The two-step method for taking a blood pressure is similar to the one-step manual blood pressure method, but requires that you take the blood pressure by feeling the brachial artery and then using a stethoscope. So, in a sense you will be taking the blood pressure twice using the same arm but with two methods.
The 2-step blood pressure method is used to assess for a most accurate blood pressure. Professionals tends to say it is the most reliable method, especially if you are needing the most accruate blood pressure reading on a patient who is having blood pressure issues.
In the previous article, I talked about how to take a manual blood pressure using the one-step method and this included a video demonstration as well.
In this article, I am going to give you step-by-step instructions on how to take a manual blood pressure using the two-step method. In addition, you can watch this video demonstration.
Video on How to Check a Blood Pressure with the 2-Step Method
Steps on How to take a Manual Blood Pressure using the Two-Step Method
- Have the patient in a sitting or lying position with arm at heart level
- Turn patient’s arm so palms are up and expose the upper arm
- Palpate brachial pulse and place the blood pressure cuff 1-2 inches above where you found the pulse
- Wrap cuff around the upper arm, so it fits appropriately. Tip: you should be able to get 2 fingers snuggly underneath it.
- Then palpate the brachial pulse with your non-dominate hand and inflate the cuff using the rubber bulb with your dominate hand
- As you are inflating the cuff note when you no longer feel the brachial pulse this is the systolic reading
- Then slowly deflate the cuff by turning the valve counter-clockwise until you no longer feel the pulse. Note the number where you no longer felt the pulse, this is the diastolic reading.
- Then deflate the cuff fully
- Wait 30 seconds. Now you are going to use the stethoscope and use the same arm.
- Locate the brachial pulse with the diaphragm or bell of your stethoscope
- Turn the rubber valve bulb clockwise so you can inflate the cuff again
- Inflate the cuff 30 mmhg ABOVE the patient’s systolic pressure that you collected from the first reading
- Then deflate the cuff while letting the sphygmomanometer drop at a rate of 2-3 mmhg per second.
- The first sound you hear will be the systolic pressure
- Then note when the sound disappears this the patient’s diastolic pressure
- Then deflate the cuff and tell the patient the reading and document
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