Put your stethescope directly over it above the antecubital fossa, not in the " crook" of the arm. That can help alot. Also make sure there is nothing touching the tubing or your stethescope as you can get alot of artifact. BP's should ALWAYS be taken on skin, not over clothing. Ask them to slide their arm out of their sleeve in order to get an accurate reading if they can't push it up far enough. HTH

Your Professional Title/Credentials: CMA/ RMA/CNA /SN

Are You Still In School? Yes

Are You Working? Yes

It also might help to ausculate the brachial artery where it lies closest to the skin (where the brachial crosses over from the medial side to the anterior side of the arm-over the ulna). Just make sure to line up the artery marker on the BP cuff with the artery and stethoscope...

Are You Still In School? RMA, BMO

My classmates were shown to put the diaphragm over the MIDDLE of the crook of the arm. I shook my head when I saw that. After many of them were failing to comp out I showed them to feel a slight mound above the crook on the INNER side of my arm,next to my body,and to press down hard because arteries are deep. THEN they were able to get it,and were feeling a brachial pulse for the first time. Also,always tuck the ear pieces in tightly,and don't use a large size cuff for a regular size arm,it's too awkward.

Your Professional Title/Credentials: MA

Are You Still In School? No

Are You Working? yes

I would shake my head too. Yes find the point where you feel the pulse and listen there. Regarding cuff size not only is a large cuff awkard to use on a regular sized arm just as a cuff that is too small will give you a false reading so will one that is too large. Always use the right size for the arm or leg you are using to obtain your B/P.

Chris

Your Professional Title/Credentials: Instructor for CMA\\'s and SST\\'s

Are You Still In School? Yes as an instructor

Are You Working? Yes