Checklist for Skill 1 - ICTR
Competency Checklist for Blood Pressure
Name _________________________________________________________________ Date ____________________________
Instructor ______________________________________________________________
|Blood Pressure |Able to |Able to Perform |Unable to |Initials and |
| |Perform |with Assistance |Perform |Date |
|General Guidelines for Vital Signs | | | | |
|1. Check record for baseline and factors (age, illness, medications, etc.) influencing vital |[pic] |[pic] |[pic] | |
|signs. | | | | |
|2. Gather equipment, including paper and pen, for recording vital signs. Wash hands. |[pic] |[pic] |[pic] | |
|3. Prepare participant by telling them what you will be doing. |[pic] |[pic] |[pic] | |
|4. Check the accuracy of participant’s name and birthdate per identification policy before|[pic] |[pic] |[pic] | |
|starting the procedure | | | | |
|Cuff Size | | | | |
|1. Use the correct cuff size of (small, medium, large, and extra large) |[pic] |[pic] |[pic] | |
|Safety | | | | |
|1. Do not take a blood pressure (BP) on an injured or painful extremity or one where there is|[pic] |[pic] |[pic] | |
|an intravenous line (IV). Do not take Blood Pressure on an extremity if the particpant | | | | |
|directs you not to -due to medical reasons. | | | | |
|Blood Pressure, Auscultation or Palpation | | | | |
|Procedure | | | | |
|1. Steps 1–4 of General Guidelines. | | | | |
|Comments: |[pic] |[pic] |[pic] | |
|2. Cleanse ear pieces and bell/diaphragm of stethoscope with an alcohol wipe. | | | | |
|Comments: |[pic] |[pic] |[pic] | |
|3. Position Adult | | | | |
|a. Arm: Sitting or recumbent position with forearm supinated and slightly flexed and | | | | |
|supported at heart level. |[pic] |[pic] |[pic] | |
| | | | | |
|Comments: | | | | |
|4. Remove clothing as necessary to expose extremity. |[pic] |[pic] |[pic] | |
|Comments: | | | | |
|5. Place correct size cuff around the extremity with the center of the cuff over the artery. | | | | |
|a. Arm: Cuff should be placed around upper arm with the lower edge about 3 cm above the | | | | |
|antecubital fossa. |[pic] |[pic] |[pic] | |
| | | | | |
|Comments: | | | | |
|6. Locate the artery by palpation. |[pic] |[pic] |[pic] | |
|Comments: | | | | |
|7. Palpate a pulse distal to the cuff, e.g., brachial or radial. Close air valve and rapidly | | | | |
|inflate cuff to 30 mm Hg above where pulse no longer felt or above expected systolic blood |[pic] |[pic] |[pic] | |
|pressure. | | | | |
|Comments: | | | | |
|8. Place stethoscope gently over artery. |[pic] |[pic] |[pic] | |
|NOTE: To obtain a blood pressure reading by palpation, keep fingers on a distal pulse. | | | | |
|Comments: | | | | |
|9. Open the valve and slowly release the air, permitting the pressure to drop 2–3 mm Hg per | | | | |
|heart beat while auscultating for BP sounds or palpating for a pulse. |[pic] |[pic] |[pic] | |
|NOTE: Do not reinflate cuff without letting cuff totally deflate. | | | | |
|Comments: | | | | |
|10. Obtain a blood pressure reading. | | | | |
|a. Auscultation. | | | | |
|1. Systolic pressure: The pressure at which you first hear sounds. |[pic] |[pic] |[pic] | |
|2. Diastolic pressure: The pressure when sounds become inaudible is the diastolic pressure | | | | |
| |[pic] |[pic] |[pic] | |
| | | | | |
|Comments: | | | | |
|11. Do not leave the cuff inflated for a prolonged period. |[pic] |[pic] |[pic] | |
|Comments: | | | | |
|12. Deflate the cuff rapidly and completely and remove from the arm. |[pic] |[pic] |[pic] | |
|Comments: | | | | |
|13. Wait 2 minutes before taking another blood pressure. |[pic] |[pic] |[pic] | |
|Comments: | | | | |
| | | | | |
| | | | | |
|Blood Pressure, Electronic | | | | |
|Procedure | | | | |
|1. Steps 1–4 of General Guidelines. | | | | |
|Comments: | | | | |
| |[pic] |[pic] |[pic] | |
|2. Set up machine according to instructions: | | | | |
|a. Plug in monitor/machine. |[pic] |[pic] |[pic] | |
|b. Connect dual air hose to back of monitor. |[pic] |[pic] |[pic] | |
|c. Connect correct size cuff by screwing the pressure cuff’s tubing into the other end of the|[pic] |[pic] |[pic] | |
|air hose. | | | | |
|Comments: | | | | |
|3. Place cuff. (See step 5 of Blood Pressure, Auscultation or Palpation.) |[pic] |[pic] |[pic] | |
|Comments: | | | | |
|4. Turn machine on and follow manufacturer’s instructions. |[pic] |[pic] |[pic] | |
|Comments: | | | | |
|5. Obtain reading. |[pic] |[pic] |[pic] | |
|Comments: | | | | |
|6. Remove cuff. |[pic] |[pic] |[pic] | |
|Comments: | | | | |
|Documentation/Follow up | | | | |
|1. Blood pressure reading. |[pic] |[pic] |[pic] | |
|2. Method used. |[pic] |[pic] |[pic] | |
|3. Site. |[pic] |[pic] |[pic] | |
|4. Size of cuff. |[pic] |[pic] |[pic] | |
|5. What would be the parameters to report in an urgent fashion? |[pic] |[pic] |[pic] | |
|6. Who should you report the urgent findings to? | | | | |
| | | | | |
|Comments: | | | | |
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