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The Correct Way to Take a Patient's Blood Pressure

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When the blood pressure of a patient is taken, it is common practice to measure it with the patient sitting in the up-right position with the arm resting on the arm of a chair and feet flat on the floor. The reference point for the measurement of BP is the right atrium, the so-called ‘heart level’ (Guyton, 1986). Though, the guidelines of the World Health Organistation/International Society of Hypertension (WHO/ISH) recommend that the BP be measured with the patient comfortably seated with the arms supported at heart level (1993). It has been proposed that BP should be measured in the sitting, standing, and the supine position (Netea 2003). It is suggested that the BP measurement from the sitting and supine position will produce similar results if the extremity is at the level of the heart. Because the upper extremities are easily accessible by medical professionals, they are utilized more-so than the lower extremities. In order to obtain an approximant heart level in the sitting or standing position, resources suggest that we use the level of the midsternum as a point of reference when taking blood pressure measurements (Netea 2003). For the supine position, resources suggest that the heart level lies approximately half the distance between the surface in which the patient is lying on and the top of the sternum (Netea 2003). Though not common in everyday practices, the BP measurement of lower extremities sometimes may be the only alternative; such as, colonoscopies or
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