Checklist
| Preparation | Wash – Name – Explain | |
| Position patient appropriately for procedure | ||
| Gather equipment | Wash hands | |
| Sphygmomanometer | ||
| Appropriately sized cuff | ||
| Stethoscope | ||
| Site identification | Return to patient | |
| Wash hands | ||
| Select appropriate site | ||
| Palpate brachial artery | ||
| Blood pressure estimation | Apply cuff to patient’s arm | |
| Inflate cuff whilst palpating brachial artery | ||
| Note value at which pulse no longer palpable | ||
| Deflate cuff | ||
| Blood pressure measurement | Place stethoscope over brachial artery | |
| Inflate cuff to 20-30mmHg above estimated value | ||
| Slowly deflate cuff | ||
| Listen for Korotkoff sound onset – note value | ||
| Listen for Korotkoff sound cessation – note value | ||
| Fully deflate cuff | ||
| Remove cuff from patient’s arm | ||
| Finishing | Wash hands | |
| Document blood pressure value in patient notes |
Explanation
Preparation
Wash, name, explain:
- Wash your hands
- Introduce yourself by name and role
- Check the patient’s name and date of birth
- Explain the task and get consent
“Hello, I’m one of the doctors. I’ve been asked to check your blood pressure. This involves placing a cuff on your upper arm and briefly inflating it. It may be slightly uncomfortable, but should not be painful. You can ask me to stop at any time. Would that be okay?”
Position the patient appropriately for the procedure. For blood pressure measurement, ensure that they are seated comfortably and have been resting for around five minutes beforehand. This is to make sure the measurement is an accurate representation of the resting blood pressure. Remove any tight clothing from the patient’s upper arm and provide a surface for them to rest their arm on, ideally at chest height so that their upper arm is level with their heart.
Gather Equipment
Gather the following equipment:
- Sphygmomanometer
- Blood pressure cuff – ensure that this is the appropriate size for the patient. The cuff should fit close around the upper arm with just enough room to slide two fingers between the cuff and the patient’s skin. Using a cuff that is too large or too small will underestimate or overestimate the blood pressure reading, respectively. Cuffs are usually labelled with their size.
- Stethoscope
Site Identification
Return to the patient, wash your hands, and confirm that they are still happy to proceed. Ask the patient if they have a preferred arm for the blood pressure measurement. Avoid arms that are painful, have an IV infusion attached, or are affected by lymphoedema.
Palpate the brachial artery, which is located in the medial aspect of the antecubital fossa.
Blood Pressure Estimation
Attach the cuff to the patient’s upper arm, ensuring a good fit and that the patient is still comfortable.
Palpate the brachial artery with one hand, and using the other hand slowly inflate the blood pressure cuff. Note the value at which the brachial pulse is no longer palpable – this is an estimate of the systolic blood pressure and will be used in the next part of the procedure.
Fully deflate the cuff.
Blood Pressure Measurement
Place the diaphragm of the stethoscope over the brachial artery. Inflate the blood pressure cuff to around 20-30mmHg higher than the value you noted when estimating the systolic blood pressure.
Slowly deflate the cuff whilst auscultating the brachial artery. Note the value at which you first hear the Korotkoff sounds (knocking noise); this is the systolic blood pressure. Note the value at which the Korotkoff sounds cease; this is the diastolic blood pressure.
Fully deflate the cuff and remove it from the patient’s arm.
Finishing
Confirm that the patient is feeling well. Wash your hands.
Document the blood pressure reading in the patient’s notes.
Last updated Mar 2025
Head to members.zerotofinals.com for practice OSCE stations, including an interactive checklist, specific cases and clinical findings.
