1. Blood pressure measurement Automated devices

2. Based on EHES Manual, Part B. Fieldwork Procedures, 2nd edition (2016)
Available at:
These slides can be used freely, translated and adapted to national use (e.g. concerning the equipment). However, it is important to keep in mind that no changes should be made to the measurement techniques, which need to be standardized.

3. Equipment Watch and thermometer Measurement device Cuffs Measurement
tape
Cuffs
Measurement device

4. Checking the device daily
AC adapter cord of the device carefully plugged in or battery power
Check model specific instructions
Rubber tubes not cracked and have no tears
All tubes carefully attached
Cuffs clean and intact

5. Checking the cuffs weekly
Material is clean and intact
Rubber tubes
no cracks or tears

6. Setting up the measurement site
Requirements
quiet, without disturbance
comfortable temperature
a comfortable chair for the participant, a desk for the devices and a level to support the participant’s arm
Place the device so that
you can see the screen of the device clearly
the participant cannot see the screen of the device

7. Exclusion criteria Blood pressure is not measured If a participant has
open wounds or sores, casts or severe rash on both arms
malformation or amputation of both arms preventing to place the cuff properly
severe swelling in both arms (lymph node malfunction)
If the participant refuses

8. Instructions to the participants
Before the blood pressure measurement, ask
If the participant has abstained for one hour from
heavy physical exercise
smoking
eating
drinking (except water) and
alcohol use
If the participant needs to empty his/her bladder

9. Position of the participant
Ask the participant to sit
back supported
feet resting firmly on the floor
feet not crossed
Check that the position does not change during the measurement
Back supported
Feet resting on the floor, not crossed

10. Position of the arm Take the measurement from the right arm
Arm resting on the desk or arm rest
elbow pit (antecubital fossa) at the level of the heart
if needed, adjust the chair or use a pillow
Palm facing up
Help the participant to feel relaxed and comfortable
Right arm, resting
Palm facing up
Level of
the heart

11. Clothing Roll sleeves up, if not constrictive
Undress constrictive sleeve

12. Measurement Ask the participant
to sit still for 5 minutes
not to talk or move during the measurements
Explain that you will take three measurements and tell all results later
Measure arm circumference and select the cuff

13. Select the cuff (1/2)
Measure the greatest circumference of the upper arm

14. Select the cuff (2/2)
Bladder length at least 80% of the arm circumference
Bladder width at least 40% of the arm circumference

15. Place the cuff
On the right arm about 2-3 cm above the elbow pit (actecubital fossa)
Check that the top edge of the cuff is not restricted by clothing
Check that the tubes of the cuff are not under the arm or otherwise tied up
Check that the cuff is not too tight
one finger fits between the cuff and the arm
Check device specific instructions
Cuff 2-3 cm above antecubital fossa

16. Measure pulse rate
Palpate the radial pulse and count the pulse rate for 60 seconds
Record 60 sec pulse rate and whether the pulse was regular or not

17. Measure blood pressure
Follow instructions of the automated device
Take the measurement 3 times, one minute between measurements

18. Record
Recording form
room temperature
time of the blood pressure measurement
used arm
posture during the measurement
arm circumference
used cuff size
pulse for 60 seconds
results of the 3 blood pressure measurements
all exceptions in the protocol
Record the results also in the participant’s feedback form and explain the results to the participant

19. Acknowledgements Slides: Hanna Tolonen, Päivikki Koponen
Photographs: Hanna Tolonen
Measurement demonstrations: Sanna Ahonen, Shadia Rask and voluntary participants
Experiences and feedback from the EHES network have been utilized in the preparation of these slides
Funding: Preparation of the slides is part of the activities of the EHES Coordinating Centre which has received funding from the EC/DG SANTÉ in through SANCO/2008/C2/02-SI EHES and Grand Agreement number , and in through Grand Agreement number /BRIDGE Health

20. Disclaimer
The views expressed here are those of the authors and they do not represent the Commission’s official position.