Measurement
Sphygmomanometer: The cuff size (wide) should be at least 40% of the circumference
of the extremity used. If it is narrower, the BP will be overestimated and viceversa.
It also should be long enough to complete 1.5 turns around the extremity. Fit the cuff
evenly around the arm with the lower edge 1 inch above the elbow and the air bladder
over the brachial artery. The arm at the level of the heart.
Closing and opening the fist increases the sounds when they are muffled or
inaudible.
The auscultatory Gap is a silent period between the systolic and diastolic pressures.
The Normal BP has a normal variation of up to 10 mmHg between the two arms.
The systolic pressure in the legs is normally 20 mmHg higher than in the arms, the diastolic
is the same. When the systolic pressure (leg) exceeds that in the arm by more than 20
mmHg, usually aortic regurgitation (Hill's sign).