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We are going to carry out a  manual blood pressure.

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To carry out a manual blood pressure I need my spigmometer
 and I also need a stephoscope.

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We've gained consent from the patient
and we've also explained the prcedure

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and what the patient's role in this prcedure is.

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It is really important that whilst taking the blood pressure
the patient is nice and settled and relaxed and that they are quiet.

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So that you can hear the sounds that 
you need to look out for.

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So to start off with I'm going to pop the blood pressure cuff
around the arm.

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And as it says on the little patch
on this particular cuff

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the pipe should follow the artery
down the arm.

10
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And you should also, once you have put the cuff in place
be able to get one finger comfortably up the cuff as well

11
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so it shouldn't be tight to the arm.

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Okay, to start of with we are going to feel, palpate the pulse

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and once we have located that we are going to take the spig
and we are going to pump up to the point where we can't feel that pulse anymore.

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We make a note of the reading on the dial
and we release the air so it is not too uncomfortable for the patient.

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Okay, we release it back down to 0.

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At this point it is good to release the cuff
making sure that the bladder is not full of air

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and you've got all of that air out

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and we redo the cuff up.

19
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Making sure we've still got that gap between the cuff and the arm.

20
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So, resetting the spig again.
We've taken a note of our reading

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I am going to pop the stephoscope in place
over that pulse that we felt, so that we can hear it.

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Now we are going to pump the spig back up to
that reading that we had, plus 20.

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We pump the cuff back up.

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Now at this point you should not be able to hear any noises

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and then we release their air slowly out of the cuff,
listening for that first noise

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and at the point that we can hear a noise, a pulse
then that is your systolic reading.

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We continue to let their air out, nice and slowly

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and at the point we can't hear anything else and the noises stop
that is your diastolic reading.

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Making sure we have let all of the air out of the cuff
we will release it off the patient's arm

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as soon as we can so that there is no discomfort.

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Then document those two readings on the chart
as per policy.