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Step-by-Step guide to Measuring Blood Pressure Manually

Updated on December 30, 2010

Before you begin reading any further, make sure you're familiar with the terms and concepts associated with blood pressure, because they maybe used throughout this guide. If you need a recap, click on this hub for the basics and this one for the low down on high blood pressure (hypertension). Check out this article for an introduction to measuring blood pressure.

(Note that this is not a strict professional guide for medical or nursing students, this is merely a tutorial on how to take blood pressure only)

Ideally you should find a fairly quiet place to practice this skill, because you'll be using your ears as well as your brain and hands. Yes, this is proof that we indeed can multifunction effectively. Hurrah.

Gathering your equipment before you begin is essential. Not only will it save you from running allover the place looking for things; it will also give you a peace of mind during the procedure, allowing you to focus on what you're doing and ensuring everything goes as smoothly as possible. Having said that, if you mess the procedure up the first few times, don't worry ! Best practice makes it perfect.


Lets have a look at our equipment.

Hand Sanitiser

 This is optional, but make sure your hands are clean prior to beginningthe procedure.


Ok, this big long word is pronounced: S-fig-mo-ma-nom-meter. Do the checks for the right size etc (see Introduction to measuring blood pressure for more info), and make sure it's working properly. Place the dial on a flat surface where you can easily see. Hold the pump in the palm of your dominant hand and close the valve using the fingers on that hand. Clamp your fingers down repeatedly and quickly on the pump that's still in your palm. If the cuff inflates and the dial increases, That means it is working. Simple as it may sound, this takes practice to master.

Hang the dial on the cuff.

As well as the one shown here, there is also a mercury sphygmomanometer.


  It is no longer used in many health care institutions because of it's prone to breaking and causing mercury toxicity, which is a health hazard.


Hang this around your neck and you'll feel like a doctor (:

Alcohol Swabs

You can buy these at a chemist. Take one and wipe the earpieces of the stethoscope before use.

Measuring Blood Pressure Manually

Starting from when you have done the checks and have the blood pressure cuff in place...

Step 1: Feel for the brachial pulse of the arm with the cuff on. This pulse is located in the inside of the elbow on the bone that's near your body...

Always use your fingers when taking a pulse, not your thumb, because there is a strong pulse in the thumb. You may confuse it with the actual pulse you are taking. We are taking the brachial pulse instead of the radial pulse -located on the wrist- because the brachial is closer to the area where the cuff is, and any changes could be felt more quicker. The differences are subtle, but present.

Step 2: Keep feeling the pulse and inflate the cuff until you cannot feel it anymore. Look at the dial and note the number on which the pointer has landed. This will give you a rough guide as to what the systole is. For example, the pointer has landed on 120mmHg. Deflate the cuff immediately.

Step 3: Wait a few minutes to give the persons arm a rest. In the meantime, you could put on your stethoscope and rub the diaphragm (end of the stethoscope you will use on the person's skin) against the palm of you hand to warm it up a bit for the persons comfort.

Step 4: Place the diaphragm against the person's arm where you had taken the brachial pulse. If you prefer, you could also slot the end of the stethoscope under the cuff.

Step 5: Remember the number on the dial ? Now add 20.

So 120 + 20 = 140. This new number is gonna be the number on the dial you will inflate the cuff to.

Step 6: Inflate the cuff to 140mmHg and slowly, but not too slowly, deflate it. Keeping your eye on the dial, you wanna listen out for the thumping sound. If you cannot hear it in the first few tries, don't worry, look at the dial for the first slight jerk of the pointer. Note the value on the dial...This is the systole.

Step 7: Contine to slowly deflate the cuff until the thumping sound stops, or when the pointer on the dial ceases to jerk. Note the value on the dial again - this is the diastole. Deflate the cuff immediately thereafter.

Again if you don't get this the first few tries, don't fret. Measuring somebody's blood pressure manually requires a good bit of practice. Once you follow the steps and understand the rationale for these steps, the rest will soon follow. I hope this helped...Good luck !


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    • Majidsiko profile image


      4 years ago from Kenya

      Its important to listen for when the sounds disappear, rather than the looking at the dial. In some conditions the sound may not disappear, even if the cuff is fully deflated. here you have to listen for the muffling of the sound. This will correspond to the diastolic pressure.

    • profile image 

      6 years ago

      Is it necessary to have the artery arrow directly over the artery or is this just a guide?

    • rishigupta02445 profile image


      6 years ago

      A nice website for practicing to take blood pressure is

    • profile image


      6 years ago

      So happy... Now i can measure b.p of poor people in my locality.... Thanks

    • profile image

      Craig Taylor 

      6 years ago

      Hello, a nursing freshmen. I was wondering if you could help me. I am seeking for a good Blood Pressure device and my friend suggested me some of the sites that he used to buy from and I have picked a site where to buy one. The question is what is a good Blood Pressure device that I could use? Is there any specification that I should follow or should I use a branded one? here is where i want to buy my instrument

      please do help me. thank you.

    • profile image


      6 years ago

      Wot if ther is no stethoscope cnt u take it manualy.

    • profile image

      V Dass 

      6 years ago

      Thanks!good effort

    • profile image


      6 years ago

      Thanks It's helpful!

    • profile image


      6 years ago

      your answer so very karat-karat

    • profile image


      6 years ago

      thank you very much. Are a teacher? or someone who is helping out. You are great.

    • cookibuq profile imageAUTHOR


      7 years ago from Ireland / Hong Kong

      hi david. thanks for reading the hub. Maybe your pulse is not easily felt, but I'm sure -and glad- it's present, otherwise I will not have had the chance to read your comment (:

      I have come to know a good few bald/ing guys, some as young as 20, so i guess it's not highly uncommon. Some even say it's in fashion (: If you could spare a moment, maybe you can check out this hub's quite short light-hearted and surprisingly very true. Hope the links there will be of some use to you.

      All the best~!


    • profile image

      david hardy 

      7 years ago

      thanks for giving me information as I have no pulse any of the time. I think im dead to be honest. I have a bald head too, my life is ruined.

    • cookibuq profile imageAUTHOR


      7 years ago from Ireland / Hong Kong

      You're very welcome, I'm glad it did (:

    • profile image


      7 years ago

      thanks this helps a whole lot!!!!!!!!!!!1


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