Blood Pressure

By Auscultation--Lower Extremities

  1. Assist patient to prone position. If unable to assume position, assist patient to supine position with knee slightly flexed.
  2. Move aside bed linen and any constrictive clothing from leg.
  3. Locate popliteal artery behind knee.
  4. Apply large leg cuff 2.5 cm (1 inch) above popliteal artery around posterior aspect of middle thigh. Center arrows marked on cuff over artery.
  5. Position manometer vertically at eye level. Observer should be no farther than 1 m (approximately 1 yard) away.
  6. Using the popliteal artery, auscultate the lower extremities:
  7. Place stethoscope earpieces in ears, and be sure sounds are clear, not muffled.
  8. Relocate popliteal artery, and place bell or diaphragm of stethoscope over it. Do not allow chestpiece to touch cuff or clothing.
  9. Close valve of pressure bulb clockwise until tight. Quickly inflate cuff to 30 mm Hg above patient’s usual systolic pressure.
  10. Slowly release pressure bulb valve and allow manometer needle to fall at rate of 2 to 3 mm Hg/sec. Note point on manometer when first clear sound is heard. The sound will slowly increase in intensity.
  11. Continue to deflate cuff gradually, noting point at which sound disappears in adults. Note pressure to nearest 2 mm Hg. Listen for 10 to 20 mm Hg after the last sound, and then allow remaining air to escape quickly.
  12. If this is first assessment of patient, repeat procedure on other leg.
  13. Assist patient in returning to comfortable position, and cover leg if previously clothed.
  14. Discuss findings with patient as needed.
  15. Perform hand hygiene. Clean earpieces and diaphragm of stethoscope with alcohol swab as needed (optional).