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":"