Blood Pressure Palpation

Measuring an auscultated BP in the back of an ambulance is challenging at best. In loud or chaotic environments, it may be easier to assess blood pressure by “palpation” or feel. The assessment is approximately 10mm Hg systolic below their auscultated BP. You will only obtain systolic pressure, diastolic can’t be obtained via palpation.

  1. Gather your equipment. You won’t need the stethoscope for this one.
  2. Ask the patient to remove any bulky clothing. You can take a BP over T-shirt material; anything more needs to be removed.
  3. Place the cuff around the desired arm. You will want to line up the “artery” marker on the cuff with the anterior/medial (front/middle) side of the patient’s arm.
  4. Encourage the patient to relax their arm, palm up.
  5. The patient should not be suspending or holding their arm in the air. Encourage them to rest their arm on their leg or allow the limb to be supported.
  6. Place the gauge in a comfortable position to view it while your hands are full.
  7. Feel for the radial pulse.
  8. Inflate the cuff until you no longer feel the radial pulse.
  9. Deflate the cuff, while feeling for the first beat.
  10. Document the number on the sphygmomanometer when you feel the beat “#/palp”.
A gloved EMT obtains blood pressure by palpation using two fingers on a patient's wrist.
Image by Nickolas Oatley, licensed under CC BY-NC 2.0.
Blood Pressure by Palpation Skills Verification Table

BP

1

2

3

4

5

6

7

8

9

10 (instructor)

BP Recording “#/palp”

Initials

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Oregon EMS Psychomotor Skills Lab Manual Copyright © 2023 by Chris Hamper, BS, NRP; Carmen Curtz, Paramedic, BS; Holly A. Edwins, Paramedic, B.S.; and Jamie Kennel, PhD, MAS, NRP is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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