Assessing Brachial Artery Blood Pressure

Goal: The patient’s blood pressure is measured accurately with minimal discomfort to the patient.

1. Check physician’s order or nursing care plan for frequency of blood pressure measurement. More frequent measurement may be appropriate based on nursing judgment.

2. Perform hand hygiene and put on PPE, if indicated.

3. Identify the patient.

4. Close curtains around bed and close the door to the room, if possible. Discuss procedure with patient and assess patient’s ability to assist with the procedure. Validate that the patient has relaxed for several minutes.

5. Put on gloves, if appropriate or indicated.

6. Select the appropriate arm for application of the cuff.

7. Have the patient assume a comfortable lying or sitting position with the forearm supported at the level of the heart and the palm of the hand upward. If the
measurement is taken in the supine position, support the arm with a pillow. In the sitting position, support the arm yourself or by using the bedside table. If the patient is sitting, have the patient sit back in the chair so that the chair supports his or her back. In addition, make sure the patient keeps the legs uncrossed.

8. Expose the brachial artery by removing garments, or move a sleeve, if it is not too tight, above the area where the cuff will be placed.

9. Palpate the location of the brachial artery. Center the bladder of the cuff over the brachial artery, about midway on the arm, so that the lower edge of the cuff is about 2.5 to 5 cm (1 to 2 inches) above the inner aspect of the elbow. Line the artery marking on the cuff up with the patient’s brachial artery. The tubing should extend from the edge of the cuff nearer the patient’s elbow.

10. Wrap the cuff around the arm smoothly and snugly, and fasten it. Do not allow any clothing to interfere with the proper placement of the cuff.

11. Check that the needle on the aneroid gauge is within the zero mark. If using a mercury manometer, check to see that the manometer is in the vertical position and that the mercury is within the zero level with the gauge at eye level.