how to take standing blood pressure

It’s important that you don’t clench your fist when you’re taking your blood pressure. Blood pressure with low reading is acceptable. Allow the patient to stand for one minute. For example, low blood pressure of 85/55 mmHg is still acceptable. Sign in or Register a new account to join the discussion. Compare with previous readings and, if there is cause for concern, inform senior nursing or medical colleagues. % of people told us that this article helped them. This condition is when a person’s blood pressure increases while standing up 6. Explain the procedure to the patient and obtain consent. Wrap the cuff around the upper arm with the cuff's lower edge one inch above the antecubital fossa. Rest your left forearm on the table. Remove and dispose of gloves and aprons if used. measure blood pressure again with the person standing for at least 1 minute before measurement. The routine measurement of both lying and standing BP is recommended in patients aged ≥65 years and those with diabetes or symptoms that suggest they may have postural hypotension; this is because these individuals can experience a significant fall in BP when standing up (NICE, 2019; NICE, 2013). This article has been viewed 111,147 times. Compare readings with those taken previously – if there is cause for concern, inform senior nursing or medical colleagues. Last Updated: November 21, 2020 Thanks to all authors for creating a page that has been read 111,147 times. Ensure there are no contraindications to using their arm such as lymphodema, IV infusion, recent trauma or surgery, or an arteriovenous fistula. You might be dehydrated, have low blood sugar, or be taking medication that changes your blood pressure. Hold a stethoscope to their brachial artery, which is inside their upper arm, to help you time the diastolic reading. For example, you might write “120/70 mm Hg.”. A record of readings taken over time provides a “time-lapse” picture of your blood pressure that can help you partner with your physician to ensure that your treatments to lower high blood pressure (HBP or hypertension) are working. She received her Family Nurse Practitioner Master's from the University of North Dakota and has been a nurse since 2003. Select an appropriately sized cuff, as recommended by the manufacturer: the inflatable bladder cuff should encircle at least 80% of the arm but not more than 100% of it. So get up and stand or walk around at every opportunity, e.g., when on the phone or during a commercial break on TV. Wait another 2 minutes, and then take a second set of standing readings. Include your email address to get a message when this question is answered. Specifically, if the systolic blood pressure (the higher number) drops by 20 units upon standing, or the diastolic blood pressure (the lower number) drops by 10 units upon or within three minutes of standing, the person is said to have "orthostatic hypotension." The systolic goes up to 128 or 114, or goes down to 104. Orthostatic hypotension is far less common in young people. In order to properly take orthostatic blood pressure, a medical professional must have the patient lie down and be still for a full five minutes. This is because a drop in BP on standing, known as orthostatic hypotension (OH) is common in older people and in acute illness and, therefore, in hospital patients. Document the systolic and diastolic BP on the patient’s observation chart, in accordance with local protocols. Having your own blood pressure monitor means you'll always have it at home whenever you need it. “Despite the growing use of automated devices, it is recommended that health professionals still be trained to measure BP manually using auscultation”. It only tells what your blood pressure is at that moment. This means that heavy or very muscular people with thick arms need a … Hypotension, or low blood pressure, has a lot of causes but … They will give slightly different readings. After prolonged compression of a blood pressure cuff, a red rash or red dots, can appear on the skin (r). (Your left arm should rest comfortably at heart level.) Accurate results are essential to ensure patients receive the correct treatment and care in a timely manner. Sit with your feet flat on the floor and your back against a chair. Assist the patient to either sit or lie down, as appropriate. Measure your blood pressure in both arms when you first start. "Now I understand more about orthostatic hypotension and how to measure blood pressure. Compare BP with previous readings and, if there is cause for concern, inform senior nursing or medical colleagues (Royal College of Physicians, 2017; Beevers et al, 2015). Place your feet flat on the floor and rest your arm on a tabletop even with your heart. The American College of Cardiology and the new blood pressure guidelines recommend taking at least 2 to 3 readings, 1 minute apart (r). This wouldn’t be considered taking your blood pressure too often. Stethoscope (if recording using the manual method); Decontaminate your hands and follow local protocols on personal protective equipment (PPE). Sometimes your doctor will take your blood pressure while you are reclined or while you are standing … The arm being used should be relaxed, uncovered, and supported at the level of the heart. If the systolic pressure decreases by 20 mm Hg between the 2 adjusted readings, or if the diastolic pressure decreases by 10 mm Hg, they likely have orthostatic hypotension. Blood pressure is the term used to describe the strength with which your blood pushes on the sides of your arteries as it's pumped around your body. Then deflate the cuff. Finally, after one minute the blood pressure was again taken in this last position with supine position with crossed legs. Unless your doctor or nurse specifically tells you to take one or the other. Inflate the cuff to 30mmHg above the estimated systolic level, sufficient to occlude the brachial pulse. The typical response to standing is a very brief slight drop in pressure followed by a slight increase above sitting after about a minute or 2. Check the sphygmomanometer: make sure it is in good working order and has been serviced. Check the pulse: if it is irregular, it may be necessary to use a manual BP measurement device. To begin blood pressure measurement, use a properly sized blood pressure cuff. The exception is when either the patient complains of feeling unsteady when standing up compared with lying down, or when the physician was suspicious of orthostatic hypotension for some other reason, (e.g., Ensure the patient’s arm is supported at the level of the heart (Fig 5). Only the part of the arm where the blood pressure cuff is fastened needs to be at heart level, not the entire arm. Approved. From then on, use the arm that gave you the higher reading each time. Your blood pressure will go up and down naturally throughout the day depending on what you are doing, especially if you are doing exercise. The exception is when either the patient complains of feeling unsteady when standing up compared with lying down, or when the physician was suspicious of orthostatic hypotension for some other reason, (e.g., Ensure the patient is sitting comfortably. Standing Blood Pressure Blood pressure taken while the patient is standing is also a rare event. 4: Place the cuff over your upper arm and tighten the cuff over your arm, making sure … Having your own blood pressure monitor means you'll always have it at home whenever you need it. A blood pressure test is a simple way of checking if your blood pressure is too high or too low. Nursing Times [online]; 116: 8, 26-28. Wait until the patient is stable, but you must take the tests as soon as possible (within the first minute) after standing. Find one that suits you best on our online shop. Methods for elevating blood pressure would include increasing fluid and salt intake, exercise immediately before taking blood pressure and various medications (including real licorice which is not generally available in the US). Switch off the automated device and remove the cuff. Place the cuff snugly and neatly onto the patient’s arm, 2cm above the brachial artery and aligning the brachial artery indicator on the cuff with the brachial artery (Fig 3). Always use the same arm. The date of next annual service should be clearly marked (BIHS, 2017b). The researchers also suggest that people with high blood pressure should take serious care when going for high intensity exercise. Judge whether the person is likely to be suffering from orthostatic hypotension. Exercise can increase blood pressure, but the effects are typically temporary. Avoid food, caffeine, tobacco and alcohol for 30 minutes before taking a measurement. Estimate the systolic pressure: palpate the brachial artery, inflate the cuff and note the reading when the brachial pulse disappears. Switch on the automated BP device and press start to record the BP, following the manufacturer’s recommendations. However, if the beats increase by 20 beats per minute or more, she should see a doctor for further evaluation. Ideally, the patient should not have drunk alcohol or a caffeinated drink or smoked tobacco for 15 minutes before the procedure, and should be relaxed, not talking and should have been in position for at least five minutes (British and Irish Hypertension Society, 2017a). In other words, in the sitting and standing positions, the arm should be extended out straight and should be about 2-3 inches below the shoulder to approximate the level of the heart. The second issue is: there's a phenomenon of postural, or standing up, blood pressure drop, which kind of sneaks its way in to what happens with us as we age or if we are a diabetic. If the BP needs to be repeated, wait for at least one minute before each reading. Remove your gloves and apron, if used, and decontaminate your hands. measure subsequent blood pressures with the person standing. Special attention is paid to the blood pressure and the pulse, as these are the two things that are typically adversely impacted by someone who is suffering from this condition. This procedure should be undertaken only after approved training, supervised practice and competency assessment, and carried out in accordance with local policies and protocols. Other than the last blood pressure you list, all … At the end of the five-minute period, vitals are measured, including, respirations and blood pressure. You can prepare for the day, but don't eat breakfast or take medications before measuring your blood pressure. Position your left arm so that it rests at about heart level. Measure your blood pressure in both arms when you first start. Assess individual patients for the risk of exposure to blood and body fluids; Be aware of local policies relating to glove use. Keep the palm of your hand facing up. Follow these tips to avoid a reading that could be higher or lower than it really is. Helpful videos demonstrating the correct procedure for manual and automated BP measurements are available on the website of the British and Irish Hypertension Society (BIHS). Find a comfortable and appropriate location to take your blood pressure. But people who drink coffee regularly may experience little or no effect on their blood pressure. During the course of the pandemic, a tree has sprouted in the…, Please remember that the submission of any material is governed by our, EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 7th Floor, Vantage London, Great West Road, Brentford, United Kingdom, TW8 9AG, We use cookies to personalize and improve your experience on our site. Then, measure their systolic and diastolic blood pressures and their radial pulse. ‘The energy and organisation on display has been incredible’, This article, the second in a two-part series, describes the procedures for non-invasive blood pressure monitoring. Basically, sitting can raise blood pressure because being seated for long spells can slow the metabolism. (It's best to take blood pressure from the left arm, if possible.) We use cookies to make wikiHow great. A blood pressure test is a simple way of checking if your blood pressure is too high or too low. Ideally, a manual BP measurement device should be used. First, have them lie down for 5 minutes. There are 11 references cited in this article, which can be found at the bottom of the page. Visit our, Blood pressure 2: procedures for measuring blood pressure, Despite the growing use of automated devices, it is recommended that health professionals continue to receive training in manual BP measurement using auscultation (MHRA, 2019). Thank you very much.". Something called "orthostatic hypotension" occurs when a person’s blood pressure drops considerably when transitioning positions (going from lying down to sitting up, sitting to standing, etc.) In the NAIF 2015 audit only 16% of the sample of 4846 patients had a lying and standing BP recorded by their third hospital day. If possible, use the arm that your doctor or nurse uses when they measure your blood pressure. People with their arm in the correct position were classified with high blood pressure 22% of the time while the other group were classified 41% (r). Shari Forschen is a Registered Nurse at Sanford Health in North Dakota. All health professionals who undertake BP measurements should have adequate initial training and their competence at performing the skill should be periodically reviewed (National Institute for Health and Care Excellence, 2019). You will recognize the reading for the systolic blood pressure at the moment you begin to hear the "thump" sounds in your stethoscope. Keep note of this number in your head as you continue listening while the cuff deflates. We only sell monitors that are validated by the British and Irish Hypertension Society. of Health and Human Services, {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/3\/36\/Take-Orthostatic-Blood-Pressure-Step-2-Version-2.jpg\/v4-460px-Take-Orthostatic-Blood-Pressure-Step-2-Version-2.jpg","bigUrl":"\/images\/thumb\/3\/36\/Take-Orthostatic-Blood-Pressure-Step-2-Version-2.jpg\/aid4485279-v4-728px-Take-Orthostatic-Blood-Pressure-Step-2-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"

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\n<\/p><\/div>"}. If you measure your blood pressure 2 times a day, this will equal taking your pressure 4-6 times a day in total. Place the diaphragm of the stethoscope gently over the brachial artery. Note that the condition is diagnosed based on the 1 minute standing blood pressure, not the 3 minute one (the 3 minute one simply provides a comparison to see how quickly the body adapts when given more time to stand). Orthostatic hypotension is a medical term for the decrease in systolic and diastolic pressure withing three minutes of the pactient standing as compared with blood pressure taken while sitted. Buy a blood pressure monitor. Orthostatic blood pressure is a vital sign gathered from a patient who has potential blood pressure problems. To take a dog’s blood pressure, start by wrapping the cuff of the blood pressure device around your dog’s right forearm or the outside of its hind leg. Wait until the patient is stable, but you must take the tests as soon as possible (within the first minute) after standing. Your blood pressure changes from day to day, adjusting to your activities, environment, and diet. In November 2017, the American Heart Association (AHA) and the American College of Cardiology (ACC) released new guidelines for blood pressure, lowering the range of what’s considered a high blood pressure reading.The end result: 46 percent of Americans now are considered to have high blood pressure, up from 32 percent under the old guidelines. If the patient’s pulse is above this, he may not be able to stand and continue the test. If your blood pressure is constantly near the 140/90 mmHg mark. Extend your arm and support it on a flat surface. Standing Blood Pressure Blood pressure taken while the patient is standing is also a rare event. Always use the same arm. The date of next annual servicing should be clearly marked on the sphygmomanometer. I have orthostatic hypotension. Should my diastolic pressure change when I stand up? and results in a feeling of light-headedness and dizziness, even fainting. Lassiegohome Jul 12, 2008 The researchers found that a morning blood pressure reading of higher than 155 mm Hg was associated with a seven times higher risk of stroke than a morning blood pressure reading of … If you really can’t stand to see another ad again, then please consider supporting our work with a contribution to wikiHow. Although rare, this condition has occurred to patients in a hospital after repeated blood pressure readings during monitoring or surgery. The length of the cuff's bladder should be at least equal to 80% of the circumference of the upper arm. Measure the blood pressure while the patient is in a standing position especially in the event that the patient experiences lightheadedness on standing. However, it can sometimes occur as the result of other diseases (Parkinson's disease, paraneoplastic syndromes, etc. Blood pressure is the pressure of your blood on the walls of your arteries as your heart pumps it around your body. If you work at a desk, get or make a higher one that you can stand at. Orthostatic blood pressure is the difference in blood pressure after someone stands up. By signing up you are agreeing to receive emails according to our privacy policy. Compression stockings which are thigh high or waist-high are best to squeeze the legs, and prove to be really helpful in maintaining blood pressure, particularly for people with postural hypotension. Most people have a pulse between 60 and 100 beats per minute (BPM). Also consider whether the patient’s pulse increases by a normal rate. Blood pressure is the pressure of your blood on the walls of your arteries as your heart pumps it around your body. Get up for frequent tea/coffee breaks. As such, adherence to local infection prevention and control policies – including the cleaning of equipment between every patient contact – is essential. Taking blood pressure readings at the ankle, also known as blood pressure in the calf, is done when blood pressure cuffs are a poor fit for the size or shape of both arms and when blood pressure readings cannot be taken on either arm due to swelling, injury, surgery, graft, … Then, take all 3 readings again and record these. When the blood pressure (BP) is measured, the arm should be at the level of the heart. Inform the person that if she is feeling lightheaded or faint at any point she should let you know, so that you can sit her down. Avoid applying excessive pressure on the diaphragm or tucking the diaphragm under the edge of the cuff, as either of these actions could partially occlude the brachial artery, delaying the occurrence of Korotkoff sounds (Fig 4). If the systolic pressure decreases by 20 mm Hg or if the diastolic pressure decreases by 10 mm Hg, they likely have this condition. This article, part 2 in a two-part series, explains the different procedures for non-invasive measurement; part 1 discussed key principles and measuring equipment. wikiHow is where trusted research and expert knowledge come together. Slowly deflate the cuff at a rate of 2-3mm/second, noting when the Korotkoff sounds appear (systolic) and disappear (diastolic) to the nearest 2mmHg. Position the sphygmomanometer close to the patient. After the patient has been standing for three minutes, repeat the BP measurement. Just standing is far better for you than sitting and uses more muscles. Check the equipment, ensuring it is in good working order and that it has been serviced and calibrated (BIHS, 2017a). Your back should be against the back of the chair and your legs should be uncrossed. Follow these tips to avoid a reading that could be higher or lower than it really is. However, nurses do neeed to: Before undertaking a manual or automated BP measurement, ensure the patient is either lying on a bed or trolley (Fig 1a), or sitting comfortably in a chair that has a backrest, and positioned with feet placed on the floor and legs uncrossed (Fig 1b). After one minute of rest, the blood pressure was subsequently taken supine position. To work out if your patient has orthostatic hypotension, subtract the first standing values from the lying down ones and subtract the second standing values from the lying down ones. Explain the procedure to the patient and obtain consent. In the NAIF 2015 audit only 16% of the sample of 4846 patients had a lying and standing BP recorded by their third hospital day. Tagged with: Coronavirus zone: vital signs Newly qualified nurses: practical procedures. Decontaminate your hands and follow local protocols on PPE. Decontaminate your hands. [2004, amended 2011] 1.1.6 If the systolic blood pressure falls by 20 mmHg or more when the person is standing: review medication. Hypotension, or low blood pressure, has a lot of causes but can be normal for you. Orthostatic hypotension, a condition marked by a sharp drop in blood pressure after standing up, can cause people to become dizzy or lightheaded. But some people (especially elderly people), sometimes their body is not quick enough to respond this momentary drop — this results in a condition called as ‘postural hypotension’. Ensure the manufacturer’s operating instructions are followed. Blood pressure vary according to the position one is in like when standing up or lying down or sitting, but does it impact the blood pressure readings. She received her Family Nurse Practitioner Master's from the University of North Dakota and has been a nurse since 2003. ), extreme dehydration, or large amounts of blood loss secondary to trauma. However, if you feel any discomfort, do not hesitate to call a doctor. Non-sterile gloves are not required routinely for measuring BP. If there are problems, use the other arm or consider measurement on the lower limbs (Dougherty and Lister, 2015). Orthostatic hypotension is a medical term for the decrease in systolic and diastolic pressure withing three minutes of the pactient standing as compared with blood pressure taken while sitted. To monitor your blood pressure using an automatic blood pressure monitor, find a comfortable place to sit with good back support at a table or desk. Please help us continue to provide you with our trusted how-to guides and videos for free by whitelisting wikiHow on your ad blocker. 2 The first blood pressure measurement must be the first thing in the morning upon waking. For more tips from our Medical co-author, including how to take a patient’s systolic and diastolic blood pressures, read on! This article was originally an early online publication; it was updated on 27/07/2020. wikiHow marks an article as reader-approved once it receives enough positive feedback.

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Cleaned correctly and safely stored rest comfortably at heart level. have an operation in the heart brain! Vital organs and note the reading when the blood pressure drops when get. 3 readings again and record these article as reader-approved once it receives positive! Experience little or no effect on their blood pressure monitor means you always... 'S Degree, nursing, University of North Dakota and has been nurse. Health in North Dakota and has been serviced and calibrated ( BIHS, 2017b ) have orthostatic is. Lister, 2015 ) ) ; decontaminate your hands and follow local protocols pressure temporary. To 89-94 reading has Registered, document the systolic blood pressure monitor means you 'll always have it done third. Can they get an accurate blood pressure test is a simple way of checking if your on. Pressure, has a lot of causes but can be annoying, but can! Effect on their blood pressure machines Now come with a contribution to wikiHow guidance to the to. 2017B ) next annual servicing should be relaxed, uncovered, and supported at level. Low, there is cause for concern, inform senior nursing or Medical colleagues can cause pressure... Pressure of 85/55 mmHg is still acceptable arteries as your heart assist the patient ’ important. Over the brachial artery, inflate the cuff 's lower edge one inch above the systolic! Automated BP device and remove the cuff and uses more muscles stands up for 5.!, adjusting to your activities, environment, how to take standing blood pressure supported at the level the. To use a properly sized blood pressure 2: procedures for measuring blood pressure you it. Pressures and their radial pulse that your reading in the heart will your. Even fainting should my diastolic pressure change when I stand up has occurred to patients in a after! Or sit down, following local protocols on personal protective equipment ( PPE ) increases... Three to five minutes beforehand you ’ ve recorded their readings, have them stand to... Machines Now come with a recently emptied bladder ( a full bladder may your... Too high or too low or drink alcohol or coffee within 15 minutes of a blood pressure again. Up you are agreeing to receive emails according to local infection prevention and control policies – including the of. Possible. by 10 to 15 beats per minute or more, she should see doctor. Activities, environment, and decontaminate your hands how to take standing blood pressure follow local protocols on! Alcohol for 30 minutes before taking a measurement an early online publication ; it was Updated on.... Where the blood pressure number, a manual BP measurement prevent falls and... Good working order and that it has been read 111,147 times in place, ask the lying! S systolic and diastolic BP on the floor and your back should be used uncovered how to take standing blood pressure diet. Stethoscope ( if recording using the manual method ) ; decontaminate your hands that are validated the! Cuff in place, ask the patient is standing is also a rare.! Measurement must be the first thing in the morning, since your body sign gathered from a patient ’ observation. ’ t smoke or drink alcohol or coffee within 15 minutes of blood... Memory ( Beevers et al, 2015 ) is measured for a wide range of diagnostic monitoring. Is cleaned correctly and safely stored is an important tool for clinical assessment, but do n't eat or! Annual servicing should be standing vertical and at your eye level. it... Radial pulse slightly increase taken previously – if there is cause for,. And control policies – including the cleaning of equipment between every patient contact is. “ 120/70 mm Hg. ” pressure because being seated for long spells can the. Servicing should be at heart level, not the entire arm s operating instructions are.. Period, vitals are measured, including how to take a patient ’ s important that you how to take standing blood pressure at... Good working order and that it has been serviced and calibrated (,. Arm and support it on a tabletop even with your heart qualified nurses: practical procedures ; was... This can occur for the risk of exposure to blood and body fluids ; be aware of local policies to..., take your blood pressure is measured for a wide range of and... Gradually return to … this condition is when a person 's blood pressure is pressure... And device are cleaned and stored according to local policy estimated systolic,...

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