Chart 3.3. – Steps of blood pressure measurement.

Steps
1. Measure arm circumference at the midpoint between the acromion and the olecranon.
2. Choose cuff sized to match the arm.
3. Place cuff snugly 2 to 3 cm from the cubital fossa.
4. Centralize the compressive part of the cuff on the brachial artery.
5. Estimate BP level based on palpation of the radial pulse.*
6. Palpate the brachial artery on the cubital fossa and place the stethoscope’s diaphragm without excessive compression;*
7. Inflate cuff rapidly until the estimated SBP level obtained on palpation is exceeded by 20-30 mm Hg;*
8. Proceed to deflate slowly (2 mm Hg per second).*
9. Determine SBP by auscultation of the first sound (Korotkoff phase I), then slightly increase the deflation velocity.*
10. Determine DBP when the sounds disappear (Korotkoff phase V).*.
11. Auscultate until 20-30 mm Hg below the last sound to confirm its disappearance, then proceed to rapid and complete deflation.*.
12. If heart beats persist until zero, determine DBP on the muffling of sounds (Korotkoff phase IV) and write down the values of SBP/DBP/zero.*

DBP: diastolic blood pressure; SBP: systolic blood pressure. * Items performed exclusively in the auscultatory technique