How to Take Blood Pressure Without a Stethoscope

When discussing how to take a blood pressure, the most popular instructions given are for the widely used methods of registering this vital sign. They include measuring blood pressure using an instrument called a sphygmomanometer and listening with a stethoscope, known as auscultation, and use of the blood pressure monitor which is a machine that is used to control the inflation of the cuff and to detect the changes in the flow of blood. They are very widely used in emergency rooms and in emergency medical services (EMS) systems since great improvement has been made in their quality.

Systolic Blood Pressure: The Palpation Method Step by Step

There are basically two situations in which it is a good idea to know how to take a blood pressure by palpation. They include times when there is too much noise around a patient that prevents you from hearing even through the most powerful stethoscope, and in the event, for whatever reason, you do not have access to a stethoscope. This would be rare because a stethoscope is normally kept in the same bag with the sphygmomanometer; but, who knows, things happen.

Basically, the same steps followed to take a blood pressure by auscultation are followed to take this vital sign by palpation; but, there are some important differences to keep in mind. Instead of repeating the general instructions for the popular stethoscope method, I'll focus on the differences in the palp method. Of course, you begin by placing the cuff in the same manner as if you were going to use a stethoscope; however, instead of locating the brachial pulse, it's best to locate the radial pulse. If for any reason you are unable to find the radial pulse, go ahead and locate the brachial one. Assuming you do find the preferred radial pulse, proceed by inflating the cuff as usual to a point where you are no longer able to detect the person's radial pulse. Make a note of this point on the gauge and continue to inflate the cuff approximately 30 mmHg beyond this point (the "disappearance" of the pulse). The note that you make at this point is simply a mental one so that you know where 30 mmHg past the loss of the pulse is on the gauge; this point is not to be recorded as the systolic blood pressure.

Now you must slowly deflate the cuff and note the exact reading at which the radial pulse can again be felt or palpated. This is the actual reading indicating systolic pressure. Your findings should be recorded as, for example, "blood pressure 130 by palpation" or "130/P." It's also important to note the time. The diastolic blood pressure cannot be measured by the palpation method. Also, the systolic blood pressure by palp is not as accurate as the auscultation method; but, it is better than not obtaining a blood pressure at all.

Source:

My EMT training and experience (current NREMT certification and current state license)