Welch Allyn Blood Pressure Accuracy and Variability Quick Reference Guide

Blood Pressure AccurAcy &
VAriABility Quick reference

Accurate Blood Pressure Tips

• Use the proper size cuff; if two cuff sizes fit, use the
larger one.

• Place the cuff on a bare arm.

• Place the artery marker over the brachial artery.

• Apply the cuff snugly, allowing room for no more than
two fingers underneath.

• Have the patient sit quietly for a few minutes.

• Do not talk to the patient while taking a blood
pressure.

• Support the patient’s back and feet; keep legs
uncrossed.

• Keep the upper arm at heart level with the lower arm
passively supported, i.e. resting on lap.

• Keep the arm still during the measurement cycle.

Blood Pressure Variability

The following activities affect a blood pressure reading.

Activity Systolic (mmHg)

Cuff too small
Cuff over clothing

2,4,6,7,8,10,12,14,16,18,19

10,16,18

Back/feet unsupported

1,5,9,16,17,18

Legs crossed

5 to 8 ⇑
Not resting 3 to 5 minutes
Patient talking
Labored breathing
Full bladder

16

Pain

2,10,11,16,17,18

16,18

13,16,18

10 to 15 ⇑

10 to 30 ⇑

Arm below heart level

10 to 40 ⇑

10 to 40 ⇑ or ⇓

3,18

5 to 15 ⇑

2,10,16,18,19,20

10 to 20 ⇑

10 to 15 ⇑

5 to 8 ⇑

2,10,13,16,17,18

1.8 /inch ⇑

4.6 /cm ⇑

10,13,16,17,18

Arm above heart level

1.8 /inch ⇓

4.6 /cm ⇓

For references, refer to the footnotes listed on this card.

References

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3. Cushman WilliamC, Cooper KarenM, Horne RichardA, Meydrech EdwardF. Effect of

back support and stethoscope head on seated blood pressure determinations. Am J
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4. Fonseca-Reyes Salvador, Garcia de Alba-Garcia Javier, Parra-Carrillo JoseZ, Paczka-

Zapata Jose Antonio. Effect of standard cuff on blood pressure readings in patients
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Braun LynneT. The effects of crossed leg on blood pressure measurement. Nursing
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12. Manning DennisM, Kuchirka Carolee, Kaminski Jill. Miscuffing: inappropriate blood

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Mancia Giuseppe, Mengden Thomas, Myers Martin, Padfield Paul, Palatini Paolo,
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Hill MarthaN, Jones DanielW, Kurtz Theodore, Sheps SheldonG, Roccella EdwardJ.
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determinant of arterial blood pressure measurements in adults.

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